While all athletes face the risk of a concussion, Special Olympics athletes with intellectual disability and developmental disabilities (IDD) remain vastly underrepresented in concussion research. Professor Kelly Arbour-Nicitopoulos of the Faculty of Kinesiology and Physical Education at the University of Toronto is intent on changing that.
With funding from the Tanenbaum Institute for Science in Sport, Arbour-Nicitopoulos worked with Associate Professor Nick Reed of the department of occupational science and occupational therapy at U of T, Associate Professor and Canada Research Chair Emily Bremer from the School of Kinesiology at Acadia University, and Special Olympics Canada, to develop a concussion surveillance tool for Special Olympic athletes that would enable coaches and medical staff to capture key characteristics of the injury, athlete demographics and sport.
“We know that annually in Canada, 2.2 per cent of individuals aged 12 years or older report having a concussion from sport or physical activity,” says Arbour-Nicitopoulos, who heads the ADAPT lab for accessible and inclusive physical activity at KPE. “However, little is known about concussion amongst Special Olympics athletes, who often face a higher risk and prolonged recovery due to preexisting cognitive impairments.
“Our study is the first of its kind to collect foundational data on concussion incidence in SO athletes in Canada.”
The researchers consulted with five competitive-level SO coaches and one SO-affiliated medical staff to establish key items to include in the tool. The resulting Concussion Surveillance Tool has 25-items with four categories (about the athlete, concussion incident description, injured athlete description and concussion follow-up/next steps) and instructions on how to use the tool during competitions.
The tool was piloted at two Provincial Games in the summer of 2025 and the researchers are currently interviewing SO staff who administrated the tool and analyzing their feedback to help them refine it.
The researchers have also been exploring Special Olympics athletes’ concussion history, including the number of times they were diagnosed, the different sports they play, and their age and gender. They surveyed 519 competitive-level SO athletes and 55 SOC caregivers across six SO events in Canada. The participants ranged in age from 14 to 72-years-old, with men making up the majority at 66 per cent.
These are the key findings:
- 74 per cent reported having no history of any diagnosed or suspected concussions.
- 26 per cent reported being diagnosed or suspecting concussion at least once in their lifetime.
- Of the 26 per cent with a concussion history:
- 30 per cent sustained concussions at SOC activities
- 66 per cent did not follow a return to sport concussion protocol
- 10 per cent had no action and did not seek any medical care and
- 79 per cent played a high-risk concussion sport.
“These results show an urgent need to integrate competitive athletes with IDD into concussion education and research to ensure safer, more equitable sport practices,” says Arbour-Nicitopoulos. “The Concussion Surveillance Tool is a practical and adaptable tool that allows us to document concussions within SOC, enhancing athlete safety and data-driven decision-making.”
Arbour-Nicitopoulos also stresses the mentoring opportunities the study provided, with 11 trainees engaged in the project – one of them an undergraduate student who received the University of Toronto Excellence Award to pursue 14 weeks of full-time research under faculty supervision.
with local Special Olympic athletes (photo supplied)
That student is Dylan Silver, a fourth-year kinesiology student at U of T, who helped create the concussion surveillance tool used by medical officers at SO events when an athlete has sustained a suspected concussion.
He travelled to British Columbia and Quebec to collect surveys on Special Olympic athletes' concussion history, learning about their concussion experiences and educating athletes, caregivers and coaches about concussion prevention and management.
“Working on this project has had a profound impact on me, as I have been able to continue advocating for underserved populations at a community-level,” says Silver, whose older brother was born with an intellectual disability. “I’ve been able to see firsthand how sport has empowered him, giving him a sense of belonging, autonomy, and meaning.
“Working on this project allowed me to expand my impact and further develop my communication skills and empathy, as I interacted directly with Special Olympic athletes.”
Silver says that conducting data collection and analyses have added to his overall academic development and the experience has inspired him to pursue a graduate degree in kinesiology.
In the meantime, he will be using the data collected to complete a research project for a directed research course taught by Arbour-Nicitopoulos.
“My project will be based on a current gap in the literature – the differences in concussion symptom clusters based on Special Olympic demographics such as age and gender, and sport type such as high- vs low-risk or team vs. individual sports,” says Silver, who is also currently serving as the event director for motionball, a national non-profit organization raising funds and awareness on behalf of the Special Olympics movement in Canada. “I am excited to create a manuscript and submit it for publication sometime next year.”