Children with deficits in attention, motor control and perception (DAMP) almost grown up: psychiatric and personality disorders at age 16 years

Paediatric motor difficulties and internalising problems: an integrative review on the environmental stress hypothesis

The current study aims to provide an in-depth analysis and extension of the Environmental Stress Hypothesis (ESH) framework, focusing on the complex interplay between poor motor skills and internalising problems like anxiety and depression. Using an integrative research review methodology, this study synthesises findings from 38 articles, both empirical and theoretical, building upon previous foundational works. The hypothesis posits that poor motor skills serve as a primary stressor, leading to internalising problems through various secondary stressors. A rigorous comparison of data was conducted, considering study design, findings, and methodologies-while exploring variables such as age, sex, and comorbidities. The study also enhances the ESH framework by including intrapersonal stressors and introducing resource buffers, including optimism and familial support as additional influencing factors. This multi-level approach yields a more nuanced and comprehensive ESH framework, highlighting the need for future studies to consider variables that intersect across multiple domains and how the relationship between poor motor skills and internalising problems may vary across different life stages.

Factor Validity and Generic Reliability of the Developmental Coordination Disorder Questionnaire in the Czech Population

The Developmental Coordination Disorder Questionnaire (DCDQ) is widely used as a brief parent questionnaire designed to screen for motor coordination in children, aged 5 to 15 years. There is no validated version of the DCDQ for the Central Europe, which could help for first catch of children with motor difficulties, whose amount has been seriously raised. In addition, the World Health Organization recommends the cross-cultural validation of existing instruments, for Loir costs and time consuming, and the availability of instruments in several languages enables therapists to use validated tools with non-English speaking clients. The aim of this study was to validate the DCDQ in the Czech culture in a population of Czech parents whose children were aged six to ten. Using data from 651 Czech parents of children (six to ten years; 7.8 ± 0.8 years), confirmatory factor analyses (CFA) were used. The goodness-of-fit indices CFI = 0.94, TLI = 0.93, and RMSEA = 0.08 supported the original three-factor model of the DCDQ. In addition, the factor loadings of each question discovered in Czech DCDQ were non-significantly different from the original DCDQ. Furthermore, we also found strong between factor correlation; general coordination and control movement r = 0.87 probably measure the same underlying construct. Even though this is in conformity with original DCDQ structure, we suggest that responses in these two DCDQ factors might have violated the local independency and, therefore, could bias the final score. The generic reliability of the individual factors was acceptable and ranged from McDonald ω 0.83-0.88. Results from this study suggest that cross-validated version of the original DCDQ can be considered as sufficiently valid and reliable clinical screening tool for children who have coordination challenges for Czech children aged six to ten.

New trends in developmental coordination disorder: Multivariate, multidimensional and multimodal

Developmental coordination disorder (DCD) is a motor development disorder that affects an individual's growth and development, and may persist throughout life. It is not caused by intellectual or physical disability. Studies have suggested DCD often occurs in childhood, resulting in a series of abnormal manifestations that hinder children's normal development; cohort studies suggest a higher incidence in boys than in girls. Early diagnosis and appropriate interventions can help relieve symptoms. Unfortunately, the relevant research still needs to be further developed. In this paper, we first start from the definition of DCD, systematically investigate the relevant research papers in the past decades and summarize the current research hotspots and research trends in this field. After summarizing, it is found that this research field has attracted more researchers to join, the number of papers published has increased year by year and has become a hot spot in multidisciplinary research, such as education, psychology, sports rehabilitation, neurobiology, and neuroimaging. The continuous development of the correlation between perinatal factors and DCD, various omics studies, and neuroimaging methods also brings new perspectives and working targets to DCD research. DCD-related research will continue to deepen along the research direction of multivariate, multidimensional, and multimodal.

White Matter Changes With Rehabilitation in Children With Developmental Coordination Disorder: A Randomized Controlled Trial

Background and Objectives: Children with developmental coordination disorder (DCD) have difficulty learning motor skills, which can affect their participation in activities of daily living and psychosocial well-being. Over 50% of children with DCD also have attention deficit hyperactivity disorder (ADHD), which further exacerbates their motor problems and impact on quality of life. A rehabilitation approach known as Cognitive Orientation to Occupational Performance uses problem-solving strategies to help children learn motor skills they wish to achieve. While this cognitive approach has been effective for children with DCD, few studies have examined the effectiveness of this approach for children with co-occurring ADHD. Further, the underlying mechanism and neural basis of this intervention are largely unknown.

Methods: In this randomized waitlist-controlled trial, we used MRI to examine white matter microstructure after intervention in 8–12-year-old children with DCD (n = 28) and with DCD and co-occurring ADHD (n = 25). Children in both groups were randomized to either a treatment group or waitlist group at their first MRI. The treatment group began the intervention after their MRI scan and returned for a post-treatment scan at 3 months, and follow-up scan at 6 months; the waitlist group waited 3 months before their second MRI, received the intervention, and then had a post-treatment scan. Each child received intervention once weekly for 10 weeks. Diffusion tensor imaging was used to acquire white matter diffusion parameters and was analyzed using tract-based spatial statistics (TBSS).

Results and Conclusion: Children with DCD showed significant improvement in white matter microstructure in the bilateral anterior thalamic radiation, bilateral sensorimotor tract, bilateral cingulum, fornix, splenium and body of corpus callosum, right inferior fronto-occipital fasciculus, and white matter pathways to bilateral inferior gyri, right middle frontal gyrus, frontal medial cortex, and left cuneus. We suggest that these rehabilitation-induced neural changes in children with DCD occurred in regions associated with attention, self-regulation, motor planning, and inter-hemispheric communication, which positively affected brain connectivity and motor function. In contrast, children with DCD and co-occurring ADHD did not show any brain changes following the intervention. Modifications to the treatment protocol might help address the attentional and self-regulatory needs of children with a dual diagnosis.

Clinical Trial Registration: ClinicalTrials.gov ID: NCT02597751.

Cognitive and motor function in developmental coordination disorder

AIM

To analyse the development of motor skill and executive function in school-aged children with and without developmental coordination disorder (DCD).

METHOD

Using a longitudinal design, 186 children (86 males, 100 females) aged 6 to 11 years at Time 1 were tested over a 2-year period, 52 of whom were diagnosed with DCD at Time 1 (27 males, 25 females; mean age 8y 5mo, SD 1y 6mo) using DSM-5 criteria. The McCarron Assessment of Neuromuscular Development assessed motor status at Time 1 and at 2-year follow-up (Time 2). Executive function was assessed using a well-validated measure, the Groton Maze Learning Test.

