Fine motor ability and psychiatric disorders in youth

Association between reported ADHD symptom and motor development delay in preschool children

Objective

To explore whether the motor developmental level is associated with the attention deficit/hyperactivity disorder (ADHD) symptoms severity reported by parents in preschool children.

Methods

Preschool children aged 4-6 years old with the chief complaint of reported inattention or hyperactivity by kindergarten teachers or parents were recruited in this study. All participants were consulted by at least one experienced developmental behavior pediatrician, according to DSM-V diagnostic criteria of ADHD. Their neuromotor developments were assessed by the Children's Neuropsychological and Behavior Scale and recorded as developmental quotient (DQ) score in gross motor, fine motor, and other domains. Regarding the evaluation of ADHD symptoms, parents of the 4-year-old group completed the Conners' Parent Symptom Questionnaire, while parents of the 5-year-old group completed The Vanderbilt ADHD Diagnostic Parent Rating Scale.

Results

A total of 137 preschool children aged 4-4.9 years (4-year-old group) and 252 were aged 5.0-5.9 years (5-year-old group) were included in the study. Children exhibiting ADHD symptoms were at a much higher risk of fine motor delays compared to gross motor delays, particularly among the younger age group. Correlation analysis and hierarchical regression showed that in the 4-year-old ADHD group, better gross motor development was associated with increased severity of parent-reported ADHD symptoms. In the 5-year-old ADHD group, poorer fine motor development was linked to higher ADHD symptom severity. For children who do not meet ADHD diagnostic criteria, no significant correlations were found between gross or fine motor developmental quotients (DQ) and the severity of ADHD symptoms.

Conclusions

Preschool children exhibiting ADHD symptoms are at a notable high risk of fine motor delays. Motor development in preschool children who meet ADHD diagnostic criteria is related to the severity of their symptoms. It is important to monitor both fine and gross motor development in preschool children with ADHD.

Boys with attention-deficit/hyperactivity disorder perform wider and fewer finger tapping than typically developing boys - Peer comparisons and the effects of methylphenidate from an exploratory perspective

AIM

This study aimed to investigate the differences in fine motor and coordination skills between boys with attention-deficit/hyperactivity disorder (ADHD) and typically developing (TD) boys and the effect of methylphenidate (MPH) in boys with ADHD.

METHODS

Fourteen boys aged 7-12 years who were diagnosed with ADHD and previously treated with MPH were instructed to tap their thumbs and index fingers together repetitively for 10 s after attaching magnetic sensors. The participants executed "in-phase" and "anti-phase" tapping. A two-way analysis of variance for comparing boys with ADHD and TD boys and the paired t-test to investigate the effect of MPH between sessions with and without MPH were performed.

RESULTS

Boys with ADHD showed a significantly lower "number of taps" and a significantly higher "average of local maximum distance" than TD boys. "Energy balance" was significantly lower in ADHD boys than in TD boys. MPH caused a significant difference in the "standard deviation (SD) of phase difference" in "anti-phase tapping."

CONCLUSION

Our studies indicated that finger-tapping movements in boys with ADHD tended to be significantly wider and fewer than those in TD boys, and MPH may improve the phase difference of bimanual fine motor coordination skills in boys with ADHD who are above 1.0 SD. The results should be interpreted with caution because we conducted statistical tests for many outcomes and groups without considering the multiplicity factor from an exploratory perspective.

Transdiagnostic symptom subtypes across autism spectrum disorders and attention deficit hyperactivity disorder: validated by measures of neurocognition and structural connectivity

BACKGROUNDS

Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are neurodevelopmental disorders that exhibit within-disorder heterogeneity and cross-disorder phenotypic overlap, thus suggesting that the current disease categories may not fully represent the etiologic essence of the disorders, especially for highly comorbid neurodevelopmental disorders. In this study, we explored the subtypes of a combined sample of ASD and ADHD by integrating measurements of behavior, cognition and brain imaging.

