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Goulardins JB, Nascimento RO, Casella EB, Silva MA, Piek J, Matos MA, de Oliveira JA. Do Children with Co-Occurring ADHD and DCD Differ in Motor Performance? J Mot Behav 2024:1-11. [PMID: 38811009 DOI: 10.1080/00222895.2024.2361103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 05/23/2024] [Indexed: 05/31/2024]
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inappropriate levels of activity, impulsivity, and inattention. Developmental Coordination Disorder (DCD) is a condition involving challenges in acquiring and executing motor skills. This cross-sectional study aimed to distinguish motor symptoms between ADHD and ADHD/DCD. A total of 283 children from two elementary schools underwent screening, leading to the identification of 27 children with ADHD. The assessment encompassed the Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV), the Movement Assessment Battery for Children (MABC-2), and the Motor Development Scale (MDS). The groups consisted of ADHD (14) and ADHD/DCD (13). Statistical analysis revealed significant differences in general motor age means between groups (p = 0.016), indicating inferior performance in the ADHD/DCD group. The coexistence of DCD significantly influenced the motor performance of children with ADHD, particularly in fine motor skills (p = 0.018) and balance (p = 0.033). Both groups exhibited mild to moderate risk of motor development delay. It is suggested that ADHD is associated with motor problems, even when DCD is not co-occurring. Specific domain-based analysis could demonstrate how the co-occurrence with DCD affects the motor performance of children with ADHD, with statistically significant differences observed in fine motor skills and balance.
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Affiliation(s)
| | - Roseane Oliveira Nascimento
- Instituto de Ciências Sociais, Educação e Zootecnia, da Universidade Federal do Amazonas, Parintins, Amazonas, Brazil
| | - Erasmo Barbante Casella
- Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Jan Piek
- School of Psychology, Curtin University, Perth, Western Australia, Australia
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Puyjarinet F, Chaix Y, Biotteau M. Is There a Deficit in Product and Process of Handwriting in Children with Attention Deficit Hyperactivity Disorder? A Systematic Review and Recommendations for Future Research. CHILDREN (BASEL, SWITZERLAND) 2023; 11:31. [PMID: 38255345 PMCID: PMC10813961 DOI: 10.3390/children11010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024]
Abstract
Handwriting abnormalities in children with attention deficit hyperactivity disorder (ADHD) have sometimes been reported both (i) at the product level (i.e., quality/legibility of the written trace and speed of writing) and (ii) at the process level (i.e., dynamic and kinematic features, such as on-paper and in-air durations, pen pressure and velocity peaks, etc.). Conversely, other works have failed to reveal any differences between ADHD and typically developing children. The question of the presence and nature of handwriting deficits in ADHD remains open and merits an in-depth examination. The aim of this systematic review was, therefore, to identify studies that have investigated the product and/or process of handwriting in children with ADHD compared to typically developing individuals. This review was conducted and reported in accordance with the PRISMA statement. A literature search was carried out using three electronic databases. The methodological quality of the studies was systematically assessed using the Critical Appraisal Skills Program (CASP) criteria. Twenty-one articles were identified. Of these, 17 described handwriting quality/legibility, 12 focused on speed and 14 analyzed the handwriting process. All the studies (100%) with satisfactory methodology procedures reported an impaired product and process in children with ADHD, while 25% evidenced a difference in the speed of production. Most importantly, the studies differed widely in their methodological approaches. Substantial gaps remain, particularly with regard to ascertaining comorbidities, ADHD subtypes and the medical status of the included children. The lack of overall homogeneity in the samples calls for higher quality studies. We conclude with recommendations for further studies.