RESULTS

The DCD cohort at Time 1 had moderate incidence of executive function deficit (41%). Most importantly, at a group level, children with persisting DCD (across Times 1 and 2) also showed significantly lower levels of executive function than children with typical motor development at both time points. At an individual level, around 26% of children in this group had persisting executive function deficits relative to normal ranges of performance.

INTERPRETATION

Children with persisting DCD are at significant risk of executive function issues. The combination of motor and cognitive issues as a potential risk factor in the longer-term development of children is discussed.

WHAT THIS PAPER ADDS

Around half of children initially diagnosed with developmental coordination disorder (DCD) had the same diagnosis at 2-year follow-up. 41% of children with DCD have impaired executive function. Children with persisting DCD show poorer executive function than those with typical motor development or remitting DCD.

The Influence of Motor Competence on Adolescent Identity Health: A Mixed Method Study

Our identity develops with age, and many impacting factors will determine whether it is healthy or unhealthy. A particularly fragile phase of identity development occurs during adolescence when level of motor competence may be influential, yet is rarely considered. Purpose: The purpose of this study was to examine male and female adolescent's perceptions towards their motor competence and identity development. In-depth information was also collected to understand what factors are important towards identity development during adolescence. Method: An explanatory sequential mixed methods study was used to examine the extent motor competence influenced the health of an adolescent's identity. A sample of 160 adolescents (male n = 103, female n = 57, M_age = 14.45 SD = .75) completed the Adolescent Motor Competence Questionnaire (AMCQ) and the Assessment of Identity Development in Adolescence (AIDA). The AMCQ scores were used to group the participants into high (HMC = > 83) and low (LMC = < 83) motor competence. Results: More females had less-healthy identities than males and those with LMC had less-healthy identities than those with HMC. Subsamples of 17 participants were interviewed in order to explain these results. The most at risk group, females with LMC, identified negative peer comparisons, poor social support and higher stress levels to achieve academic performance as key challenges. Conclusions. Well-designed support services for those with LMC, especially for the females should incorporate activities to develop individual competency and close friendships.

Balance Training as an Adjunct to Methylphenidate: A Randomized Controlled Pilot Study of Behavioral Improvement Among Children With ADHD in China

Objective: This study aimed to compare the therapeutic effects of two different approaches to attention deficit hyperactivity disorder (ADHD): (1) methylphenidate (MPH) treatment combined with balance training, and (2) MPH monotherapy. Methods: The study was based on a randomized, single-blind trial involving 27 ADHD patients. An experimental group received the treatment combining MPH and balance training, while a control group were administered just MPH. After 40 sessions of training at the 6-month mark, patients' improvement as observed in their core symptoms and behavioral problems were compared between the experimental and control group. Results: A total of 27 patients underwent randomization, with 13 assigned to the experimental group and 14 to the control group. After the 6-month trial, the experimental group outperformed the control group in terms of teachers' scores for inattention on the ADHD-RS-IV (19.38 ± 2.96 vs. 23.21 ± 3.91, t = -2.854, P = 0.009). The experimental group also showed greater improvement on the items involving behavior (3.14 ± 1.46 vs. 5.24 ± 1.04, t = 1.463, P = 0.026) and hyperactivity (1.92 ± 1.19 vs. 3.86 ± 2.32, t = -2.697, P = 0.012). Conclusion: In children with ADHD, the experimental group displayed a significant improvement in the symptoms and behavior associated with inattention than did the group whose treatment consisted of only MPH.

Motor Performance in Children With Childhood Apraxia of Speech and Speech Sound Disorders

Purpose This study sought to determine if (a) children with childhood apraxia of speech (CAS), other speech sound disorders (SSDs), and typical development (TD) would perform differently on a standardized motor assessment and (b) whether comorbid language impairment would impact group differences. Method Speech, language, and motor abilities were assessed in children with CAS (n = 10), SSD (n = 16), and TD (n = 14) between the ages of 43 and 105 months. Motor skills were evaluated using the Movement Assessment Battery for Children-Second Edition (Henderson, Sugden, & Barnett, 2007), a behavioral assessment that is sensitive in identifying fine/gross motor impairments in children with a range of motor and learning abilities. Data were reanalyzed after reclassifying children by language ability. Results The CAS group performed below the normal limit on all components of the motor assessment and more poorly than the TD and SSD groups on Aiming and Catching and Balance. When children were reclassified by language ability, the comorbid CAS + language impairment group performed worse than the SSD-only and TD groups on Manual Dexterity and Balance and worse than the TD group on Aiming and Catching; all 7 children with CAS + language impairment evidenced performance in the disordered range compared to 1 of 3 children in the CAS-only group and 2 of 6 children in the SSD + language impairment group. Conclusions Children with CAS + language impairment appear to be at an increased risk for motor impairments, which may negatively impact social, academic, and vocational outcomes; referrals for motor screenings/assessments should be considered. Findings may suggest a higher order deficit that mediates cognitive-linguistic and motor impairments in this population.

Fine motor deficits and attention deficit hyperactivity disorder in primary school children

Background

Many children with attention deficit hyperactivity disorder (ADHD) display motor deficiencies during their daily routine, which may have impact on their developmental course. Children with ADHD who experience motor deficiencies often display deficits in tasks requiring movements, such as handwriting.

Aim

This study investigated deficiencies in fine motor skills in primary school children with ADHD. The study further sought to establish whether ADHD subtypes differ in deficiencies of fine motor performance, recorded for both the dominant and non-dominant hands.

Methods

The Disruptive Behavior Disorders Rating Scale, completed by educators and parents, was used to screen for ADHD symptoms. Researchers confirmed the diagnosis of ADHD. Motor functioning was assessed using the Grooved Pegboard and Maze Coordination. The children diagnosed with ADHD were matched for age and gender with controls without ADHD. The sample consisted of an ADHD group (160) and control group (160) of primary school children from the Moletjie area.

Results

Children with ADHD (predominantly inattentive subtype) and ADHD (combined subtype) performed significantly more poorly than the control group on the Grooved Pegboard (p < 0.05) with both the dominant and non-dominant hand. No significant difference between the hyperactivity and impulsiveness subtype and the controls were found. There was no difference on the Maze Coordination Task (p > 0.05) between the ADHD subtypes and the controls.

