Exercise impact on sustained attention of ADHD children, methylphenidate effects A Randomized Trial Examining the Effects of Aerobic Physical Activity on Attention-Deficit/Hyperactivity Disorder Symptoms in Young Children The effects of exercise on children with attention-deficit hyperactivity disorder. Parent-assisted transfer of children's social skills training: effects on children with and without attention-deficit hyperactivity disorder. The effectiveness of methylphenidate in the management of Attention Deficit Hyperactivity Disorder (ADHD) in people with intellectual disabilities: A systematic review. Effectiveness of a School-Based Multicomponent Program for the Treatment of Children with ADHD Randomised social-skills training and parental training plus standard treatment versus standard treatment of children with attention deficit hyperactivity disorder - The SOSTRA trial protocol Effects of atomoxetine with and without behavior therapy on the school and home functioning of children with attention-deficit/hyperactivity disorder. The effects of a stress-management program on self-concept, locus of control, and the acquisition of coping skills in school-age children diagnosed with attention deficit hyperactivity disorder. Attention Deficit Hyperactivity Disorder Symptoms Mediate Early-Onset Smoking An efficacy study of a combined parent and teacher management training programme for children with ADHD Impulsiveness as a timing disturbance: neurocognitive abnormalities in attention-deficit hyperactivity disorder during temporal processes and normalization with methylphenidate Reduced Symptoms of Inattention after Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity Disorder Sports therapy for attention, cognitions and sociality. Treatment of Children With Attention-Deficit/Hyperactivity Disorder (ADHD) and Irritability: Results From the Multimodal Treatment Study of Children With ADHD (MTA)
Attention deficit hyperactivity disorder ( ADHD ) is related to a deficiency of central catecholamines ( CA ) in cognitive , biochemical , and physical tests , and pharmaceutical intervention may have no effect if it is not accompanied by changes in the environment . The objective of our study was to test the hypothesis that central CA are responsible for the increase in speed reaction seen after physical activity ( PA ) and to measure the impact of high intensity PA on the sustained attention of 25 children diagnosed with ADHD consistent with the Disease Statistical Mental-IV ( DSM-IV ) criteria . It is possible that practicing sports assists in the management of the disorder . The children were divided between users ( US ) and non-users ( NUS ) of methylpheni date ( MTP ) , and the groups were compared to evaluate the effect of the drug on cognition after PA . Post-exercise performance on Conner ’s Continuous Performance Test-II ( CPT ) was not affected by MTP , we observed significant improvements in response time , and we saw normalization in the impulsivity and vigilance measures . These results suggest that the improvements in cognition after physical effort are not CA dependent . Additionally , our results suggest that  children ’s attention deficits can be minimized through PA irrespective of treatment with MTP . Additional studies are necessary to confirm that exercise mitigates the harmful symptoms of ADHD The goal of this study was to compare the effects of before school physical activity ( PA ) and sedentary classroom-based ( SC ) interventions on the symptoms , behavior , moodiness , and peer functioning of young children ( Mage = 6.83 ) at risk for attention-deficit/hyperactivity disorder ( ADHD-risk ; n = 94 ) and typically developing children ( TD ; n = 108 ) . Children were r and omly assigned to either PA or SC and participated in the assigned intervention 31 min per day , each school day , over the course of 12 weeks . Parent and teacher ratings of ADHD symptoms ( inattention , hyperactivity/impulsivity ) , oppositional behavior , moodiness , behavior toward peers , and reputation with peers , were used as dependent variables . Primary analyses indicate that the PA intervention was more effective than the SC intervention at reducing inattention and moodiness in the home context . Less conservative follow-up analyses within ADHD status and intervention groups suggest that a PA intervention may reduce impairment associated with ADHD-risk in both home and school domains ; interpretive caution is warranted , however , given the liberal approach to these analyses . Unexpectedly , these findings also indicate the potential utility of a before school SC intervention as a tool for managing ADHD symptoms . Inclusion of a no treatment control group in future studies will enable further underst and ing of PA as an alternative management strategy for ADHD symptoms PURPOSE The effects of exercise on children with attention-deficit hyperactivity disorder ( ADHD ) were evaluated by study ing the rate of spontaneous eye blinks , the acoustic startle eye blink response ( ASER ) , and motor