METHODS

A total of 164 participants, including 65 with ASD, 47 with ADHD, and 52 controls, were recruited. Unsupervised machine learning with an agglomerative hierarchical clustering algorithm was used to identify transdiagnostic symptom clusters. Neurocognition and brain structural connectivity measurements were used to assess symptom clusters. Mediation analysis was used to explore the relationship between transdiagnostic symptoms, neurocognition and brain structural connectivity.

RESULTS

We identified three symptom clusters that did not fall within the diagnostic boundaries of DSM. External measurements from neurocognition and neuroimaging domains supported distinct profiles, including fine motor function, verbal fluency, and structural connectivity in the corpus callosum between these symptom clusters, highlighting possible biomarkers for ASD and ADHD. Additionally, fine motor function was shown to mediate the relationship between the corpus callosum and perseveration symptoms.

CONCLUSIONS

In this transdiagnostic study on ASD and ADHD, we identified three subtypes showing meaningful associations between symptoms, neurocognition and brain white matter structural connectivity. The fine motor function and structural connectivity of corpus callosum might be used as biomarkers for neurodevelopmental disorders with social skill symptoms. The results of this study highlighted the importance of precise phenotyping and further supported the effects of fine motor intervention on ASD and ADHD.

Missing the forest for the trees? A high rate of motor and language impairments in Disruptive Mood Dysregulation Disorder in a chart review of inpatient adolescents

Youths with severe and persistent irritability have a particularly high rate of school failures and learning difficulties. The aim of this study was to determine whether inpatient adolescents with Disruptive Mood Dysregulation Disorder (DMDD) have more motor and/or language impairments compared to patients with other psychiatric disorders. A retrospective chart review of all consecutive cases admitted in two adolescent inpatient units between January 2017 and December 2018 was conducted (N = 191). All patients received multi-disciplinary clinical and developmental assessments. For a subtest of subjects, additional standardized tests were used to document motor and language impairments. In this clinical chart 53 adolescents with a DMDD (mean age 13.6 ± 1.5, min 12, max 16, 70% males) were compared to patients with a major depressive disorder (MDD, n = 64, mean age 15.3 ± 1.6, 52% males) and patients with a non-mood disorder (NMD, n = 61, mean age 14.4 ± 1.55, 59% males). Among inpatients with DMDD, 71% had an associated motor and/or language disorder, with combined forms in around two-thirds of cases. Compared to youths with MDD, participants with DMDD were more likely to have an associated developmental coordination disorder (67% vs. 22%, OR = 4.7) and a written language disorder (35% vs. 10%, OR = 4.6). While 31% of inpatients with DMDD had an associated communication/oral language disorder, this rate was not statistically different from those observed in the MDD group (11%, OR = 3.2). The frequencies of motor and language impairments were not statistically different between participants in the DMDD group and in the NMD group. The high rate of motor and written language disorders found in DMDD patients may partly account for their academic difficulties. Such finding, if confirmed, supports systematic screening of motor and written language impairments in youths with chronic irritability and suggests remediation potential.

How can schools be integrated in promoting well-being, preventing mental health problems and averting substance-use disorders in urban populations?

PURPOSE OF REVIEW

Mental health and substance use problems are among the most prevalent and challenging problems faced by both high-income and low-income countries worldwide. This review will focus on summarizing scattered evidence of school-based interventions to promote well-being and prevent mental health problems and substance use disorders in children and adolescents.

RECENT FINDINGS

We focus on two main areas of research: promotion of healthy school climate and prevention of bullying. Choosing among available interventions might be challenging, both because of the difficulties in assessing their efficacy and tailoring interventions to specific needs, but also because of the scarcity of intervention in low-resource settings. We provide some guidance on principles encompassed by the available evidence that can be used for policymakers and local communities aiming to integrate mental health promotion and prevention into their schools.

SUMMARY

Developing, implementing, scaling and sustaining school-based interventions is a necessity of our field if we want to move closer to sustainable development goals.