Conclusion

Difficulties in fine motor skills are prevalent in children with ADHD, particularly in the ADHD-PI and ADHD-C. Problems are encountered in distal, complex, speeded tasks. The effect may lead to poor handwriting and academic performance.

Empathy, social relationship and co-occurrence in young adults with DCD

Empathy is defined as an emotional or cognitive response to another's emotional state. It is considered essential for navigating meaningful social interactions and is closely linked to prosocial behavior. Developmental coordination disorder (DCD) is characterized by an impairment of motor coordination that has a marked impact on both academic and day-to-day living activities. Children and adolescents with DCD have been shown to have less developed social support and friendships. The research linking empathy and DCD is scarce. The aims of this study are to gain an understanding of the relationship between DCD and empathy in young adults with DCD only, and with DCD coupled with other neurodevelopmental disorders, in comparison with typically developing adults.

METHODS

The study included 212 young adults aged 18-40 years. The subjects in this study were from mainstream populations in the UK. The study groups included: (a) "DCD only" with 42 individuals; (b) "DCD + ASD" with 21 individuals; (c) "DCD + ADHD" with 45 individuals; (d) "DCD + ASD + ADHD" with 29 individuals; and (e) the control group of 75 individuals.

RESULTS

ANOVA on the Empathy Questionnaire (EQ) showed a statistically significant difference between groups (F [4,257] = 35.63; p < 0.001; η_p² = 0.409). No significant differences were found between the DCD-only and the control. MANOVA was performed to assess differences in the Socialising and Friendship Questionnaire (SAF-Q) scores. The results showed a statistically significant difference between groups (F [8,257] = 9.98; p < 0.001; η = 0.162). Pearson correlation coefficients were performed, revealing significant high correlations between the EQ and the two parts of the SAF-Q ("past" and "currently").

CONCLUSION

The results of this study indicate that social difficulties in the DCD-only group are not due to lack of empathy, but may be driven by an accumulation of external factors. In this study we also concluded that DCD does not appear to be the factor that reduces the ability to empathize, but rather the presence of ADHD and/or ASD.

The Correlation Between Cognitive and Movement Shifting and Brain Activity in Children With ADHD

OBJECTIVE

We assessed the correlation between the deficits of cognition, movement, and brain activity in children with Attention Deficit Hyperactvity Disorder (ADHD).

METHOD

We recruited 15 children with ADHD and 15 age- and sex-matched healthy control participants. Clinical symptoms, cognitive shifting, movement shifting, and brain activity were assessed using the Korean ADHD Rating Scale, the Wisconsin Card Sorting Test (WCST), the 7- and 14-ring drill test with hop jumps (7 HJ and 14 HJ), and 3.0 Tesla functional magnetic resonance imaging scanner, respectively.

RESULTS

ADHD children showed an increased distance traveled and decreased speed on the 14 HJ task. In response to the WCST task, ADHD children showed decreased activation within right gyrus. Total distance on the 14 HJ task was negatively correlated with the mean β value of Cluster 2 in ADHD children.

CONCLUSION

These results suggested that children with ADHD showed difficulty with attention shifting as well as with movement shifting.

Understanding Organisational Ability and Self-Regulation in Children with Developmental Coordination Disorder

PURPOSE OF THE REVIEW

This paper examines physical and emotional coherence in young people with developmental coordination disorder (DCD). Specifically, the transactional relationship between motor and non-motor/executive dysfunction in children with DCD and its impact on psychosocial functioning is explored.

RECENT FINDINGS

This paper integrates the subjective reported experiences of young people with DCD with objective measurements and findings from neuroimaging studies.

SUMMARY

Consideration of the transactional relationship between the person, the activity and the environment, whether these factors be physical, social, attitudinal or virtual, will be fundamental to our understanding of the mechanisms underpinning organisational and emotional issues presenting in DCD. Integrating the experiences of young people with research evidence will be essential to improve outcomes for young people with DCD in clinical practice.

Is Questionnaire-Based Screening Part of the Solution to Waiting Lists for Children with Developmental Coordination Disorder?

This study was undertaken to determine whether questionnaire-based screening could be part of the solution to a long waiting list of referrals for occupational therapy assessment by identifying the requirement for clinical assessments. The performance of two questionnaires – the Developmental Coordination Disorder Questionnaire (DCDQ) completed by parents and the Checklist of the Movement Assessment Battery for Children (C-ABC) completed by teachers – was compared with a more traditional clinical assessment for the identification of DCD in children already referred to occupational therapy. It was found that the parent report was quite reliable in the identification of DCD if no other developmental problem was present. However, there was little benefit to using the teacher report to screen children.

Several confounding variables, including an unequal proportion of children with DCD in the sample and the inclusion of children who were younger than the age range of the DCDQ, may have influenced how well the questionnaires performed. Although questionnaires cannot replace a full clinical assessment, the results showed that there may be some value in including the parent report in the identification of DCD.

Study of clinical characteristics in young subjects with Developmental coordination disorder

BACKGROUND

Developmental Coordination Disorder (DCD) is a chronic neurological disorder observed in children. DCD is characterized by slowness in activities and motor impairment that affects the children's daily living and academic achievements, and later their professional and social behavior. Our aim in this work was to report characteristics frequencies in a group of children with DCD and to propose a subtyping of DCD characteristics.

METHODS

Thirty three clinical DCD characteristics, the mostly reported in the literature, were assessed in 129 patients, boys and girls aged from 4years to 18years, and their subtyping was proposed. The statistical analyses were carried out with the Chi square, the t-test and the correlation for the statistical differences, and with the Ward clustering method for subtyping.

RESULTS

We found that there were 3.17 boys for one girl, all patients were characterized as slow, 47% were left-handers or ambidextrous, 36% and 26% had orofacial and verbal dyspraxia, respectively, 83% were found anxious, and 84% were described as being clumsy.

CONCLUSIONS

It appears from these results that a child with DCD expresses more than a single difficulty. Three subtypes emerged from the statistical analysis in this study: (1) clumsiness and other characteristics except language difficulties; (2) self-esteem and peer relation without clumsiness and language difficulties; (3) language difficulties and orofacial dyspraxia.