impersistence among 8- to 12-yr-old children ( 10 boys and 8 girls ) meeting DSM-III-R criteria for ADHD . METHODS Children ceased methylpheni date medication 24 h before and during each of three daily conditions separated by 24 - 48 h. After a maximal treadmill walking test to determine cardiorespiratory fitness ( VO(2peak ) ) , each child was r and omly assigned to counterbalanced conditions of treadmill walking at an intensity of 65 - 75 % VO(2peak ) or quiet rest . Responses were compared with a group of control participants ( 11 boys and 14 girls ) equated with the ADHD group on several key variables . RESULTS Boys with ADHD had increased spontaneous blink rate , decreased ASER latency , and decreased motor impersistence after maximal exercise . Girls with ADHD had increased ASER amplitude and decreased ASER latency after submaximal exercise . CONCLUSIONS The findings suggest an interaction between sex and exercise intensity that is not explained by physical fitness , activity history , or selected personality attributes . The clinical meaning of the eye blink results is not clear , as improvements in motor impersistence occurred only for boys after maximal exercise . Nonetheless , these preliminary findings are sufficiently positive to encourage additional study to determine whether a session of vigorous exercise has efficacy as a dopaminergic adjuvant in the management of behavioral features of ADHD OBJECTIVE Previous research has demonstrated that peer rejection is a significant part of the clinical presentation of many children with attention-deficit hyperactivity disorder ( ADHD ) . Outcome studies of treatment interventions have typically failed to show generalization of treatment gains to the home and classroom . This has been especially true for children who have comorbid oppositional defiant disorder ( ODD ) . The present study was intended to demonstrate generalization of an outpatient social skills training program when parents were trained in skills relevant to their child 's social adjustment . METHOD Thirty-five children with ADHD and 14 children without ADHD were given  12 sessions of treatment ( treatment group ) . Outcome was compared with 12 children with ADHD and 12 children without ADHD who were on a waitlist for treatment ( waitlist group ) .  Nineteen children with ODD were in the treatment group and five in the waitlist . Stimulant medication was prescribed for all children with ADHD . RESULTS Subjects with ADHD showed improvement comparable with that of subjects without ADHD on all teacher- and parent-reported measures of peer adjustment and social skills , except teacher-reported withdrawal . Children with ODD had outcome comparable with that of children without ODD . Effect sized ranged from 0.93 to 1.34 indicating that the average treatment group subject was better off than 83.4 % of waitlist subjects on outcome measures . CONCLUSIONS The present results suggest that children with ADHD are best heiped by a combination of social skills training for themselves , collateral training for their parents and stimulant medication BACKGROUND The effectiveness of psychostimulants , primarily methylpheni date ( MPH ) , in the treatment of Attention Deficit Hyperactivity Disorder ( ADHD ) in the general population of typically growing children and adolescents is well established through many R and omised Controlled Trials ( RCTs ) . AIMS AND METHODS We carried out a systematic review of all the RCTs in people with intellectual disabilities ( ID ) that assessed effectiveness of MPH on the core ADHD symptoms . OUTCOMES AND RESULTS We included 15 papers from 13 studies that were all on children and adolescents with ID ( 315 participants were on MPH and placebo respectively ) , 12 of which used a cross over design , and one used a parallel design . On average around 40 - 50 % responded to MPH in the ID group whereas around 70 - 80 % response rate is reported among the non-ID children . Because of the heterogeneity of the outcome data it was not possible to carry out a meta- analysis . Significant adverse events included sleep difficulties and poor appetite along with weight loss and also irritability , social withdrawal and increased motor activities including tic . CONCLUSIONS AND IMPLEMENTATION On the basis of the poor quality evidence that is available , it seems that MPH may be effective in some but not all children and adolescents with ID and ADHD The objective of this study was to evaluate the efficacy of a multicomponent program for treating attention-deficit/hyperactivity disorder ( ADHD ) carried out by teachers in a classroom context . Dependent measures included neuropsychological tasks , behavioral rating scales for parents and teachers , direct observation of behavior in the classroom , and academic records of children with ADHD . Fifty children with ADHD participated in the study . The teachers of 29 of the 50 students  were trained in the use of behavior modification techniques , cognitive behavior strategies , and instructional management strategies . The other 21 students formed the  control group . Parents ' and teachers'ratings detected improvements in primary symptoms ( inattention — disorganization , hyperactivity — impulsivity ) and in behavioral difficulties usually associated with ADHD ( e.g. , antisocial behavior , psychopathological disorders , anxiety ) . Furthermore , the results showed increased academic scores , enhanced classroom behavioral observations , and improved teachers ' knowledge about the strategies directed toward responding to the children 's educational needs Background Children with attention deficit hyperactivity disorder ( ADHD ) are hyperactive and impulsive , can not maintain attention , and have difficulties with social interactions . Medical treatment may alleviate symptoms of ADHD , but seldom solves difficulties with social interactions . Social-skills training may benefit ADHD children in their social interactions . We want to examine the effects of social-skills training on difficulties related to the children 's ADHD symptoms and social interactions . Methods / Design The design is r and omised two-armed , parallel group , assessor-blinded trial . Children aged 8 - 12 years with a diagnosis of ADHD are r and omised to social-skills training and parental training plus st and ard treatment versus st and ard treatment alone . A sample size calculation estimated that at least 52 children must be included to show a 4-point difference in the primary outcome on the Conners 3rd Edition subscale for ' hyperactivity-impulsivity ' between the intervention group and the control group . The outcomes will be assessed 3 and 6 months after r and omisation . The primary outcome measure is ADHD symptoms . The secondary outcome is social skills . Tertiary outcomes include the relationship between social skills and symptoms of ADHD , the ability to form attachment , and parents ' ADHD symptoms . Discussion We hope that the results from this trial will show that the social-skills training together with medication may have a greater general effect on ADHD symptoms and social and emotional competencies than medication alone . Trial registration Clinical Trials ( NCT ) : OBJECTIVE To evaluate the effects of atomoxetine alone and in combination with behavior therapy on the school functioning of children with attention-deficit/hyperactivity disorder ( ADHD ) . Most atomoxetine studies have not assessed school functioning other than by measuring the change in ADHD symptoms . Combining behavior therapy with atomoxetine may be particularly beneficial for the academic domain as medication has not been found to produce sustained benefits in this realm . However , there is little research examining the effects of combining atomoxetine and behavior therapy . METHOD In an 8-week open-label trial , 56 children aged 6 - 12 years with ADHD diagnosed according to DSM-IV-TR were r and omly assigned to receive  atomoxetine and behavior therapy or atomoxetine alone . Behavior therapy consisted of an 8-week parenting course , a child social skills course , and a teacher-implemented daily report card of classroom behavior . The primary outcome was direct observation of the subject 's classroom behavior . Secondary outcomes included change in ADHD symptoms and functioning at home and school . All data were collected between March 2007 and May 2008 . RESULTS Classroom observations showed that atomoxetine decreased rule violations ( P < .0001 ) . Moreover , atomoxetine was associated with significant improvements in ADHD and oppositional defiant disorder symptoms at home and school and enhanced functioning in both domains ( Impairment Rating Scale : all P < .001 ) . Combined treatment led to greater improvements in parent-rated symptoms of inattention ( P < .01 ) , problem behaviors ( P < .001 ) , and academic impairment ( P < .05 ) . However , teachers did not report significant group differences . CONCLUSIONS Atomoxetine improved ADHD symptoms and classroom functioning as measured by parents , teachers , and direct observation . The addition of behavior therapy led to further improvements at home but not at school . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00918567 PROBLEM What is the effectiveness of a stress-management program on self-concept , locus of control , and acquisition of appropriate coping strategies in children with attention deficit hyperactivity disorder ( ADHD ) ? METHODS Forty-two children with ADHD ( age range 9 - 12 ) were r and omly assigned to a control group , a therapist-led group , or a group in which the stress-management techniques were taught by the parents . The subjects were pre- and posttested on self-concept , locus of control , and acquisition of coping skills . FINDINGS Although there were no significant changes in any of the three groups for acquisition of coping skills , the children in the therapist-led group reported more appropriate coping strategies . CONCLUSIONS Involving parents in a cognitive-behavioral approach could improve  parent-child relationships and further increase the