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Affiliation(s)
- Frédéric Puyjarinet
- Montpellier Psychomotor Training Institute, UFR de Medicine Montpellier-Nîmes, University of Montpellier, 34090 Montpellier, France
| | - Yves Chaix
- Pediatric Neurology Unit, Children’s Hospital, Toulouse University Hospital Center, 31059 Toulouse, France;
- Toulouse NeuroImaging Center (ToNIC), University of Toulouse, INSERM, 31024 Toulouse, France
| | - Maëlle Biotteau
- Pediatric Neurology Unit, Children’s Hospital, Toulouse University Hospital Center, 31059 Toulouse, France;
- Toulouse NeuroImaging Center (ToNIC), University of Toulouse, INSERM, 31024 Toulouse, France
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3
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Broletti MC, Efthymiou C, Murray AL, McDougal E, Rhodes SM. Investigating the Mediating Role of Executive Function in the Relationship Between ADHD and DCD Symptoms and Depression in Adults. J Autism Dev Disord 2023:10.1007/s10803-023-06148-7. [PMID: 37966535 DOI: 10.1007/s10803-023-06148-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2023] [Indexed: 11/16/2023]
Abstract
This study was designed to test the effects of Attention Deficit Hyperactivity Disorder (ADHD) and Developmental Co-ordination Disorder (DCD) on depression levels and investigate the mediating role of executive function (EF) in adults. Adults with ADHD, DCD, and ADHD + DCD (N = 139) completed self-report measures of ADHD, DCD, depression, and EF. There were distinct profiles of EF across diagnostic groups, and higher depression symptoms in adults with ADHD + DCD than DCD alone. All EF domains were predicted by ADHD symptoms, and several by DCD symptoms. ADHD and DCD symptoms, and most EF domains, predicted depression symptoms. Overall EF difficulties fully mediated the relationships between ADHD/DCD and depression symptoms. Several specific EF domains relating to behavioural regulation and metacognition also showed full/partial mediating effects. The mediating role of EF difficulties between these neurodevelopmental conditions and depression symptoms has implications for their understanding and treatment, suggesting that targeting EF may be important for preventing co-occurring depression.
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Affiliation(s)
- Maria C Broletti
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | | | | | - Emily McDougal
- Child Life and Health/Centre for Clinical Brain Sciences, University of Edinburgh, Royal Hospital for Children and Young People, Edinburgh, EH16 4TS, UK
- Evidence Based Practice Unit, Anna Freud and University College London, London, UK
| | - Sinéad M Rhodes
- Child Life and Health/Centre for Clinical Brain Sciences, University of Edinburgh, Royal Hospital for Children and Young People, Edinburgh, EH16 4TS, UK.
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Lelong M, Zysset A, Nievergelt M, Luder R, Götz U, Schulze C, Wieber F. How effective is fine motor training in children with ADHD? A scoping review. BMC Pediatr 2021; 21:490. [PMID: 34736439 PMCID: PMC8567617 DOI: 10.1186/s12887-021-02916-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/11/2021] [Indexed: 11/30/2022] Open
Abstract
Background Motor deficiencies are observed in a large number of children with ADHD. Especially fine motor impairments can lead to academic underachievement, low self-esteem and frustration in affected children. Despite these far-reaching consequences, fine motor deficiencies have remained widely undertreated in the ADHD population. The aim of this review was to systematically map the evidence on existing training programs for remediating fine motor impairments in children with ADHD and to assess their effectiveness. Methods The scoping review followed the PRISMA-ScR guidelines. In March 2020, PsycINFO, MEDLINE (PubMed), Web of Science, Google Scholar and The Cochrane Database of Systematic Reviews were searched for evidence. The eligibility criteria and the data charting process followed the PICO framework, complemented by study design. The investigated population included children with a formal ADHD diagnosis (either subtype) or elevated ADHD symptoms aged between 4 and 12 years, both on and off medication. All training interventions aiming at improving fine motor skills, having a fine motor component or fine motor improvements as a secondary outcome were assessed for eligibility; no comparators were specified. Results Twelve articles were included in the final report, comprising observational and experimental studies as well as a review. Both offline and online or virtual training interventions were reported, often accompanied by physical activity and supplemented by training sessions at home. The training programs varied in length and intensity, but generally comprised several weeks and single or multiple training sessions per week. All interventions including more than one session were effective in the treatment of fine motor deficiencies in children with ADHD and had a wide range of additional positive outcomes. The effects could be maintained at follow-up. Conclusions Fine motor training in children with ADHD can be very effective and multiple approaches including specific fine motor and cognitive training components, some kind of physical activity, feedback mechanisms, or multimodal treatments can be successful. Training programs need to be tailored to the specific characteristics of the ADHD population. A mHealth approach using serious games could be promising in this context due to its strong motivational components. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02916-5.
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Affiliation(s)
| | - Annina Zysset
- School of Health Professions, Institute of Health Science, Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland
| | - Mirjam Nievergelt
- Zurich University of Teacher Education, Centre for Inclusion and Health in Schools, Zuerich, Switzerland
| | - Reto Luder
- Zurich University of Teacher Education, Centre for Inclusion and Health in Schools, Zuerich, Switzerland
| | - Ulrich Götz
- Zurich University of the Arts, Institute for Design Research, Zuerich, Switzerland
| | - Christina Schulze
- School of Health Professions, Institute of Occupational Therapy, Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland
| | - Frank Wieber
- School of Health Professions, Institute of Health Science, Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland. .,Department of Psychology, University of Konstanz, Konstanz, Germany.