Motor Proficiency in Children Reporting Low Levels of Participation in Physical Activity

This study examined the motor proficiency and physical activity levels of young children with low levels of perceived self-efficacy regarding their participation in physical activities. This group (n=48) was compared with 400 of their peers in Grades 4–8 attending the same schools and also with a group (n=44) who reported high levels of perceived self-efficacy. Although none of the students with poor self-efficacy had been identified by their schools as having a learning or behavioural disorder, these children were found to have characteristics which are typical of children with developmental coordination disorder (DCD). These findings suggest that an instrument which asks children about their confidence when participating in physical leisure activities, and their enjoyment of those same activities may have potential as a possible screening tool for DCD.

Identification of emotional and behavioral problems by teachers in children with developmental coordination disorder in the school community

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.

Desenvolvimento motor e autoconceito de escolares com transtorno do desenvolvimento da coordenação

Resumo Verificou-se a influência de um programa de intervenção motora no desenvolvimento motor e autoconceito de escolares com Transtorno do Desenvolvimento da Coordenação (TDC). Participaram do programa de intervenção de 16 semanas,12 crianças com idades de 10 anos (± 6 meses), divididas em dois grupos;sete escolares com indicativo TDC (GT) e cinco escolares com risco para TDC (GR). Utilizou-se a bateria motora MABC-2 (Henderson, Sugden, & Barnett, 2007) e a Escala de Auto-percepção para Crianças (Harter, 1982). Para analisar os efeitos da intervenção, utilizou-se o teste de Wilcoxon, o nível de significância foi de p>0,05. O programa se mostrou efetivo quando observado o TDC proporcionando influência positiva e significante nos valores das pontuações totais, pontuação padrão e percentis do Teste MABC-2. Entretanto, para o autoconceito essa efetividade não foi totalmente confirmada.

Effects of methylphenidate on body index and physical fitness in Korean children with attention deficit hyperactivity disorder

OBJECTIVE

The side effects of methylphenidate (MPH) on growth remain a controversial concern. This study aimed to investigate the effect of MPH on clinical symptoms, growth, and physical fitness in Korean children.

METHODS

Fifty male children with attention deficit hyperactivity disorder (ADHD) treated with methylphenidate (MPH-ADHD), 69 MPH-naïve male children with ADHD (Naïve-ADHD), and 60 age-matched and sex-matched healthy control subjects were recruited. Intelligence quotient (IQ), clinical symptoms of ADHD, body index (height, weight, and body mass index [BMI]), and physical fitness (muscular strength, endurance, flexibility, agility, speed, and balance) were assessed.

RESULTS

Total IQ and performance IQ scores were significantly different among the three groups, as were mean Korean Attention Deficit Hyperactivity Disorder (K-ARS)-total, K-ARS-inattention, and K-ARS-hyperactivity scores. There was no significant difference in height, weight, or BMI among the three groups. There were significant differences in skill-related fitness scores for balance (healthy controls > MPH-ADHD > Naïve-ADHD) and agility shuttle test time (healthy controls < MPH-ADHD < Naïve-ADHD).

CONCLUSIONS

Our findings support the effectiveness of MPH treatment for improving IQ, attention, and balance and agility measures of skill-related fitness in Korean children with ADHD. MPH was not associated with growth delays in height, weight, and BMI.

The relationship between manual coordination and mental health

Motor coordination impairments frequently co-occur with other developmental disorders and mental health problems in clinically referred populations. But does this reflect a broader dimensional relationship within the general population? A clearer understanding of this relationship might inform improvements in mental health service provision. However, ascertainment and referral bias means that there is limited value in conducting further research with clinically referred samples. We, therefore, conducted a cross-sectional population-based study investigating children's manual coordination using an objective computerised test. These measures were related to teacher-completed responses on a behavioural screening questionnaire [the Strength and Difficulties Questionnaire (SDQ)]. We sampled 298 children (4-11 years old; 136 males) recruited from the general population. Hierarchical (logistic and linear) regression modelling indicated significant categorical and continuous relationships between manual coordination and overall SDQ score (a dimensional measure of psychopathology). Even after controlling for gender and age, manual coordination explained 15 % of the variance in total SDQ score. This dropped to 9 % after exclusion of participants whose SDQ responses indicated potential mental health problems. These results: (1) indicate that there is a clear relationship between children's motor and mental health development in community-based samples; (2) demonstrate the relationship's dimensional nature; and (3) have implications for service provision.

Attention-deficit/hyperactivity disorder, methylphenidate use and the risk of developing schizophrenia spectrum disorders: A nationwide population-based study in Taiwan

This study estimated the risk of developing psychotic disorders by comparing children with ADHD to non-ADHD controls, and to examine whether methylphenidate (MPH) treatment influences the risks of psychotic disorders. A nationwide cohort of patients who were newly diagnosed with ADHD (n=73,049) and age- and gender-matched controls (n=73,049) were selected from Taiwan's National Health Insurance database from January 2000 to December 2011. All participants were observed until December 31, 2011. Cox regression models were used to estimate the effects of ADHD diagnosis and MPH use on subsequent outcomes. Having a diagnosis of any psychotic disorder and of schizophrenia were set as two different outcomes and were analyzed separately. Compared to the control group, the ADHD group showed significantly increased risk of developing any psychotic disorder (adjusted hazard ratio [aHR], 5.20; 95% confidence interval [CI], 4.30-6.30) and schizophrenia (aHR, 4.65; 95% CI, 3.59-6.04). Compared to ADHD patients without psychosis, patients with ADHD who developed psychosis had significantly older age at first diagnosis of ADHD (9.4±3.3years vs. 10.6±4.0years). Among patients with ADHD, MPH use significantly increased the risk of developing any psychotic disorder (aHR, 1.20; 95% CI, 1.04-1.40), but did not increase the risk of developing schizophrenia (aHR, 1.16; 95% CI, 0.94-1.42). The results indicated that previous diagnoses of ADHD are a powerful indicator of developing psychotic disorders. Nevertheless, the specific mechanisms of the relationships between ADHD, MPH use and psychotic disorders need further elucidation in future clinical studies.

Motor abilities of children and adolescents with a psychiatric condition: A systematic literature review

AIM: To summarize research regarding the motor abilities of children and adolescents who suffer from a common psychiatric condition.

