Unlocking potential: how sport and exercise medicine clinicians can identify and empower neurodiverse athletes

Abstract

Have you ever encountered an athlete who suddenly shouts out or someone who seems disengaged? What was your initial reaction? Did you assume the athlete was being offensive or underperforming that day? Or did you wonder whether they might be neurodiverse? Neurodiversity refers to the natural variations in the human brain that influence how people process information, communicate and engage with their surroundings.1 It includes a range of clinical diagnoses (figure 1A) and emphasises that these conditions are normal variations of the human brain, rather than deficits.1 2 Neurodiverse athletes (NdA) often thrive in sports, leveraging their exceptional skills in attention to detail, pattern recognition, intense focus and heightened sensory awareness. Despite these strengths, they encounter distinct challenges that may not be well understood by sports and exercise medicine (SEM) clinicians, coaches, athlete staff and sporting organisations.2 This editorial aims to empower SEM clinicians to effectively identify and support NdA, particularly individuals with autism spectrum disorder (ASD). Figure 1 Comprehensive support for neurodiverse athletes. Identifying NdA presents several challenges due to stigma, vague definitions under the ’Neurodiversity’ spectrum, scant research, inadequate screening processes and limited access to specialised care through athletic programmes.1 2 The terms Asperger’s syndrome and ‘high-functioning autism’ have fallen out of use. Instead, the preferred terminology is ASD, categorised into three levels according to the amount of support needed, which fits under the broader context of neurodiversity3–5 (figure 1B). NdA may find it challenging to interpret social cues, resulting in misunderstandings or communication difficulties with teammates and athletic personnel. This can lead to feelings of isolation or unintentional exclusion from team bonding activities.6 Additionally, they might feel pressured to conform to neurotypical athlete (NtA) interaction styles, causing stress and forcing them to ‘mask’ their true selves, a …