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Hadar Y, Hocherman S, Lamm O, Tirosh E. The Visuo-Motor Attention Test in Boys with Attention Deficit Hyperactivity Disorder (ADHD): Methylphenidate-Placebo Randomized Controlled Trial. Child Psychiatry Hum Dev 2021; 52:96-103. [PMID: 32342235 DOI: 10.1007/s10578-020-00993-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To assess the visuomotor attention ability in children with ADHD and controls and their response to placebo and Methylphenidate (MPH) treatment. 36 boys with ADHD and 36 age matched typical controls were administered the visuomotor attention test (VMAT) as a baseline and following a week of MPH(IR) or placebo administered to the study group, in a randomized crossover design. A significant difference between the study and control groups was found on several VMAT measures. No performance difference between ADHD dimensional sub-types was observed at the baseline assessment. Under MPH treatment a significant improvement in VMAT measures was observed and particularly in the combined and predominantly hyperactive (C\HI) type. The VMAT results obtained in the present study are consistent with previous findings. ADHD subtypes appear similarly short of visuomotor attention resources; a visuomotor test can be used in the assessment of gains derived from MPH treatment.
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Affiliation(s)
- Yaffa Hadar
- Department of Special Education, Faculty of Education, Haifa University, Haifa, Israel.
| | - Shraga Hocherman
- The Rappaport Family Faculty of Medicine, Israel Institute of Technology, The Technion, Haifa, Israel
| | - Oren Lamm
- Department of Special Education, Faculty of Education, Haifa University, Haifa, Israel
| | - Emanuel Tirosh
- The Rappaport Family Faculty of Medicine, Israel Institute of Technology, The Technion, Haifa, Israel.,The Hannah Khoushy Child Development Center, Bnei Zion Medical Center, Haifa, Israel
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Chatthong W, Khemthong S, Wongsawat Y. Neuropsychological classification based on brain mapping performance in Thai children with and without ADHD. APPLIED NEUROPSYCHOLOGY-CHILD 2020; 11:18-24. [PMID: 32078777 DOI: 10.1080/21622965.2020.1729155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study investigated the cognitive strengths and weaknesses of Attention Deficit Hyperactivity Disorder (ADHD) patients by using quantitative electroencephalography (QEEG) to analyze brain mapping outcomes in relation to neuropsychological assessments. A total of 305 participants with and without ADHD were recruited. The theta relative power of QEEG was analyzed using stepwise multiple regression, and twelve scalp regions were compared between groups using independent t-tests. Increased power was found at the T5 scalp region in the ADHD group and at the F4 region in the non-ADHD group. Decreased power was found at the F7 region in the ADHD group and at the F3 region in the non-ADHD group. Six of the twelve brain locations had significantly higher theta relative power in the ADHD group than in the non-ADHD group. These brain mapping outcomes can be easily translated to neuropsychological functions, such as attention, executive function, memory, spatial ability, and language, to better understand or predict the potential behavior of ADHD patients.
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Affiliation(s)
- Winai Chatthong
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Salaya, Thailand
| | - Supalak Khemthong
- Division of Occupational Therapy, Faculty of Physical Therapy, Mahidol University, Salaya, Thailand
| | - Yodchanan Wongsawat
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Salaya, Thailand
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Athanasiadou A, Buitelaar JK, Brovedani P, Chorna O, Fulceri F, Guzzetta A, Scattoni ML. Early motor signs of attention-deficit hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 2020; 29:903-916. [PMID: 30798414 PMCID: PMC7321902 DOI: 10.1007/s00787-019-01298-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 02/18/2019] [Indexed: 11/24/2022]
Abstract
ADHD is a common neurodevelopmental disorder with onset of symptoms typically in early childhood. First signs of the disorder, including language delay, motor delay and temperament characteristics, may be evident as early as infancy. The present review describes published evidence about early motor signs of either children with later symptoms of ADHD or a later diagnosis of the disorder. Nine published cohort studies were included after a systematic search of related terms in PubMed and PsycInfo databases. Study eligibility criteria included: (1) report on early motor function or any motor-related signs; (2) the presence of a participants' assessment by/at 12 months of age; (3) report of a later presence of ADHD symptoms. The limited number of reports included suggests an association between mild early neurological markers and later developmental coordination disorder and motor overflow movements. Unfortunately, due to their small sample sizes and focus on group reports rather than individuals, they have limited power to find strong associations. Early motor indicators of ADHD, if present, appear to be non-specific, and therefore not yet useful in clinical screening. Spontaneous motility seems to be a promising measure for early ADHD detection, although further studies with large cohorts are recommended to determine its clinical role in children at risk for ADHD.