METHODS: In order to outline the current knowledge regarding the motor abilities of children and adolescents with autism spectrum disorders (ASD), attention deficit hyperactivity disorder (ADHD), disruptive behavior disorders (DBD) and depression, a comprehensive systematic literature search was carried out using PubMed, Medline and ERIC databases. The databases were searched for relevant English language articles published between January 1990 and April 2014. Only studies that conducted a quantitative evaluation of motor ability and concerned individuals aged 0-18 years were included. A separate search was conducted for each disorder (ASD, ADHD, DBD, depression) in conjunction with each of the following keywords: (psycho/perceptuo) motor/movement skill(s), (psycho/perceptuo) motor/movement abilities, (psycho/perceptuo) motor/movement impairment, (psycho/perceptuo) motor/movement problem(s), motor function, motor coordination, motor performance, motor deficit(s). To detect supplementary relevant literature, the reference lists of the retrieved articles were examined.

RESULTS: The search strategy yielded 51 studies meeting the inclusion criteria. In total, 28 studies were included that examined the motor abilities of children and adolescents with ASD. All studies indicated that they performed below average on various standardized motor assessment instruments. The overall prevalence rate for impairment in motor abilities ranged from 33% to 100%. Twenty-seven studies examined the motor abilities of children and adolescents with ADHD. Depending on the type of motor assessment tool and the cut-off points used by different researchers, prevalence rates of impairment in motor abilities are highly variable and ranged from 8% to 73%. Remarkably, there is a paucity of research addressing the motor abilities of individuals with DBD or depression. Furthermore, methodological problems, such as measurement and comorbidity issues, complicate the generalization of the findings.

CONCLUSION: Research suggests that motor impairment is highly prevalent in some psychiatric conditions, particularly ASD and ADHD. However, future work is necessary to draw sound conclusions.

Motor abilities of adolescents with a disruptive behavior disorder: The role of comorbidity with ADHD

The aim of this study was to explore the incidence, type and severity of motor impairment in male adolescents with a disruptive behavior disorder (DBD) and evaluate the role of comorbid ADHD. The Bruininks-Oseretsky test of motor proficiency, Second Edition was administered to examine a detailed motor profile and to compare the motor abilities of individuals with DBD (n = 99) to those of controls (n = 87). Additional subgroup analyses were conducted within the clinical population and encompassed (1) analyzing differences in motor profiles between individuals diagnosed with oppositional defiant disorder (ODD) or conduct disorder (CD) and (2) comparing the motor profiles of individuals with or without comorbid ADHD. The results indicated that individuals with a DBD showed a mixed motor impairment profile. Even after controlling for IQ, the DBD group obtained significantly lower scores in comparison to controls. The ODD and CD subgroups showed a similar motor profile. Presence of comorbid ADHD did not produce major differences in the motor profile. As approximately 79% of the adolescents with a DBD suffered from motor impairment, motor ability needs to be adequately addressed in research as well as in clinical practice.

The neurocognitive functioning in bipolar disorder: a systematic review of data

BACKGROUND

During the last decades, there have been many different opinions concerning the neurocognitive function in Bipolar disorder (BD). The aim of the current study was to perform a systematic review of the literature and to synthesize the data in a comprehensive picture of the neurocognitive dysfunction in BD.

METHODS

Papers were located with searches in PubMed/MEDLINE, through June 1st 2015. The review followed a modified version of the recommendations of the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses statement.

RESULTS

The initial search returned 110,403 papers. After the deletion of duplicates, 11,771 papers remained for further evaluation. Eventually, 250 were included in the analysis.

CONCLUSION

The current review supports the presence of a neurocognitive deficit in BD, in almost all neurocognitive domains. This deficit is qualitative similar to that observed in schizophrenia but it is less severe. There are no differences between BD subtypes. Its origin is unclear. It seems it is an enduring component and represents a core primary characteristic of the illness, rather than being secondary to the mood state or medication. This core deficit is confounded (either increased or attenuated) by the disease phase, specific personal characteristics of the patients (age, gender, education, etc.), current symptomatology and its treatment (especially psychotic features) and long-term course and long-term exposure to medication, psychiatric and somatic comorbidity and alcohol and/or substance abuse.

Co-occurring development of early childhood communication and motor skills: results from a population-based longitudinal study

BACKGROUND

Communicative and motor development is frequently found to be associated. In the current study we investigate to what extent communication and motor skills at 1½ years predict skills in the same domains at 3 years of age.

METHODS

This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Heath. Data stem from 62,944 children and their mothers. Mothers completed questionnaires on their child's communication and motor skills at ages 1½ and 3. Associations between communication and motor skills were estimated in a cross-lagged model with latent variables.

RESULTS

Early communication skills were correlated with early motor skills (0.72). Stability was high (0.81) across time points for motor skills and somewhat lower (0.40) for communication skills. Early motor skills predicted later communication skills (0.38) whereas early communication skills negatively predicted later motor skills (-0.14).

CONCLUSION

Our findings provide support for the hypothesis that these two difficulties are not symptoms of separate disorders, but might rather be different manifestations of a common underlying neurodevelopmental weakness. However, there also seem to be specific developmental pathways for each domain. Besides theoretical interest, more knowledge about the relationship between these early skills might shed light upon early intervention strategies and preventive efforts commonly used with children with problems in these areas. Our findings suggest that the relationship between language and motor skills is not likely to be simple and directional but rather to be complex and multifaceted.

Association between Attention-Deficit Hyperactivity Disorder in childhood and schizophrenia later in adulthood

PURPOSE

To estimate the risk of schizophrenia in adulthood among children and adolescents with ADHD compared to the background population.

SUBJECTS/MATERIALS AND METHODS

Two hundred and eight youths with ADHD (183 boys; 25 girls) were followed prospectively. Diagnoses of schizophrenia were obtained from The Danish Psychiatric Central Register. The relative risk (RR) of schizophrenia for cases with ADHD, compared to the normal population, was calculated as risk ratios. Hazard ratios (HR's) by Cox regression were calculated in the predictor analyses.

RESULTS

Mean age for ADHD cases at follow-up was 31.1years. Schizophrenia diagnoses were given to 3.8% of these cases. Compared to the general population, RR of schizophrenia in cases with ADHD was 4.3 (95% CI 1.9-8.57).

DISCUSSION AND CONCLUSION

This prospective follow-up study found children with ADHD to be at higher risk of later schizophrenia than controls. If replicated, these results warrant increased focus on the possible emergence symptoms of schizophrenia or schizophreniform psychosis during clinical follow-up of patients with ADHD.

