https://orcid.org/0000-0001-5612-6321
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Julia E Maietta, Julianna M Santangelo, Nathan E Cook, Grant L Iverson, Interpreting Scores from Adolescents with Attention-Deficit/Hyperactivity Disorder on Sway Medical System Balance and Cognitive Modules, Archives of Clinical Neuropsychology, Volume 41, Issue 1, February 2026, acaf052, https://doi.org/10.1093/arclin/acaf052
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ABSTRACT
Many high schools in the United States conduct preseason “baseline” cognitive and balance testing as part of their concussion management procedures. Prior research has identified differences in cognitive and balance test scores between youth with and without attention-deficit/hyperactivity disorder (ADHD). The present study examined whether preseason baseline scores on the Sway Medical System Balance and Cognitive Modules differed between adolescent athletes with self-reported ADHD and those without ADHD.
The Sway Medical System is a smartphone or tablet-based assessment that includes both cognitive and balance tests that can be administered at baseline and following concussion or suspected concussion. Cognitive and balance test results were examined from 23,566 adolescents (49.8% girls) between 14- and 18-year-old who underwent baseline testing during the summer of 2022.
For both boys and girls, adolescents with ADHD obtained slightly worse scores on all four cognitive tests and the balance test (p values<.001). The effect sizes for these differences were very small-to-small (r = 0.04–0.07; Hedges' g = 0.13–0.22).
Adolescents with self-reported ADHD had slightly lower scores on the Sway Medical System Balance and Cognitive Modules, with small-to-very small effect sizes that may be of limited clinical significance. The Sway Medical System currently provides normative data stratified by age and gender. Our results suggest that further stratifying by ADHD status may not be necessary for adolescents—although future research might reveal subgroups of children or young adults with ADHD that have larger score differences.
