Efficacy of a Structured Home Program to Improve Motor Coordination in Elementary School Children with Attention Deficit/Hyperactivity Disorder
Objectives : To evaluate whether the motor coordinate rehabilitation structural home program affected motor incoordination and attention-deficit/hyperactivity symptoms in elementary school children with attention-deficit/hyperactivity disorder.
Methods : The study was a one-group pretest-posttest experimental design. Seven children (n=7) who had been diagnosed with attention/deficit hyperactivity disorder (ADHD) with motor coordination problems at childhood and adolescent psychiatric outpatient department at Maharaj Nakorn Chiang Mai Hospital in 2016-2018 agreed to participate in the three-month motor coordinated rehabilitation structured activities home program. Each participant was assessed before and after the intervention using measures of ADHD symptoms and motor proficiency to evaluate the efficacy of interventions. ADHD symptoms were evaluated by the Swanson, Nolan, and Pelham IV questionnaire-short form (SNAP-IV) Thai version, and the motor proficiency was evaluated by the Bruininks-Oseretsky test of motor proficiency-second edition (BOT-2). The effects of interventions were analyzed using the Wilcoxon signed ranks test by the SPSS software version 26.
Results : Five of seven participants completed the interventions. All participants who followed the 12-week intervention period had clinical improvement in motor proficiency in the aspects of fine motor precision, fine motor integration, and manual dexterity after the training. However, there was no statistically significant difference between the pre-intervention and the post-intervention score on BOT-2 (p>0.05). No significant difference was found in ADHD symptoms
Conclusion : Structure activities home program may have benefits to clinical improvement on fine manual control and manual coordination in children with ADHD and motor coordination problems. Due to no statistically significant outcomes, further investigation is needed to determine the effect of the structured home program in a more intensive regimen. Keywords : motor coordination, attention deficit hyperactivity disorder, children
Polanczyk G, de Lima M, Horta B, Biederman J, Rohde L. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007; 164(6): 942-948.
Willcutt E. The prevalence of DSM-IV attentiondeficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics 2012; 9(3): 490-499.
Peasgood T, Bhardwaj A, Biggs K, Brazier J, Coghill D, Cooper C, et al. The impact of ADHD on the health and well-being of ADHD children and their siblings. Eur Child Adolesc Psychiatry 2016; 25(11): 1217-31.
Caci H, Doepfner M, Asherson P, Donfrancesco R, Faraone S, Hervas A, et al. Daily life impairments associated with self-reported childhood/adolescent attention-deficit/ hyperactivity disorder and experiences of diagnosis and treatment: results from the European Lifetime Impairment Survey. Eur Psychiatry 2014; 29(5): 316-23.
Nasol E, Lindly O, Chavez A, Zuckerman K. Unmet need and financial impact disparities for US children with ADHD. Acad Pediatr 2019; 19(3): 315-324. 6. Fleck K, Jacob C, Philipsen A, Matthies S, Graf E, Hennighausen K, et al. Child impact on family functioning: a multivariate analysis in multiplex families with children and mothers both affected by attention-deficit/hyperactivity disorder (ADHD). ADHD Atten Def Hyp Disord 2015; 7(3): 211-223.
Le H, Hodgkins P, Postma M, Kahle J, Sikirica V, Setyawan J, et al. Economic impact of childhood/adolescent ADHD in a European setting: the Netherlands as a reference case. Eur Child Adolesc Psychiatry 2013; 23(7): 587-98.
Gillberg C, Gillberg I, Rasmussen P, Kadesjö B, Söderström H, Råstam M, et al. Co-existing disorders in ADHD -- implications for diagnosis and intervention. Eur Child Adolesc Psychiatry 2004;13 (Suppl 1): I80-92.
Fliers E, Franke B, Lambregts-Rommelse N, Altink M, Buschgens C, Nijhuis-van der Sanden M et al. Undertreatment of motor problems in children with ADHD. Child Adolesc Ment Health 2010;15(2): 85-90.
Goulardins J, Marques J, De Oliveira J. Attention deficit hyperactivity disorder and motor impairment. Percept Mot Skills 2017; 124(2): 425-440.
Lee I, Chen Y, Tsai C. Kinematic performance of fine motor control in attention-deficit/ hyperactivity disorder: the effects of comorbid developmental coordination disorder and core symptoms. Pediatr Int 2013; 55(1): 24-9.
Kaiser M, Schoemaker M, Albaret J, Geuze R. What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? systematic review of the literature. Res Dev Disabil 2015; 36: 338-357.
Buderath P, Gärtner K, Frings M, Christiansen H, Schoch B, Konczak J, et al. Postural and gait performance in children with attention deficit/hyperactivity disorder. Gait Posture 2009; 29(2): 249-254.
Mendes L, Manfro G, Gadelha A, Pan P, Bressan R, Rohde L, et al. Fine motor ability and psychiatric disorders in youth. Eur Child Adolesc Psychiatry 2017; 27(5): 605-613.