Mood impairments in adults previously diagnosed with developmental coordination disorder

BACKGROUND

Developmental coordination disorder (DCD) affects up to 6% of the population and is diagnosed on the basis of poor motor coordination. While we know rather little about its lifetime consequences, clear and significant difficulties remain through the lifespan for the majority. Reduced physical activity and, outside of the motor domain, significant mental health issues exist for many with DCD.

AIMS

This study provides the first investigation of the presence of mood disorders in adults with DCD.

METHOD

Symptoms of anxiety and depression were assessed using the Beck Depression and Spielberger Anxiety Inventories in 36 adults previously diagnosed with DCD vs. 49 age- and gender-matched typical controls. Amount and type of physical activity undertaken each week were also reported.

RESULTS

After controlling for their reduced level of weekly physical activity, the group with DCD reported significantly more symptoms of depression, state and trait anxiety than their peers.

CONCLUSIONS

This finding has important implications for consideration of intervention in DCD, as well as for investigation of the risk and protective factors at play in long-term outcome. Finally, the findings highlight the need for awareness of motor difficulties in those presenting with high levels of anxiety and depression, and vice versa.

Anxiety profiles in children with and without developmental coordination disorder

Previous work has highlighted that children diagnosed with DCD may be at risk of greater problems related to emotional wellbeing. However, to date much work has relied on population based samples, and anxiety has not been examined within a group of children given a clinical diagnosis of DCD. Additionally, the profile of individual differences has generally not been considered within this group. Therefore, a group of parents (n=27) completed the parent version of the Spence Children's Anxiety Scale (SCAS-P; Spence, 1998) in relation to their children with a diagnosis of DCD. Their responses on this measure were compared to those of parents with typically developing (TD) children (n=35; both groups 6-15 years of age). Children diagnosed with DCD were reported to experience significantly greater levels of anxiety overall, as well as having significantly greater difficulty than the TD group in the domains of panic/agoraphobic anxiety, social phobia, and obsessive compulsive anxiety. In addition, the individual profiles of types of anxiety reportedly experienced varied widely across the DCD group. These findings suggest that anxiety is a major problem for a proportion of children diagnosed with DCD, and raises questions regarding intervention, long term outcomes, and the nature of the disorder itself.

Attention-deficit/Hyperactivity Disorder in the context of Autism spectrum disorders

Autism spectrum disorders (ASD) are frequently marked by symptoms consistent with attention-deficit/hyperactivity disorder (ADHD), namely inattention, hyperactivity, and impulsivity. Recent work has established that about half of the ASD population also meets diagnostic criteria for ADHD, although the comorbid diagnoses are precluded by the DSM-IV-TR. Individuals with co-occurring ASD and ADHD symptoms are more severely impaired, with significant deficits seen in social processing, adaptive functioning, and executive control. Children with ASD and ADHD symptoms are also prone to motor problems, which lead to especially poor outcomes. Recent work has also demonstrated high rates of ASD symptoms in a subset of children with ADHD. Medication studies have demonstrated the efficacy of methylphenidate, atomoxetine, and guanfacine, among others, in treating ADHD symptoms co-occurring with ASD. However, these effects were not as great as those seen when treating primary ADHD, and they are less well-tolerated in the ASD population.

Motor coordination and emotional-behavioral problems in children

PURPOSE OF REVIEW

To summarize recent research on developmental coordination disorder (DCD), with particular attention to comorbidity and related questions of etiology.

RECENT FINDINGS

Although a general consensus on the disorder definition exists, case identification in research studies remains problematic. Despite this, recent research has reported high levels of attention deficit/hyperactivity disorder and internalizing disorders among children with poor motor coordination. These findings offer some support for the longstanding view that DCD may be one facet of a broader syndrome that includes learning difficulties and deficits in attention. 'Pure' cases are common, however, and other work suggests that DCD and attention deficit/hyperactivity disorder have distinct causes. There is also some evidence that internalizing disorder may be a consequence of DCD.

SUMMARY

Measurement issues in DCD persist, whereas findings on comorbidity have both illuminated the nature of the disorder and heightened debate on its usefulness as a distinct diagnostic entity.

Significance of long-chain polyunsaturated fatty acids (PUFAs) for the development and behaviour of children

omega-6 and omega-3 polyunsaturated fatty acids (PUFAs) play a central role in the normal development and functioning of the brain and central nervous system. Long-chain PUFAs (LC-PUFAs) such as eicosapentaenoic acid (EPA, C20:5omega-3), docosahexaenoic acid (DHA, C22:6omega-3) and arachidonic acid (AA, C20:4omega-6), in particular, are involved in numerous neuronal processes, ranging from effects on membrane fluidity to gene expression regulation. Deficiencies and imbalances of these nutrients, not only during the developmental phase but throughout the whole life span, have significant effects on brain function. Numerous observational studies have shown a link between childhood developmental disorders and omega-6:omega-3 fatty acid imbalances. For instance, neurocognitive disorders such as attention-deficit hyperactivity disorder (ADHD), dyslexia, dyspraxia and autism spectrum disorders are often associated with a relative lack of omega-3 fatty acids. In addition to a high omega-6 fatty acid intake and, in many cases, an insufficient supply of omega-3 fatty acids among the population, evidence is increasing to suggest that PUFA metabolism can be impaired in individuals with ADHD. In this context, PUFA imbalances are being discussed as potential risk factors for neurodevelopmental disorders. Another focus is whether the nutritive PUFA requirements-especially long-chain omega-3 fatty acid requirements-are higher among some individuals. Meanwhile, several controlled studies investigated the clinical benefits of LC-PUFA supplementation in affected children and adolescents, with occasionally conflicting results.

Dyslexia and developmental co-ordination disorder in further and higher education-similarities and differences. Does the 'label' influence the support given?

Developmental co-ordination disorder (DCD) is a developmental disorder affecting motor co-ordination. The Diagnostics Statistics Manual-IV classification for DCD describes difficulties across a range of activities of daily living, impacting on everyday skills and academic performance in school. Recent evidence has shown that difficulties persist into adulthood. As a consequence, increasing numbers of students are arriving at university and colleges in the UK with a diagnosis of DCD and requesting Disabled Students' Allowance (DSA) to gain support. This preliminary study examined a cohort of 115 students currently in further or higher education in order to compare and contrast similarities and differences in three subgroups: those with a diagnosis of DCD, a second group with DCD and dyslexia and a third group with dyslexia only. It examines how students were supported in the past and now as students. Additionally it identifies differences in reported strengths and difficulties. A higher percentage of those with dyslexia receive DSA. All students have similar types of support not dependent on their diagnosis. The DCD only group lives at home with parents more and has a significantly greater reported motor and executive functioning difficulty than the other two groups.

