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McCracken HS, Murphy BA, Ambalavanar U, Glazebrook CM, Yielder PC. Sensorimotor integration and motor learning during a novel force-matching task in young adults with attention-deficit/hyperactivity disorder. Front Hum Neurosci 2023; 16:1078925. [PMID: 36684834 PMCID: PMC9849696 DOI: 10.3389/fnhum.2022.1078925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that exhibits unique neurological and behavioral characteristics. Those with ADHD often have noted impairments in motor performance and coordination, including during tasks that require force modulation. The present study provides insight into the role of altered neural processing and SMI in response to a motor learning paradigm requiring force modulation and proprioception, that previous literature has suggested to be altered in those with ADHD, which can also inform our understanding of the neurophysiology underlying sensorimotor integration (SMI) in the general population. Methods Adults with ADHD (n = 15) and neurotypical controls (n = 15) performed a novel force-matching task, where participants used their right-thumb to match a trace template that varied from 2-12% of their Abductor Pollicis Brevis maximum voluntary contraction. This motor task was completed in pre, acquisition, and post blocks. Participants also completed a retention test 24 h later. Median nerve somatosensory-evoked potentials (SEPs) were collected pre and post motor acquisition. SEPs were stimulated at two frequencies, 2.47 Hz and 4.98 Hz, and 1,000 sweeps were recorded using 64-electrode electroencephalography (EEG) at 2,048 Hz. SEP amplitude changes were normalized to each participant's baseline values for that peak. Results Both groups improved at post measures (ADHD: 0.85 ± 0.09; Controls: 0.85 ± 0.10), with improvements maintained at retention (ADHD: 0.82 ± 0.11; Controls: 0.82 ± 0.11). The ADHD group had a decreased N18 post-acquisition (0.87 ± 0.48), while the control N18 increased (1.91 ± 1.43). The N30 increased in both groups, with a small increase in the ADHD group (1.03 ± 0.21) and a more pronounced increase in controls (1.15 ± 0.27). Discussion Unique neural differences between groups were found after the acquisition of a novel force-matching motor paradigm, particularly relating to the N18 peak. The N18 differences suggest that those with ADHD have reduced olivary-cerebellar-M1 inhibition when learning a novel motor task dependent on force-modulation, potentially due to difficulties integrating the afferent feedback necessary to perform the task. The results of this work provide evidence that young adults with ADHD have altered proprioceptive processing when learning a novel motor task when compared to neurotypical controls.
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Affiliation(s)
- Heather S. McCracken
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Bernadette A. Murphy
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada,*Correspondence: Bernadette A. Murphy,
| | - Ushani Ambalavanar
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Cheryl M. Glazebrook
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada,Health, Leisure & Human Performance Research Institute, University of Manitoba, Winnipeg, MB, Canada
| | - Paul C. Yielder
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada,Faculty of Health, School of Medicine, Deakin University, Waurn Ponds, VIC, Australia
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Hua J, Du W, Dai X, Wu M, Cai X, Shen M, Zhu L. International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder - Chinese (Mandarin) translation. Dev Med Child Neurol 2020; 61. [PMID: 33249559 PMCID: PMC7839484 DOI: 10.1111/dmcn.14693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/17/2018] [Indexed: 01/18/2023]
Abstract
