ADHD and baseball

I posted about this topic once before, but it bears looking at again.

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In this article from ESPN.com, there is an alarming statistic presented right at the beginning of the article:

Eight percent of Major League Baseball players last year qualified for ADHD exemptions to take stimulants that would otherwise be banned by the MLB.

Now, let's ignore my own personal history, which renders me intimately familiar with ADHD, and look at this from an objective point of view:

ADHD is a neurological disorder, one of the most common in children, that results in inattentive, impulsive and sometimes hyperactive behavior. It affects 3-5% of all chilren, meaning that in a class of 25, there will probably be at least one child that has it.*

Let's dissect that.

First, ADHD is one of the most common neurological disorders in children. While it's true some professional baseball players are still adolescents, most are adults, in both the physical and legal sense.

Secondly, ADHD affects 3-5% of all children. It would be understandable if the rate in baseball mirrored the actual average, even if many adults are able to develop coping mechanisms and thus not exhibit the signs or symptoms of ADHD. However, the eight percent rate given by ESPN has to turn a few heads.

While it's true that some disorders can find a higher prevalence do to environmental factors--like a higher incidence of depression in extreme northern areas like northern Canada and Scandinavia due to the long, dark winters--it makes no sense that baseball would draw those that have ADHD.

Baseball is a sport that demands a lot of focus for long periods of time. This, of course, would explain why a drug like Ritalin or Adderall would be so attractive to a baseball player, but, at the same time, it makes it hard to imagine that someone previously diagnoses with ADHD would choose this particular sport. One or two cases? Sure...but nearly a tenth of all baseball players?

Unless psychologists and psychiatrists are peddling baseball as the new ADHD cure-all, that just doesn't fly.

Consider also the following, from the article cited above:

The diagnostic guidelines also contain specific requirements for determining when the symptoms indicate ADHD. The behaviors must appear early in life, before age 7, and continue for at least 6 months. Above all, the behaviors must create a real handicap in at least two areas of a person’s life such as in the schoolroom, on the playground, at home, in the community, or in social settings. So someone who shows some symptoms but whose schoolwork or friendships are not impaired by these behaviors would not be diagnosed with ADHD. Nor would a child who seems overly active on the playground but functions well elsewhere receive an ADHD diagnosis.

If ADHD was that prevalent in baseball, you would think that ESPN and Baseball Tonight would be airing a few more 'fluff' pieces about playing the game with the neurological disorder...

The point here, and it's a point that needs to be made to the general public, as well, is that ADHD isn't just having a hard time paying attention.

ADHD is being inattentive to the point that it seriously impacts multiple, if not all, facets of your life. It's not just being unable to sit still in class; it's being unable to do what the coach asks in basketball practice, stay tuned to the same episode of Lost for more than ten minutes, maintain silence when a friend is speaking...all of these things.

Perhaps the most damning, is, again taken from the above cited, this paragraph about adult ADHD:

To be diagnosed with ADHD, an adult must have childhood-onset, persistent, and current symptoms.18 The accuracy of the diagnosis of adult ADHD is of utmost importance and should be made by a clinician with expertise in the area of attention dysfunction. For an accurate diagnosis, a history of the patient’s childhood behavior, together with an interview with his life partner, a parent, close friend, or other close associate, will be needed. A physical examination and psychological tests should also be given. Comorbidity with other conditions may exist such as specific learning disabilities, anxiety, or affective disorders.

(bold my emphasis)

For ADHD to be properly diagnosed in adults, there must be evidence of childhood symptoms.

This is a tricky thing--children are, by nature, hyperactive and lack long attention spans. When diagnosing a child, one has immediate access to a child's school environment and can tell fairly easily if a child is that much more inattentive than the rest of the children around him or her.

As an adult, however, one only has access to memory, and, if they're lucky, former school records, not to mention that as time progresses, different standards are expected from children. There's simply no surefire way of knowing if behavior as a child was along the lines of ADHD or simply a child misbehaving.

Is it possible that there are one or two baseball players that have ADHD and meet all of the diagnostic criteria? Of course.

The idea, however, that nearly a tenth of them are reported to have the condition, brings it to almost epidemic proportions--and is worthy of further examination.



*National Institute of Mental Health.