Co-occurrence of motor problems and autistic symptoms in attention-deficit/hyperactivity disorder

OBJECTIVE

To investigate the relation between parent reports of motor problems and clinically significant autistic symptoms in children with and without attention-deficit/hyperactivity disorder (ADHD).

METHOD

Subjects were male (n = 521) and female (n = 330) twins from an epidemiological study of ADHD, ages 7 to 19 years at assessment using the Child Behavior Checklist and semistructured psychiatric diagnostic interviews. Parent-rated Social Responsiveness Scale questionnaires were returned for 62% of 1,647 individuals who participated in interviews. After exclusion of subjects with incomplete data or evidence of mental retardation, 851 subjects (52%) were available for the present study analysis. Each subject was classified by DSM-IV ADHD subtype and assigned to one of seven population-defined ADHD subtypes based on latent class analysis of DSM-IV ADHD symptoms. Within each ADHD subtype, we examined the relation between Child Behavior Checklist motor problem endorsement and elevated autistic symptoms on the Social Responsiveness Scale.

RESULTS

Motor problems and high levels of autistic traits were most common in individuals with combined-type ADHD. Within each of the clinically relevant DSM-IV and latent class ADHD subtypes, individuals with the combination of motor problems and ADHD were more likely to have high levels of autistic traits than those with ADHD alone.

CONCLUSIONS

Children with the combination of ADHD and parent-reported motor coordination deficits have elevated levels of autistic symptoms. Targeted treatment and prevention interventions may be warranted. The exclusion criteria for DSM-IV ADHD should be revised to reflect these population-based findings.

Differences in Schoolwork Performance between Typically Developing Students and Students with Mild Disabilities

The purpose of this study was to examine whether students with mild disabilities differed from typically developing students in their ability to perform schoolwork tasks. The participants, selected from the School Assessment of Motor and Process Skills (School AMPS) database, comprised 175 students in each group. Their data were subjected to many-faceted Rasch analyses and then analyzed for statistically significant differences in mean school motor and school process abilities between groups. The relative and actual item difficulty calibration values were then compared to identify meaningful differences between groups. The results revealed a statistically significant mean difference in school motor and school process ability between groups (large effect sizes), essentially stable relative skill item hierarchies between groups, and actual hierarchies that differed such that some school motor and almost all school process skill items (occupational performance skills) were more difficult to perform for the mild disabilities group. The results of this study also provided evidence of validity for the use of the School AMPS measures to assist in identifying lower than expected schoolwork performance of students with mild disabilities.

Cooccurrence of problems in activity level, attention, psychosocial adjustment, reading and writing in children with developmental coordination disorder

The purpose of this paper was to investigate the cooccurrence of problems in activity level, attention, reading, writing and psychosocial adjustment of children with developmental coordination disorder (DCD). A parent-report questionnaire, the Developmental Coordination Disorder Questionnaire - Chinese version (DCDQ-C), was used to screen first to third graders from 13 mainstream schools in Taipei. Two standardized motor tests were then administered to those who scored below 10% on the DCDQ-C. Tests of activity level, attention, reading, writing and psychosocial adjustment were then administered to this sample. Thirty-eight children identified as DCD, 32 as suspect for DCD and 82 as normal comparison were included in the final sample. Multivariate analysis of variance comparing the three groups (DCD, suspect DCD, and comparison) revealed that both children with DCD and suspect for DCD obtained significantly poorer scores on measures of attention and reading, and were more hyperactive than comparison children. Children with DCD and suspect for DCD were also reported to have more internalizing and social problems than children without motor problems. No significant differences, however, were noted between children with different degree of motor coordination problems (categorized as DCD and suspect for DCD) on any measure. Furthermore, a high percentage of children in both the DCD and suspect groups fell in the clinical range of attention, activity level and psychosocial adjustment problems. The results revealed a high risk for these problems in nonreferred children with motor coordination problems. The high percentage of clinical range behavioral problems warrants attention of clinicians who work with children with motor coordination difficulties to the need to promote early identification and referral.

Depressive symptomatology in child and adolescent twins with attention-deficit hyperactivity disorder and/or developmental coordination disorder

Previous research has demonstrated a link between attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorder (DCD), and depression. The present study utilized a monozygotic (MZ) differences design to investigate differences in depressive symptomatology between MZ twins discordant for ADHD or DCD. This extends previous research as it controls for genetic effects and shared environmental influences and enables the investigation of nonshared environmental influences. In addition, children and adolescents with comorbid ADHD and DCD were compared on their level of depressive symptomatology to those with ADHD only, DCD only, and no ADHD or DCD. The parent-rated Strengths and Weaknesses of ADHD Symptoms and Normal Behavior, Developmental Coordination Disorder Questionnaire, and Sad Affect Scale were used to assess ADHD, DCD, and depressive symptomatology respectively. The results revealed higher levels of depressive symptomatology in MZ twins with ADHD or DCD compared to their nonaffected co-twins. In addition, children and adolescents with comorbid ADHD and DCD demonstrated higher levels of depressive symptomatology compared to those with ADHD only, DCD only, and no ADHD or DCD. The implications of these findings are discussed with emphasis on understanding and recognizing the relationship between ADHD, DCD, and depression in the assessment and intervention for children and adolescents with these disorders.

Developmental Coordination Disorder and Joint Hypermobility Syndrome--overlapping disorders? Implications for research and clinical practice

BACKGROUND

Joint Hypermobility Syndrome (JHS) and Developmental Coordination Disorder (DCD) are two childhood disorders usually identified separately. DCD is a heterogeneous condition with little known of the underlying aetiology of the disorder. This paper examines the potential overlap between DCD and JHS and examines children with DCD for symptoms which may be consistent with a diagnosis of JHS. Implications for research and clinical practice are considered.

METHODS

A questionnaire covering a range of symptoms consistent with a diagnosis of JHS and related autonomic nervous systemic symptoms was completed by parents from 27 children with DCD and compared with responses from parents of 27 typically developing children.

RESULTS

Children with DCD showed a significant difference from the group of typically developing children on questions regarding hypermobility, pain and autonomic nervous system symptoms, typifying JHS.