目的本国际临床指南由欧洲残疾儿童学会(the European Academy of Childhood Disability,EACD)牵头制定,旨在解决发育性协调障碍(developmental coordination disorder,DCD)的定义、诊断、评估、干预以及与社会心理方面的临床应用关键问题。方法本指南针对五个领域的关键问题,通过文献综述和专家团队的正式讨论达成共识。为保证指南的循证基础,以“机制”、“评估”和“干预”为检索词, 对2012年更新以来提出的最新建议以及新增的“社会心理问题”和“青少年/成人”为检索词进行检索。根据牛津大学循证医学中心证据等级 (证据水平 [level of evidence, LOE]1–4) 将结果进行分类,最终转化为指南建议。并由国际、多学科专家小组举行了两次会议,5个回合的Delphi 专家问卷调查,制定了高质量临床应用实践 (good clinical practice,GCP) 。结果本指南共制定35条建议。其中8条以文献综述为依据 (3 条涉及“评估”,5条涉及“干预”); 22 条在 2012 年指南的基础上进行了更新;其他为涉及诊断、评估 (3条GCP) 及社会心理问题 (2 条 GCP) 的新建议。此外,其中有1条(LOE)新建议提出视频游戏可作为以活动和参与为导向的传统干预措施的辅助手段,并针对青少年和成人DCD提出了 2 条新建议 (1 条 GCP,1 条 LOE)。结论本指南是基于当前的研究证据和专家共识对DCD进行全面概述。它反映了不同学科临床和科研人员的最新科技水平。本国际指南可作为各国制定指南的基础。
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Affiliation(s)
- Jing Hua
- Shanghai First Maternity and Infant HospitalTongji University School of MedicineShanghaiChina
| | - Wenchong Du
- Department of PsychologyNottingham Trent UniversityNottinghamUK
| | - Xiaotian Dai
- Shanghai First Maternity and Infant HospitalTongji University School of MedicineShanghaiChina
| | - Meiqin Wu
- Shanghai First Maternity and Infant HospitalTongji University School of MedicineShanghaiChina
| | - Xianying Cai
- Yangzhi Rehabilitation HospitalTongji UniversityShanghaiChina
| | - Min Shen
- Yangzhi Rehabilitation HospitalTongji UniversityShanghaiChina
| | - Liping Zhu
- Shanghai Center for Women and Children’s HealthShanghaiChina
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Montes-Montes R, Delgado-Lobete L, Pereira J, Santos-del-Riego S, Pousada T. Psychometric Validation and Reference Norms for the European Spanish Developmental Coordination Disorder Questionnaire: DCDQ-ES. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072425. [PMID: 32252448 PMCID: PMC7178027 DOI: 10.3390/ijerph17072425] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 11/26/2022]
Abstract
The Developmental Coordination Disorder Questionnaire (DCDQ) is a widely used and well-validated tool that contributes to the diagnosis of Developmental Coordination Disorder (DCD). The aim of this study was to further analyze the psychometric properties of the European Spanish cross-culturally adapted version of the Developmental Coordination Disorder Questionnaire (DCDQ-ES) in a sample of Spanish children aged 6–11 years and to establish reference norms with respect to age groups. Parents of 540 typically developing children completed the DCDQ-ES. A second sample of 30 children with probable DCD (pDCD) was used to test its discriminant validity. Confirmatory factor analysis supported the original three-factor structure and the internal consistency was excellent (Cronbach’s α = 0.907). Significant differences between age groups were found. The pDCD group scored significantly lower than the reference sample in the three subscales and DCDQ-ES total score (p < 0.001; AUC = 0.872). The DCDQ-ES is a reliable and valid tool for screening motor coordination difficulties in Spanish children and for identifying children with probable DCD. The findings of this research suggest that context-specific cut-off scores should be systematically utilized when using cross-cultural adaptations of the DCDQ. Age-specific cut-off scores for Spanish children are provided.
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Affiliation(s)
- Rebeca Montes-Montes
- TALIONIS Research Group, Research Centre of the Galician University System. Centre for Information and Communications Technology Research (CITIC), Universidade da Coruña, 15008 A Coruña, Spain; (R.M.-M.); (J.P.); (T.P.)
| | - Laura Delgado-Lobete
- Health Integration and Promotion Research Unit (INTEGRA SAÚDE), Faculty of Health Sciences, University of A Coruña, 15011 A Coruña, Spain;
- Correspondence: ; Tel.: +34-881-014-339
| | - Javier Pereira
- TALIONIS Research Group, Research Centre of the Galician University System. Centre for Information and Communications Technology Research (CITIC), Universidade da Coruña, 15008 A Coruña, Spain; (R.M.-M.); (J.P.); (T.P.)
| | - Sergio Santos-del-Riego
- Health Integration and Promotion Research Unit (INTEGRA SAÚDE), Faculty of Health Sciences, University of A Coruña, 15011 A Coruña, Spain;
| | - Thais Pousada
- TALIONIS Research Group, Research Centre of the Galician University System. Centre for Information and Communications Technology Research (CITIC), Universidade da Coruña, 15008 A Coruña, Spain; (R.M.-M.); (J.P.); (T.P.)