Fenollar-Cortés J, Gallego-Martínez A, Fuentes L. The role of inattention and hyperactivity/impulsivity in the fine motor coordination in children with ADHD. Res Dev Disabil 2017; 69: 77-84.
Klimkeit E, Sheppard D, Lee P, Bradshaw J. Bimanual coordination deficits in attention deficit/hyperactivity disorder (ADHD). J Clin Exp Neuropsychol 2004; 26(8): 999-1010. 16. Lifshitz N, Josman N, Tirosh E. Disorganization as related to discoordination and attention deficit. J Child Neurol 2012; 29(1): 66-70.
Dewey D, Volkovinskaia A. Health-related quality of life and peer relationships in adolescents with developmental coordination disorder and attention-deficit-hyperactivity disorder. Dev Med Child Neurol 2018; 60(7): 711-717.
Missiuna C, Cairney J, Pollock N, Campbell W, Russell D, Macdonald K, et al. Psychological distress in children with developmental coordination disorder and attention-deficit hyperactivity disorder. Res Dev Disabil 2014; 35(5): 1198-1207.
Smits-Engelsman B, Vinçon S, Blank R, Quadrado V, Polatajko H, Wilson P. Evaluating the evidence for motor-based interventions in developmental coordination disorder: a systematic review and meta-analysis. Res Dev Disabil 2018; 74: 72-102.
World Health Organization. Towards a common language for functioning, disability and health ICF [Internet]. 2002 [cited October 25,]. Available from: https://www.who.int/classifications/icf/ icfbeginnersguide.pdf
Watemberg N, Waiserberg N, Zuk L, Lerman-Sagie T. Developmental coordination disorder in children with attention-deficithyperactivity disorder and physical therapy intervention. Dev Med Child Neurol 2007; 49(12): 920-5.
Ziereis S, Jansen P. Effects of physical activity on executive function and motor performance in children with ADHD. Res Dev Disabil 2015; 38: 181-91.
Verret C, Guay M, Berthiaume C, Gardiner P, Béliveau L. A physical activity program improves behavior and cognitive functions in children with ADHD. J Atten Disord 2010; 16(1): 71-80.
Khan N, Jahan M, Kanchan A, Singh A. Management of attention deficit and fine motor incoordination of primary school going ADHD (inattentive type) children. Acta Neuropsychologica 2017; 15(3): 283-301.
Chaingam S, Narkpongphun A. Prevalence and associated factors of developmental coordination disorder among patients with attention deficit hyperactivity disorder at Maharaj Nakorn Chiang Mai Hospital. Journal of the Psychiatric Association of Thailand 2019; 64(4): 309-16
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, D.C.: American Psychiatric Publishing; 2013.
Buranasuksakul T, Pityaratsatian N. Validity and reliability of the Thai version of Swanson, Nolan and Pelham version IV (SNAP-IV). Bangkok: Chulalongkorn Hospital; 2008.
Pityaratstian N, Booranasuksakul T, Juengsiragulwit D, Benyakorn S. ADHD screening properties of the Thai version of Swanson, Nolan, and Pelham IV Scale (SNAP-IV) and strengths and difficulties questionnaire (SDQ). Journal of the Psychiatric Association of Thailand 2014; 59: 97-110.
Cools W, Martelaer K, Samaey C, Andries C. Movement skill assessment of typically developing preschool children: a review of seven movement skill assessment tools. J Sports Sci Med 2009; 8(2): 154-68.
Hands B, Licari M, Piek J. A review of five tests to identify motor coordination difficulties in young adults. Res Dev Disabil 2015; 41-42: 40-51.
Shirley Ryan AbilityLab [Internet]. BruininksOseretsky Test of Motor Proficiency, Second Edition [updated 2017 April 21; cited October 24,]. Available from: https://www.sralab.org/rehabilitation-measures/bruininks-oseretsky-testmotor-proficiency-second-edition
Bruininks R.H., Bruininks B.D. BruininksOseretsky test of motor proficiency: manual. pearson assessments. 2nd ed. MN: AGS Publishing. Circle Pines; 2005.
Monga S, Birmaher B, Chiappetta L, Brent D, Kaufman J, Bridge J et al. Screen for child anxiety-related emotional disorders (SCARED): convergent and divergent validity. Depress Anxiety 2000; 12(2): 85-91.
Hale W, Crocetti E, Raaijmakers Q, Meeus W. A meta-analysis of the cross-cultural psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED). J Child Psychol Psychiatry 2010; 52(1): 80-90.
Rappaport B, Pagliaccio D, Pine D, Klein D, Jarcho J. Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment- and non-treatmentseeking youth. J Anxiety Disord 2017; 51: 22-31.
Screen for Child Anxiety Related Disorders (SCARED)-Thai version [Internet]. Pediatricbipolar.pitt.edu. 2014 [cited October 24,]. Available from: https://www.pediatricbipolar. pitt.edu/sites/default/files/Thai%20Screen%20 for%20Child%20Anxiety%20Related%20Disorders%20%28SCARED%29%20Child%20 Version.pdf.pdf
Trangkasombat U, Likanapichitkul D. The Children’s Depression Inventory as a screen for depression in Thai children. J Med Assoc Thai 1997; 80: 491-9.
