Juliana B. Goulardins

Attention deficit hyperactivity disorder and developmental coordination disorder: Two separate disorders or do they share a common etiology.

Attention deficit hyperactivity disorder (ADHD) has been described as the most prevalent behavioral disorder in children. Developmental coordination disorder (DCD) is one of the most prevalent childhood movement disorders. The overlap between the two conditions is estimated to be around 50%, with both substantially interfering with functioning and development, and leading to poorer psychosocial outcomes. This review provides an overview of the relationship between ADHD and DCD, discussing the common presenting features, etiology, neural basis, as well as associated deficits in motor functioning, attention and executive functioning. It is currently unclear which specific motor and cognitive difficulties are intrinsic to each disorder as many studies of ADHD have not been screened for DCD and vice-versa. The evidence supporting common brain underpinnings is still very limited, but studies using well defined samples have pointed to non-shared underpinnings for ADHD and DCD. The current paper suggests that ADHD and DCD are separate disorders that may require different treatment approaches.

Attention Deficit Hyperactivity Disorder and Motor Impairment: A Critical Review

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder during childhood, affecting approximately 3–6% of school-aged children; its cardinal symptoms of high activity, impulsivity, and behavioral distractibility might be assumed to have close relationships to interferences with motor skills. A separate body of literature attests to ways that motor problems can severely impact children’s daily lives, as motor problems may occur in 30–50% of children with ADHD. This article critically reviews research on motor impairment in children with ADHD, notable differences in motor performance of individuals with ADHD compared with age-matched controls, and possible neural underpinnings of this impairment. We discuss the highly prevalent link between ADHD and developmental coordination disorder (DCD) and the lack of a clear research consensus about motor difficulties in ADHD. Despite increasing evidence and diagnostic classifications that define DCD by motor impairment, the role of ADHD symptoms in DCD has not been delineated. Similarly, while ADHD may predispose children to motor problems, it is unclear whether any such motor difficulties observed in this population are inherent to ADHD or are mediated by comorbid DCD. Future research should address the exact nature and long-term consequences of motor impairment in children with ADHD and elucidate effective treatment strategies for these disorders together and apart.

Motor development of children with attention deficit hyperactivity disorder

OBJECTIVE To compare both global and specific domains of motor development of children with attention deficit hyperactivity disorder (ADHD) with that of typically developing children. METHODS Two hundred children (50 children with clinical diagnoses of ADHD, according to the DSM-IV-TR and 150 typically developing controls), aged 5 to 10 years, participated in this cross-sectional study. The Motor Development Scale was used to assess fine and global motricity, balance, body schema, and spatial and temporal organization. RESULTS Between-group testing revealed statistically significant differences between the ADHD and control groups for all domains. The results also revealed a deficit of nearly two years in the motor development of children with ADHD compared with the normative sample. CONCLUSION The current study shows that ADHD is associated with a delay in motor development when compared to typically developing children. The results also suggested difficulties in certain motor areas for those with ADHD. These results may point to plausible mechanisms underlying the relationship between ADHD and motor difficulties.

Health-related physical fitness children with severe and moderate developmental coordination disorder

The present study aims to examine physical fitness among children with developmental coordination disorder (DCD) with varying degrees of severity (moderate and severe - mDCD, sDCD), and a group of children without DCD (wDCD), in the city of Manaus, Brazil. Initially, 180 children aged 6-10 years old participated in this study. After being diagnosed according to the DSM-IV-TR, 63 children were then divided into three groups (21 in each group). Health-related physical fitness was measured by means of the Fitnessgram, which included several core components, namely, body composition, muscle strength and endurance, flexibility, and cardiorespiratory resistance. The results showed no statistically significant differences between both groups in any of the assessed components. However, when analyzing the results of each component according to the criteria of the Fitnessgram, we observed that, regardless of the classification group, less than half of the children achieved scores that, according to the motor tests, would classify them as having a healthy fitness. Children with sDCD, mDCD and wDCD presented similar levels of health-related physical fitness, with an unsatisfactory performance for the component strength and muscular endurance. We therefore emphasize the importance of further research in this area, more particularly when it comes to following the development of motor skills and physical fitness in children with DCD, as well as the observation of the interactions between these variables over time.