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Blank R, Barnett AL, Cairney J, Green D, Kirby A, Polatajko H, Rosenblum S, Smits‐Engelsman B, Sugden D, Wilson P, Vinçon S. International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Dev Med Child Neurol 2019; 61:242-285. [PMID: 30671947 PMCID: PMC6850610 DOI: 10.1111/dmcn.14132] [Citation(s) in RCA: 358] [Impact Index Per Article: 71.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/17/2018] [Indexed: 12/16/2022]
Abstract
AIM These international clinical practice recommendations (CPR) for developmental coordination disorder (DCD), initiated by the European Academy of Childhood Disability (EACD), aim to address key questions on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD relevant for clinical practice. METHOD Key questions in five areas were considered through literature reviews and formal expert consensus. For recommendations based on evidence, literature searches on 'mechanisms', 'assessment', and 'intervention' were updated since the last recommendations in 2012. New searches were conducted for 'psychosocial issues' and 'adolescents/adults'. Evidence was rated according to the Oxford Centre for Evidence-Based Medicine (level of evidence [LOE] 1-4) and transferred into recommendations. For recommendations based on formal consensus, two meetings of an international, multidisciplinary expert panel were conducted with a further five Delphi rounds to develop good clinical practice (GCP) recommendations. RESULTS Thirty-five recommendations were made. Eight were based on the evidence from literature reviews (three on 'assessment', five on 'intervention'). Twenty-two were updated from the 2012 recommendations. New recommendations relate to diagnosis and assessment (two GCPs) and psychosocial issues (three GCPs). Additionally, one new recommendation (LOE) reflects active video games as adjuncts to more traditional activity-oriented and participation-oriented interventions, and two new recommendations (one GCP, one LOE) were made for adolescents and adults with DCD. INTERPRETATION The CPR-DCD is a comprehensive overview of DCD and current understanding based on research evidence and expert consensus. It reflects the state of the art for clinicians and scientists of varied disciplines. The international CPR-DCD may serve as a basis for national guidelines. WHAT THIS PAPER ADDS Updated international clinical practice guidelines on developmental coordination disorder (DCD). Refined and extended recommendations on clinical assessment and intervention for DCD. A critical synopsis of current research on mechanisms of DCD. A critical synopsis of psychosocial issues in DCD, with implications for clinical practice. The first international recommendations to consider adolescents and adults with DCD.
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Affiliation(s)
- Rainer Blank
- Clinic for Child Neurology and Social PediatricsChild Centre MaulbronnMaulbronnGermany
- Heidelberg UniversityHeidelbergGermany
| | - Anna L Barnett
- Department of Psychology, Health & Professional DevelopmentOxford Brookes UniversityOxfordUK
| | - John Cairney
- Faculty of Kinesiology and Physical EducationUniversity of TorontoTorontoONCanada
- Department of Family MedicineMcMaster UniversityHamiltonONCanada
| | - Dido Green
- Department of RehabilitationSchool of Health and WelfareJönköping UniversityJönköpingSweden
| | - Amanda Kirby
- Dyscovery CentreUniversity of South WalesNewportUK
| | - Helene Polatajko
- Department of Occupational Science and Occupational TherapyRehabilitation Sciences InstituteUniversity of TorontoTorontoONCanada
| | - Sara Rosenblum
- Laboratory of Complex Human Activity and ParticipationDepartment of Occupational TherapyUniversity of HaifaHaifaIsrael
| | - Bouwien Smits‐Engelsman
- Department of Health and Rehabilitation ServicesUniversity of Cape TownCape TownSouth Africa
| | - David Sugden
- School of Special Needs EducationUniversity of LeedsLeedsUK
| | - Peter Wilson
- School of Psychology and Centre for Disability and Development ResearchAustralian Catholic UniversityMelbourneVic.Australia
| | - Sabine Vinçon
