Neurodiversity and the mental health and well-being of elite athletes

Mental health and well-being among elite athletes are accepted as central to athletic performance. Maximising health, and more recently, mental health,1 2 in elite sport is thus pivotal to the physical competencies that underpin athletic success. Neurodiversity is an umbrella term used to recognise the natural variations of all individuals, with neurodivergence often used to refer to attention-deficit/hyperactivity disorder (ADHD), autism, and other neurodevelopmental differences. Given the importance of mental health, it is surprising that the performance and personal impacts of neurodiversity in elite athletes have not been more substantially evaluated. ADHD and autism are highly prevalent in the general community.3–5 Elite athletes represent a unique subsection of the general community, and evidence increasingly suggests that autism and ADHD may occur at greater rates in athletes compared with non-athlete cohorts—convincingly greater than that of the general population.6 Within the elite athlete subgroup are some common traits through which increased neurodivergence can be hypothesised, including competitive advantage to high performance. As examples, elite sport requires commitment to routine, exclusive focus and consistent and rapid response to emerging stimuli such as responding to changes in the field or an opponent’s behaviour. The ability to hyperfocus, that is, to focus intensely on a single topic or activity for extended periods of time, is often a core strength of autism and may be adaptive in the context of the rigours and routine demanded of training in …