The Relationship Between Motor Skills, Social Problems, and ADHD Symptomatology: Does It Vary According to Parent and Teacher Report?:

Objective: This study investigated the relationship between motor performance; attentional, hyperactive, and impulsive symptoms; and social problems. Correlations between parents’ versus teachers’ ratings of social problems and ADHD symptomatology were also examined. Method: A total of 129 children aged 9 to 12 years were included. ADHD symptoms and social problems were identified based on Conners’ Rating Scales–Revised: L, and the McCarron Assessment of Neuromuscular Development was used to assess motor skills. Results: After controlling for ADHD symptomatology, motor skills remained a significant predictor of social problems in the teacher model but not in the parent model. After controlling for motor skills, inattentive (not hyperactive-impulsive) symptoms were a significant predictor of social problems in the parent model, whereas hyperactive-impulsive (not inattentive) symptoms were a significant predictor of social problems in the teacher model. Conclusion: The findings suggested that intervention strategies should consider the interaction between symptoms and environmental contexts.

The relationship between motor skills, ADHD symptoms, and childhood body weight

BACKGROUND Research has suggested an important association between motor proficiency and overweight/obesity. Many children with motor difficulties experience ADHD symptoms which have also been linked with overweight/obesity. Previous research has not considered both ADHD and motor performance when investigating their relationship with overweight/obesity. AIMS To investigate the relationships between motor performance, ADHD symptoms, and overweight/obesity in children. METHODS AND PROCEDURES A cross-sectional study was conducted involving189 children aged six to 10 years. Symptoms of ADHD were identified using the SNAP-IV rating scale. Motor impairment (MI) was identified using the Movement Battery Assessment for Children-2. Body composition was estimated from the Body Mass Index (BMI) based on World Health Organization child growth standards. OUTCOMES AND RESULTS Balance was the only motor skill associated with BMI even after controlling for gender and ADHD. Group comparisons revealed that the proportion of overweight ADHD children was significantly less than the proportion of overweight control children and overweight MI children; the proportion of underweight ADHD children was significantly greater than the proportion of underweight MI children. CONCLUSIONS AND IMPLICATIONS The results highlight the importance of taking into consideration both ADHD symptoms and motor difficulties in the assessment and intervention of physical health outcomes in children with ADHD and/or movement problems.

Does ‘ Animal Fun ’ improve aiming and catching, and balance skills in young children?

AIM The Animal Fun program, a universal early intervention program that aims to promote the motor skills and social-emotional development of young children, has shown to improve overall motor proficiency and social and behavioural outcomes. The aim of the current study was to evaluate the programs impact on childrens aiming and catching, and balance skills. METHODS A cluster randomised control trial was employed, with six intervention and six control (following normal curriculum) schools. A total sample of 511 children (257 boys and 254 girls), aged 4-6 years presented at pre-test. Children were tested across three time points, pre-test, post intervention (six months later) and follow-up (18 months after pre-test), using the Movement Assessment Battery for Children-2 Aiming and Catching, and Balance tasks. The study also tested for potential moderators including pre-test motor proficiency, age, gender, and cognitive performance. RESULTS Participation in Animal Fun improved childrens one leg balance at post-test and follow-up compared to control children, regardless of pre-test motor proficiency, age, gender, or pre-test cognitive performance. Participation in Animal Fun also improved throwing skills for those children with poorer motor proficiency compared to the controls with poorer motor performance. Interestingly, it was found that the control groups catching skills improved more than the intervention group at follow up. CONCLUSIONS The study provides some promising results regarding the efficacy of the Animal Fun program in improving one-leg balance for all children, and throwing skills for those children with poorer motor proficiency, while also suggesting potential confounding factors, such as maturational issues and other individual factors (e.g., a childs participation in extracurricular activity).

Nocturnal Enuresis Treatment: New Perspectives

Nocturnal enuresis (NE) is a very frequent problem, characterized by involuntary urination during sleep in individuals aged five years or more, after exclusion of organic causes. This set of associated symptoms may lead to deterioration of bladder function, upper urinary tract and, in extreme cases, even renal failure. The prevalence of voiding dysfunctions is as high as 10% of the worlds pediatric population. This commentary discusses the etiology and pathophysiology, and current approaches to therapeutic management of NE. Different studies have shown associations with genetic predisposition, hormonal and metabolic factors, and central nervous system maturation delay. The major pathogenetic mechanisms include nocturnal polyuria, detrusor over activity, and disturbed sleep. Psychologic and behavioral abnormalities seem to be a result, rather than a cause, of NE. We highlight the need for this condition not to be understood as an isolated phenomenon but as a combination of several possible factors in a particular child. Bedwetting is only part of a complex set of changes in children’s lives, which leads to important functional impairments and psychosocial disorders, often ignored by the family and even by the health professionals. The scenario of associated disorders demonstrates the need for a comprehensive approach.