- Clinic for Child Neurology and Social PediatricsChild Centre MaulbronnMaulbronnGermany
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van den Heuvel M, Jansen DEMC, Reijneveld SA, Flapper BCT, Smits-Engelsman BCM. Identification of emotional and behavioral problems by teachers in children with developmental coordination disorder in the school community. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 51-52:40-48. [PMID: 26780353 DOI: 10.1016/j.ridd.2016.01.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 09/02/2015] [Accepted: 01/10/2016] [Indexed: 06/05/2023]
Abstract
Current evidence on the co-occurrence of Developmental Coordination Disorder (DCD) and psychosocial problems mainly concerns parent-reported information, but rarely includes teacher information. The aim of this study was (1) to investigate the teachers' identification of emotional and behavioral problems in children with DCD and (2) to examine the performance of the teacher version of the Strengths and Difficulties Questionnaire (SDQ-T) compared with the Teacher Report Form (TRF) in children with DCD. We assessed primary school children (202 boys, 200 girls, range 4-10.8 years, mean age 7.2 years) for DCD following the DSM IV-TR criteria. Emotional and behavioral problems were measured with the TRF (n=327) and the SDQ-T (n=361). DCD was established in 23 (5.7%) children, 16 boys and 7 girls (mean age 7.0 years). Children with DCD had a higher proportion of clinical scores on both the TRF Total Problem Scale (TRF TPS) and SDQ-T Total Difficulties Score (SDQ-T TDS). Children with DCD had increased odds on the TRF domains Thought (odds ratio, OR: 5.39), Externalizing (OR: 4.12) and Internalizing (OR: 4.42) problems, and on all SDQ-T-domains and Total Difficulties score (OR: 7.30). In the DCD group the SDQ-T TDS correlated strongly (Spearman's rho 0.80) with the TRF TPS and demonstrated a moderate agreement (Cohen's Kappa 0.53). In conclusion, teachers identified significantly more emotional and behavioral problems in children with DCD compared with their peers. The SDQ-T showed moderate agreement with the TRF in identifying emotional and behavioral problems in children with DCD.
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Affiliation(s)
- Meta van den Heuvel
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands.
| | - Danielle E M C Jansen
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Boudien C T Flapper
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands
| | - Bouwien C M Smits-Engelsman
- Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium; Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Old Main Building, Groote Schuur Hospital, Cape Town, South Africa
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Brossard-Racine M, Shevell M, Snider L, Bélanger SA, Julien M, Majnemer A. Persistent Handwriting Difficulties in Children With ADHD After Treatment With Stimulant Medication. J Atten Disord 2015; 19:620-9. [PMID: 23160486 DOI: 10.1177/1087054712461936] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Children with ADHD often present with handwriting difficulties. However, the extent to which motor and attention skills influence performance in this group has not yet been explored. The objective of this study was to examine the factors associated with change in handwriting performance. METHOD This study examines the factors associated with change in handwriting performance of 49 children newly diagnosed with ADHD (mean age = 8.4 [SD=1.3] years) prior to and 3 months following use of a stimulant medication. RESULTS Handwriting legibility and speed improved significantly at follow-up evaluation. However, most of the children with legibility difficulties at baseline continued to demonstrate difficulties when evaluated 3 months after initiation of medication. Change in handwriting legibility was best determined by improvements in visual-motor integration skills (β = 0.07-0.10; p < .001), while the change in speed did not appear to be consistently related to a single factor. CONCLUSION Handwriting difficulties are common in children with ADHD, and medication alone is not sufficient to resolve these challenges.