Piyasil W, Katumarn P, Suwannapo M. Clinical practice guideline for adolescents with depression [Internet]. The Royal College of Pediatricians of Thailand. 2020 [cited October 24,]. Available from: http://www.thaipediatrics. org/Media/media-20200312101740.pdf
Wechsler D. Wechsler Intelligence Scale for Children fourth Edition [Internet]. Pearsonassessments.com. 2003 [cited October 24,]. Available from: https://www.pearsonassessments.com/store/usassessments/en/Store/ Professional-Assessments/Cognition-%26- Neuro/Wechsler-Intelligence-Scale-forChildren-%7C-Fourth-Edition/p/100000310. html?tab=product-details
Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology. Eye examination in infants, children, and young adults by pediatricians. Pediatrics 2003;111(4): 902-7.
Bureau of Health Promotion, Department of Health, Ministry of Public Health. A practical manual on visual screening in pre-school and elementary school children. 3rd ed. Bangkok: Religious Printing House; 2014:12-15.
Wicklund M. The muscular dystrophies. Continuum (Minneap Minn) 2013;19: 1535-70.
Richards C, Malouin F. Chapter 18 - cerebral palsy: definition, assessment and rehabilitation [Internet]. 2013 [cited October 25,]. Available from: https://www.sciencedirect.com/science/ article/pii/B978044452891900018X?via%3Dihub
Gulati S, Sondhi V. Cerebral palsy: an overview. Indian J Pediatr 2017; 85(11): 1006-16.
Blank R, Barnett A, Cairney J, Green D, Kirby A, Polatajko H, et al. International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Dev Med Child Neurol 2019; 61(3): 242-85.
Baerg S, Cairney J, Hay J, Rempel L, Mahlberg N, Faught B. Evaluating physical activity using accelerometry in children at risk of developmental coordination disorder in the presence of attention deficit hyperactivity disorder. Res Dev Disabil 2011; 32(4): 1343-50.
Ratcliffe I. The effect of a scissor skills program on bilateral fine motor skills in preschool children in South Africa including skill improvement, equivalence, transferability of skills and skill retention [Thesis]. Johannesburg: University of the Witwatersrand; 2009.
Feder K, Majnemer A. Handwriting development, competency, and intervention. Dev Med Child Neurol 2007; 49(4): 312-317.
Smits-Engelsman B, Niemeijer A, van Galen G. Fine motor deficiencies in children diagnosed as DCD based on poor grapho-motor ability. Hum Mov Sci 2001;20(1-2):161-182.
Golan M, Jackson P. Origametria: a program to teach geometry and to develop learning skills using the art of origami. In: Lang R, editors. Origami 4. New York: A K Peters/CRC Press; 2009: 459-469.
Yang H, Chen Y, Yin S. Design and developing technology integrated into learning origami: using the origami of one straight cut as an example [Internet]. 2016 [citedMay, 2019]. Available from: https://papers.iafor.org/submission27209/
Çetin Z, Danacı M. Collage and paper art activities and preschool children’s reading and writing readiness. HÜ Sağlık Bilimleri Fakültesi Dergisi 2015; 2(1): 39-50.
Nadkarni S, S S, Ashok D. Enhancing eye-hand coordination with therapy intervention to improve visual-spatial abilities using ‘the retraining approach’ in children with Down syndrome: three case studies. Disability, CBR & Inclusive Development 2012; 23(2): 107-20.
Francis T, Beck C. Visual motor integration for building literacy: the role of occupational therapy. OT pract 2018; 23(15): 14-8.
Sanghavi R, Kelkar R. Visual-motor integration and learning disabled hildren. The Indian Journal of Occupational Therapy 2005; 37(2): 33-8.
Kamm C, Mattle H, Müri R, Heldner M. Homebased training to improve manual dexterity in patients with multiple sclerosis: a randomized controlled trial. Mult Scler 2015; 21(12): 1546-56.
Trecroci A, Cavaggioni L, Caccia R, Alberti G. Jump rope training: balance and motor coordination in preadolescent soccer players. J Sports Sci Med 2015; (14): 792-8.
Grivedehi M, Nourbakhsh P, Sepasi H. Effects of speedy and demonstration jumping-rope training on gross motor skills. DAMA International 2014; 3(4): 321-7.
Maharaj S, Lallie R. Does a physiotherapy programme of gross motor training influence motor function and activities of daily living in children presenting with developmental coordination disorder?. S Afr J Physiother 2016; 72(1): 304.
Floría P, Sánchez-Sixto A, Ferber R, Harrison A. Effects of running experience on coordination and its variability in runners. J Sports Sci 2017; 36(3): 272-278.
Das A, Babu M, Satish K. Effect of continuous running fartlek training and interval training on selected motor ability and physiological variables among male football players. International Journal of Physical Education Sports Management and Yogic Sciences 2014; 4(1): 13.
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