CONCLUSIONS

This study has shown a similarity in symptoms seen in some DCD children to those with a diagnosis of JHS. In addition, children are also presenting with multi-system symptomatology including those involving the autonomic nervous system. This study reinforces other recent work showing the reverse pattern of JHS children showing similar functional similarities to DCD children. This has implications for future research in DCD in order to understand the underlying aetiology of this complex disorder. In addition, it is important for clinicians to be aware of these findings in order to provide appropriate and tailored support and treatment for children presenting with differing patterns of co-ordination difficulties. Children with DCD and JHS may require appropriate podiatry as well as recognition of their symptoms of pain and how this may affect participation in physical activity.

Dyspraxia or developmental coordination disorder? Unravelling the enigma

Dyspraxia is an enigma to many people, both professional and lay alike--what is it, how does it relate to developmental coordination disorder and associated conditions, how common is it, how is it recognised and diagnosed and how should it be managed? This article attempts to unravel this enigma by: dealing with the terminology of coordination difficulties from the "clumsy child syndrome" through "dyspraxia" to "developmental coordination disorder (DCD)"; briefly examining the debate as to whether dyspraxia or DCD should be regarded as a medical or social disorder; discussing the differential diagnosis of dyspraxia or DCD; considering the assessment of children with dyspraxia or DCD; reviewing the range of current treatment approaches in the UK.

The effect of pre-employment factors on job control, job strain and psychological distress: a 31-year longitudinal study

This study examined the role of pre-employment factors, such as maternal antenatal depression, low birth weight, childhood socioeconomic position, early adolescence health risk behaviours and academic performance, in the relationship between work characteristics (low job control and high job demands, or job strain) and psychological distress at age 31. The data of 2062 women and 2231 men was derived from the prospective unselected population-based Northern Finland 1966 Birth Cohort study. Results of linear regression models showed that being female, father's low socioeconomic position, and poor academic achievement in adolescence were linked to low control and high job strain jobs at age 31, and that low control and high job strain were associated with psychological distress at age 31. Although having lower school grades, high absence rate from school, and moderate alcohol consumption at age 14 were significant predictors of psychological distress at age 31, the associations between job control, job strain and psychological distress remained after controlling for these and other pre-employment effects. As such, pre-employment factors do seem to link people to risky work environments, which in turn seem to relate strongly to psychological distress. However, the relationship between pre-employment factors and later psychological distress in adulthood is not completely explained by job environment.

Motor and gestural performance in children with autism spectrum disorders, developmental coordination disorder, and/or attention deficit hyperactivity disorder

Motor and gestural skills of children with autism spectrum disorders (ASD), developmental coordination disorder (DCD), and/or attention deficit hyperactivity disorder (ADHD) were investigated. A total of 49 children with ASD, 46 children with DCD, 38 children with DCD+ADHD, 27 children with ADHD, and 78 typically developing control children participated. Motor skills were assessed with the Bruininks-Oseretsky Test of Motor Proficiency Short Form, and gestural skills were assessed using a test that required children to produce meaningful gestures to command and imitation. Children with ASD, DCD, and DCD+ADHD were significantly impaired on motor coordination skills; however, only children with ASD showed a generalized impairment in gestural performance. Examination of types of gestural errors revealed that children with ASD made significantly more incorrect action and orientation errors to command, and significantly more orientation and distortion errors to imitation than children with DCD, DCD+ADHD, ADHD, and typically developing control children. These findings suggest that gestural impairments displayed by the children with ASD were not solely attributable to deficits in motor coordination skills.

A pilot study of psychopathology in Developmental Coordination Disorder

BACKGROUND

This paper explores the prevalence of emotional and behavioural disorders in children referred to a Community Paediatric Occupational Therapy service for assessment and treatment of problems with development of motor skills.

METHODS

Parents of 47 children from a clinical sample of children who had been identified with Developmental Coordination Disorder (DCD) returned the Strengths and Difficulties Questionnaire (SDQ)--a brief measure of the pro-social behaviour and psychopathology that can be completed by parents, teachers or youths.

RESULTS

Significant emotional and behavioural problems were reported by 29 parents (62%) with a further six (13%) reporting problems in the borderline range. Seven children (15%) were without significant problems in one or more area although only four of these (9%) were outside the borderline range for all of the sub-domains of the SDQ.

DISCUSSION

A significant proportion of children with DCD were reported by their parents to be at risk of psychopathology. Further research is needed to understand the relationship between motor difficulties and emotional and behavioural symptoms; however, it is recommended that interventions for children with DCD should support mental health and behavioural problems as well as motor development.

Fine motor skills in South African children with symptoms of ADHD: influence of subtype, gender, age, and hand dominance

BACKGROUND

Motor problems, often characterised as clumsiness or poor motor coordination, have been associated with ADHD in addition to the main symptom groups of inattention, impulsiveness, and overactivity. The problems addressed in this study were: (1) Are motor problems associated with ADHD symptoms, also in African cultures? (2) Are there differences in motor skills among the subtypes with ADHD symptoms? (3) Are there gender differences? (4) Is there an effect of age? (5) Are there differences in performance between the dominant and non-dominant hand?

METHOD

A total of 528 children (264 classified as having symptoms of ADHD and 264 matched comparisons) of both genders and from seven different South African ethnic groups participated in the study. They were assessed with three simple, easy to administer instruments which measure various functions of motor speed and eye-hand coordination: The Grooved Pegboard, the Maze Coordination Task, and the Finger Tapping Test. The results were analysed as a function of subtype, gender, age, and hand dominance.

RESULTS

The findings indicate that children with symptoms of ADHD performed significantly poorer on the Grooved Pegboard and Motor Coordination Task, but not on the Finger Tapping Test than their comparisons without ADHD symptoms. The impairment was most severe for the subtype with symptoms of ADHD-C (combined) and less severe for the subtypes with symptoms of ADHD-PI (predominantly inattentive) and ADHD-HI (predominantly hyperactive/impulsive). With few exceptions, both genders were equally affected while there were only slight differences in performance between the dominant and non-dominant hand. The deficiencies in motor control were mainly confined to the younger age group (6-9 yr).

CONCLUSION

An association between the symptoms of ADHD and motor problems was demonstrated in terms of accuracy and speed in fairly complex tasks, but not in simple motor tests of speed. This deficiency is found mainly in the children with ADHD-C symptoms, but also to a lesser degree in the children with symptoms of ADHD-PI and ADHD-HI.