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Affiliation(s)
| | - Michael Shevell
- McGill University, Montreal, Quebec, Canada Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Laurie Snider
- McGill University, Montreal, Quebec, Canada Montreal Children's Hospital, Montreal, Quebec, Canada
| | | | - Marilyse Julien
- Centre Hospitalier Universitaire-Sainte-Justine, Montreal, Quebec, Canada
| | - Annette Majnemer
- McGill University, Montreal, Quebec, Canada Montreal Children's Hospital, Montreal, Quebec, Canada
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Miyahara M, Healey DM, Halperin JM. One-week temporal stability of hyperactivity in preschoolers with ADHD during psychometric assessment. Psychiatry Clin Neurosci 2014; 68:120-6. [PMID: 24552632 PMCID: PMC3930929 DOI: 10.1111/pcn.12096] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 06/03/2013] [Accepted: 07/09/2013] [Indexed: 11/28/2022]
Abstract
AIM To examine the usefulness of temporal measures of motor activity during psychometric assessment on two different assessment days, 1 week apart with a scope to help the early identification of hyperactivity. METHODS Actigraph measures at the ankle and the waist were compared on the first and the second days of psychometric assessment in a total of 169 children (93 children in ADHD group; 76 children in Non-ADHD group) aged 3 years and 4 years. RESULTS There was a significant interaction effect between group and time on the activity level at the waist. Although the activity level of the waist in the children with ADHD did not significantly differ between Day 1 and Day 2, the activity level of the children without ADHD declined significantly from Day 1 to 2. A total of 70% of children were correctly classified into ADHD or Non-ADHD groups based only on Day 2 waist activity data. CONCLUSION The temporal consistency of hyperactivity in young children with ADHD during psychometric assessment is confirmed, indicating that objective measures of motor activity at the waist over different days of psychometric assessment can provide additional information for the stability of hyperactivity.
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Affiliation(s)
- Motohide Miyahara
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
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Yang P, Cai G, Cai Y, Fei J, Liu G. Gamma aminobutyric acid transporter subtype 1 gene knockout mice: a new model for attention deficit/hyperactivity disorder. Acta Biochim Biophys Sin (Shanghai) 2013; 45:578-85. [PMID: 23656791 DOI: 10.1093/abbs/gmt043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Attention deficit/hyperactivity disorder (ADHD) is characterized by hyperactivity, impaired sustained attention, impulsivity, and is usually accompanied by varying degrees of learning difficulties and lack of motor coordination. However, the pathophysiology and etiology of ADHD remain inconclusive so far. Our previous studies have demonstrated that the gamma aminobutyric acid transporter subtype 1 (GAT1) gene knockout (ko) mouse (gat1-/-) is hyperactive and exhibited impaired memory performance in the Morris water maze. In the current study, we found that the gat1-/- mice showed low levels of attentional focusing and increased impulsivity. In addition, the gat1-/- mice displayed ataxia characterized by defects in motor coordination and balance skills. The hyperactivity in the ko mice was reduced by both methylphenidate and amphetamine. Collectively, these results suggest that GAT1 ko mouse is a new animal model for ADHD studying and GAT1 may be a new target to treat ADHD.
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Affiliation(s)
- Ping Yang
- School of Life Sciences and Technology, TongJi University, Shanghai 200092, China
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Stray LL, Kristensen Ø, Lomeland M, Skorstad M, Stray T, Tønnessen FE. Motor regulation problems and pain in adults diagnosed with ADHD. Behav Brain Funct 2013; 9:18. [PMID: 23642255 PMCID: PMC3652792 DOI: 10.1186/1744-9081-9-18] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 04/23/2013] [Indexed: 11/10/2022] Open
Abstract
Background Most children who are diagnosed with attention deficit-hyperactivity disorder (ADHD) have moderate-to-severe motor problems using the Motor Function Neurological Assessment battery (MFNU). The MFNU focuses on specific muscle adjustment problems associated with ADHD, especially motor inhibition problems and high muscle tone. Here we investigated whether adults with ADHD/hyperkinetic disorder (HKD) have similar motor problems. In our clinical experience, adults with ADHD often complain about back, shoulder, hip, and leg pain. We also investigate reported pain in adults with ADHD. Methods Twenty-five adult outpatients diagnosed with ADHD/HKD who were responders to methylphenidate (MPH) were compared to 23 non-ADHD controls on 16 MFNU subtests and using a ‘total score’ (‘TS’) parameter. The MFNU test leader was blinded to group identity. The two groups were also compared using the Pain Drawing and Numerical Pain Rating Scale. Results The adult ADHD group had significantly (p < .001) more motor problems (higher TS) than controls. On the muscle regulation subtests, 36–96% of the ADHD group showed ‘moderate’ to ‘severe’ problems compared to 13–52% of the control group, and 80% of the ADHD group reported widespread pain. Highly significant differences were found between the ADHD and control groups for the variables ‘pain level’ (p < .001) and ‘pain location’ (p < .001). Significant correlations were found between TS and ‘pain location’ and between TS and ‘pain level’. Conclusions These findings suggest that similar to children with ADHD, adults diagnosed with ADHD also have motor inhibition problems and heightened muscle tone. The presence of significantly higher pain levels and more widespread pain in the ADHD group compared to non-ADHD controls might indicate that pain is a long-term secondary effect of heightened muscle tone and restricted movement that can be demonstrated in children and adults by the MFNU battery.