opportunities for successful academic and social functioning Background / Aims : Symptoms of attention deficit hyperactivity disorder ( ADHD ) have often been associated with early-onset smoking . We hypothesize that reductions in ADHD symptoms due to an intervention have a mediating effect on early-onset smoking . Methods : In a universal , school-based , r and omized controlled intervention trial , we examined whether intervention-induced reductions in ADHD symptoms at age 9 mediated the reduced risk of tobacco use onset among these children at age 10 or 11 years . A sample of 477 first- grade boys and girls were r and omly assigned to the Good Behavior Game intervention ( n = 263 ) , a 2-year ( grade s 2 and 3 ) universal classroom-based intervention aim ed at reducing disruptive behavior problems , or to a control condition ( n = 214 ) . ADHD symptoms were assessed through teacher ratings . Early onset of tobacco use was assessed through self-report . Results : The intervention-induced reductions in ADHD symptoms fully mediated the distal effect of intervention on reductions in early-onset smoking . Conclusions : Our results showed that programs that target ADHD symptoms may protect children from early-onset smoking as well . Further research is needed to examine pathways from ADHD symptoms to tobacco use Background : Several parent training programmes and behavioural teacher training programmes built on learning theory have been developed for problem prevention and treatment of attention-deficit/hyperactivity disorder ( ADHD ) and /or oppositional defiant disorder ( ODD ) during the last few decades . Group format has often been used for parent training but single-subject design s are more common in teacher training . More studies have focussed on pre-school children than on older children , and a minority have been conducted in public mental health setting s. Aim : This study aim ed to evaluate a combined parent and teacher manual-based group training programme for children with ADHD conducted by the staff at a child and adolescent psychiatric clinic in Sweden . Method : The intervention was a modified version of Barkley 's programme .  Children were r and omized to an Intervention or a Control group .  Sixty-one parents and 68 teachers answered questions about ADHD and ODD symptoms , and about behavioural problems when the study started and at a 3-month follow-up . Results : Results showed that the intervention result ed in a reduction of the number of children who met DSM-IV criteria for ADHD and /or ODD . Effects were more pronounced in the home setting than in the school setting , and were further accentuated when both parents and teachers of the same child took part in the intervention . Teachers with more problematic classroom situations benefited most from the intervention . Conclusion : The programme , “ Strategies in Everyday Life ” , has , in a regular clinical setting , demonstrated promising effects on children 's disruptive behaviour , and a clinical implication was to recommend involving both parents and teachers in the programme We argue that impulsiveness is characterized by compromised timing functions such as premature motor timing , decreased tolerance to delays , poor temporal foresight and steeper temporal discounting . A model illustration for the association between impulsiveness and timing deficits is the impulsiveness disorder of attention-deficit hyperactivity disorder ( ADHD ) . Children with ADHD have deficits in timing processes of several temporal domains and the neural substrates of these compromised timing functions are strikingly similar to the neuropathology of ADHD . We review our published and present novel functional magnetic resonance imaging data to demonstrate that ADHD children show dysfunctions in key timing regions of prefrontal , cingulate , striatal and cerebellar location during temporal processes of several time domains including time discrimination of milliseconds , motor timing to seconds and temporal discounting of longer time intervals . Given that impulsiveness , timing abnormalities and more specifically ADHD have been related to dopamine dysregulation , we tested for and demonstrated a normalization effect of all brain dysfunctions in ADHD children during time discrimination with the dopamine agonist and treatment of choice , methylpheni date . This review together with the new empirical findings demonstrates that neurocognitive dysfunctions in temporal processes are crucial to the impulsiveness disorder of ADHD and provides first evidence for normalization with a dopamine reuptake inhibitor Attention deficit/hyperactivity disorder ( ADHD ) is one of the most common child psychiatric disorders , and is often treated with stimulant medication . Nonpharmacological treatments include dietary supplementation with omega-3 fatty acids , although their effectiveness remains to be shown conclusively . In this study , we investigated the effects of dietary omega-3 fatty acid supplementation on ADHD symptoms and cognitive control in young