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Affiliation(s)
- A. Athanasiadou
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - J. K. Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands ,Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
| | - P. Brovedani
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa Italy
| | - O. Chorna
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa Italy
| | - F. Fulceri
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - A. Guzzetta
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa Italy
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Fenollar-Cortés J, Gallego-Martínez A, Fuentes LJ. The role of inattention and hyperactivity/impulsivity in the fine motor coordination in children with ADHD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 69:77-84. [PMID: 28829996 DOI: 10.1016/j.ridd.2017.08.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 07/27/2017] [Accepted: 08/10/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Deficits in fine motor coordination have been suggested to be associated with Attention-Deficit/Hyperactivity Disorder (ADHD). However, despite the negative impact of poor fine motor skills on academic achievement, researchers have paid little attention to this problem. The aim of this study was to explore the relationship between ADHD dimensions and fine motor performance. METHOD Participants were 43 children with a diagnosis of ADHD aged between 7 and 14 years (M=9.61; 81% male) and 42 typically developing (TP) children in the same age range (M=10.76; 75.2% male). RESULTS Children with ADHD performed worse than TP on all tasks (δFine_motor_tasks, -0.19 to -0.44). After controlling for age and ADHD-HY (hyperactivity/impulsivity), higher scores on ADHD-IN (inattentiveness) predicted a larger number of mistakes among all psychomotricity tasks and conditions (β 0.39-0.58, ps<0.05). CONCLUSION The ADHD group showed poorer fine motor performance than controls across all fine motor coordination tasks. However, lower performance (more mistakes), was related to the inattention dimension but not to the hyperactivity/impulsivity dimensions. Authors recommend including training and enhancement of the fine motor skills for more comprehensive ADHD treatment.
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Affiliation(s)
- Javier Fenollar-Cortés
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Murcia, Murcia, Spain.
| | | | - Luis J Fuentes
- Departamento de Psicología Básica y Metodología, Universidad de Murcia, Murcia, Spain
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9
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Goulardins JB, Marques JCB, De Oliveira JA. Attention Deficit Hyperactivity Disorder and Motor Impairment. Percept Mot Skills 2017; 124:425-440. [DOI: 10.1177/0031512517690607] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Juliana B. Goulardins
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Juliana C. B. Marques
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Jorge A. De Oliveira
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Kaiser ML, Schoemaker MM, Albaret JM, Geuze RH. What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? Systematic review of the literature. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:338-357. [PMID: 25462494 DOI: 10.1016/j.ridd.2014.09.023] [Citation(s) in RCA: 192] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 09/08/2014] [Accepted: 09/10/2014] [Indexed: 05/16/2023]
Abstract
This article presents a review of the studies that have analysed the motor skills of ADHD children without medication and the influence of medication on their motor skills. The following two questions guided the study: What is the evidence of impairment of motor skills and aspects of motor control among children with ADHD aged between 6 and 16 years? What are the effects of ADHD medication on motor skills and motor control? The following keywords were introduced in the main databases: attention disorder and/or ADHD, motor skills and/or handwriting, children, medication. Of the 45 articles retrieved, 30 described motor skills of children with ADHD and 15 articles analysed the influence of ADHD medication on motor skills and motor control. More than half of the children with ADHD have difficulties with gross and fine motor skills. The children with ADHD inattentive subtype seem to present more impairment of fine motor skills, slow reaction time, and online motor control during complex tasks. The proportion of children with ADHD who improved their motor skills to the normal range by using medication varied from 28% to 67% between studies. The children who still show motor deficit while on medication might meet the diagnostic criteria of developmental coordination disorder (DCD). It is important to assess motor skills among children with ADHD because of the risk of reduced participation in activities of daily living that require motor coordination and attention.
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Affiliation(s)
- M-L Kaiser
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands; University Hospital of Lausanne, Pierre-Decker 5, 1011 Lausanne, Switzerland.
| | - M M Schoemaker
- University of Groningen, University Medical Center Groningen, Centre for Human Movement Science, PO Box 30,001, 9700 RB Groningen, The Netherlands
| | - J-M Albaret
- University of Toulouse III - Paul Sabatier, PRISSMH-EA4561, 118 Route de Narbonne, F-31062 Toulouse Cedex 9, France
| | - R H Geuze
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
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