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Brossard-Racine M, Shevell M, Snider L, Bélanger SA, Majnemer A. Motor skills of children newly diagnosed with Attention Deficit Hyperactivity Disorder prior to and following treatment with stimulant medication. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:2080-2087. [PMID: 22796639 DOI: 10.1016/j.ridd.2012.06.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 06/07/2012] [Accepted: 06/07/2012] [Indexed: 06/01/2023]
Abstract
Motor difficulties are common in children with Attention Deficit Hyperactivity Disorder (ADHD). Although preliminary evidence has suggested that methylphenidate can improve the motor skills in children with ADHD and Developmental Coordination Disorder (DCD), the effect of stimulant medication on motor performance in children newly diagnosed with ADHD with or without motor impairment remains unclear. A cohort study of 49 medication-naïve children (39 male; mean age 8.4±1.3 years) with ADHD was conducted. Children were evaluated using the Movement Assessment Battery for Children and the developmental test of visual motor integration at diagnosis and again three months following daily treatment with a stimulant medication. Motor difficulties were highly present at baseline (73.5%) but resolved in a subset after treatment with stimulant medication, suggesting that their motor difficulties may be attributed in part to their attentional problems. Nevertheless, motor impairment persisted in 55.1% of the sample. The severity of the behavioural symptoms was significantly associated with balance skills in children without motor impairments (r(2)=0.30, p<0.01) and with visual motor integration skills in children with persisting motor difficulties (r(2)=0.27, p<0.01). Attentional difficulties negatively affect the motor skills of children with ADHD. Following the use of stimulant medication, an important subset continued to demonstrate motor difficulties. The improvement in behaviour was insufficient to resolve motor problems and these children should therefore be targeted for rehabilitation services.
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Affiliation(s)
- Marie Brossard-Racine
- Advanced Pediatric Brain Imaging Research Laboratory, Diagnostic Imaging and Radiology/Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC, USA
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Blank R, Smits-Engelsman B, Polatajko H, Wilson P. European Academy for Childhood Disability (EACD): recommendations on the definition, diagnosis and intervention of developmental coordination disorder (long version). Dev Med Child Neurol 2012; 54:54-93. [PMID: 22171930 DOI: 10.1111/j.1469-8749.2011.04171.x] [Citation(s) in RCA: 368] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Rainer Blank
- Kinderzentrum Maulbronn and University of Heidelberg, Germany
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Brossard-Racine M, Majnemer A, Shevell M, Snider L, Bélanger SA. Handwriting capacity in children newly diagnosed with Attention Deficit Hyperactivity Disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:2927-2934. [PMID: 21640552 DOI: 10.1016/j.ridd.2011.05.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Accepted: 05/04/2011] [Indexed: 05/30/2023]
Abstract
UNLABELLED Preliminary evidence suggests that children with Attention Deficit Hyperactivity Disorder (ADHD) may exhibit handwriting difficulties. However, the exact nature of these difficulties and the extent to which they may relate to motor or behavioural difficulties remains unclear. The aim of this study was to describe handwriting capacity in children newly diagnosed with ADHD and identify predictors of performance. Forty medication-naïve children with ADHD (mean age 8.1 years) were evaluated with the Evaluation Tool of Children's Handwriting-Manuscript, the Movement Assessment Battery for Children (M-ABC), the Developmental Test of Visual Motor Integration (VMI) and the Conner Global Index. An important subset (85.0%) exhibited manual dexterity difficulties. Handwriting performance was extremely variable in terms of speed and legibility. VMI was the most important predictor of legibility. Upper extremity coordination, as measured by the M-ABC ball skills subtest, was also a good predictor of word legibility. CONCLUSION Poor handwriting legibility and slow writing speed were common in children newly diagnosed with ADHD and were associated with motor abilities. Future studies are needed to determine whether interventions, including stimulant medications, can improve handwriting performance and related motor functioning.
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Emck C, Bosscher R, Beek P, Doreleijers T. Gross motor performance and self-perceived motor competence in children with emotional, behavioural, and pervasive developmental disorders: a review. Dev Med Child Neurol 2009; 51:501-17. [PMID: 19538424 DOI: 10.1111/j.1469-8749.2009.03337.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIMS Motor performance and self-perceived motor competence have a great impact on the psychosocial development of children in general. In this review, empirical studies of gross motor performance and self-perception of motor competence in children with emotional (depression and anxiety), behavioural, and pervasive developmental disorders are scrutinized, with the objective of identifying specific motor characteristics that may be relevant to clinical practice. METHOD A systematic search of studies published between 1997 and 2007 was performed using nine search engines. RESULTS Children in all three categories (emotional, behavioural, and pervasive developmental disorders) exhibit poor gross motor performance and problematic self-perception of motor competence, with certain indications of disorder-specific characteristics. In particular, children with emotional disorders have balance problems and self-perceived motor incompetence; children with behavioural disorders show poor ball skills and tend to overestimate their motor performance; children with pervasive developmental disorders demonstrate poor gross motor performance and self-perceived motor incompetence. As a result, children with developmental and emotional disorders are restricted in participating in games and play, which may lead to inactive lifestyles and further disruption of their psychosocial and physical development. INTERPRETATION Motor problems need more, to some extent disorder-specific, attention in clinical practice than has been provided to date.
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Affiliation(s)
- Claudia Emck
- Research Institute Move, VU University Amsterdam, Van der Boechorststraat 9, Amsterdam 1081 BT, The Netherlands.
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Harvey WJ, Reid G, Grizenko N, Mbekou V, Ter-Stepanian M, Joober R. Fundamental movement skills and children with attention-deficit hyperactivity disorder: peer comparisons and stimulant effects. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2007; 35:871-82. [PMID: 17503174 DOI: 10.1007/s10802-007-9140-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to compare the fundamental movement skills of 22 children with attention-deficit hyperactivity disorder (ADHD), from 6 to 12 years of age, to gender- and age-matched peers without ADHD and assess the effects of stimulant medication on the movement skill performance of the children with ADHD. Repeated measures analyses revealed significant skill differences between children with and without ADHD (p <or= 0.001). Results from the stimulant medication trials indicated no significant effect of medication on the movement skill patterns of children with ADHD. It is concluded that children with ADHD may be at risk for developmental delays in movement skill performance. Potential factors underlying the movement skill difficulties are discussed, with suggestions for future research.
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Affiliation(s)
- William J Harvey
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC, Canada.
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Miyahara M, Piek J, Barrett N. Accuracy of drawing in a dual-task and resistance-to-distraction study: Motor or attention deficit? Hum Mov Sci 2006; 25:100-9. [PMID: 16442649 DOI: 10.1016/j.humov.2005.11.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
To determine whether manual incoordination is caused by attention deficit or not, we used an accuracy drawing task as a primary task in dual-task and resistance-to-distraction studies, and examined if thus measured attention could differentiate inattention (IA) and combined (CO) subtypes of ADHD. The secondary tasks and distractions failed to lower the primary task performance in IA, CO and control groups. We also compared the impairment scores of the accuracy drawing tasks from the Movement Assessment Battery for Children [Henderson, S. E., & Sugden, D. A. (1992). Movement assessment battery for children. London: Psychological Corporation.] between the groups with attention deficit hyperactivity disorder (ADHD) and/or developmental coordination disorder-inaccurate drawing type (DCD-ID). There were no group differences in the impairment score between the control and the ADHD groups, and between ADHD and ADHD plus DCD-ID groups. We concluded that inaccurate drawing is not caused by attention deficit, but that it is a manifestation of a motor deficit as a separate entity from attention deficit.
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Affiliation(s)
- Motohide Miyahara
- School of Physical Education, University of Otago, Dunedin, New Zealand.
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