boys with and without ADHD . A total of 40 boys with ADHD , aged 8–14 years , and 39 matched , typically developing controls participated in a 16-week double-blind r and omized placebo-controlled trial . Participants consumed 10 g of margarine daily , enriched with either 650 mg of eicosapentaenoic acid (EPA)/docosahexaenoic acid ( DHA ) each or placebo . Baseline and follow-up assessment s addressed ADHD symptoms , fMRI of cognitive control , urine homovanillic acid , and cheek cell phospholipid sampling . EPA/DHA supplementation improved parent-rated attention in both children with ADHD and typically developing children . Phospholipid DHA level at follow-up was higher for children receiving EPA/DHA supplements than placebo . There was no effect of EPA/DHA supplementation on cognitive control or on fMRI measures of brain activity . This study shows that dietary supplementation with omega-3 fatty acids  reduces symptoms of ADHD , both for individuals with ADHD and typically developing children . This effect does not appear to be mediated by cognitive control systems in the brain , as no effect of supplementation was found here . Nonetheless , this study offers support that omega-3 supplementation may be an effective augmentation for pharmacological treatments of ADHD ( NCT01554462 : The Effects of EPA/DHA Supplementation on Cognitive Control in Children with ADHD ; http:// clinical trials.gov/show/NCT01554462 ) The aim of the present study was to underst and if sport improves attention symptoms , social competency , and cognitive functions in children with attention deficit and hyperactivity disorder ( ADHD ) . The present study was design ed as a 6-week , prospect i ve trial , including 12 sessions of education/sports therapy .  13 ADHD children participated in a  90-min athletic activity ( sports-cADHD ) twice a week , while 15 ADHD children received education on behavior control ( edu-cADHD ) . During the 6-week treatment period , the sports-cADHD group showed greater improvements in DuPaul 's ADHD Rating Scale scores , parent and teacher version ( K-ARS-PT ) , compared to those of the edu-sADHD group . The cognitive functions assessed with the digit symbol and Trail-Making Test part B ( TMT B ) were improved in the sports-cADHD group , while the cognitive functions observed in the edu-sADHD group were not significantly changed . The cooperativeness scores in the sports-cADHD group were greatly increased compared to those of the edu-sADHD group . The results demonstrated a positive correlation with sports and improvement in attention symptoms , cognitive symptoms and social skills . The results of the present study suggest that therapy in the form of athletic activity may increase social competency in children with ADHD , as demonstrated by improved cognitive functions Objective Clinical ly impairing irritability affects 25 % to 45 % of children with attention-deficit/hyperactivity disorder ( ADHD ) ; yet , we know little about what interventions are effective in treating children with ADHD and co-occurring irritability . We used data from the Multimodal Treatment Study of Children With ADHD ( MTA ) to address 3 aims : to establish whether irritability in children with ADHD can be distinguished from other symptoms of oppositional defiant disorder ( ODD ) ; to examine whether ADHD treatment is effective in treating irritability ; and to examine how irritability influences ADHD treatment outcomes . Method Secondary analyses of data from the MTA included multivariate analyses , and intent-to-treat r and om-effects regression models were used . Results Irritability was separable from other ODD symptoms . For treating irritability , systematic stimulant treatment was superior to behavioral management but not to routine community care ; a combination of stimulants and behavioral treatment was superior to community care and to behavioral treatment alone , but not to medication alone . Irritability did not moderate the impact of treatment on parent- and teacher-reported ADHD symptoms in any of the 4 treatment groups . Conclusion Treatments targeting ADHD symptoms are helpful for improving irritability in children with ADHD . Moreover , irritability does not appear to influence the response to treatment of ADHD . Clinical trial registration information Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder ( MTA ) ; http://www . clinical trials.gov ; NCT00000388
Overall , the studies review ed were of moderate-to-high quality and reported benefits of a variety of exercise programmes in improving motor skills , physical fitness , attention and social behaviour in children with ADHD .
However , there was limited information regarding school-based programmes , the effects of structured exercise programmes independently or in combination with cognitive-based therapies , and the long-term benefits of exercises in alleviating behavioural problems in these children
Children with attention deficit hyperactivity disorder ( ADHD ) are educated in classrooms along with typically developing children .
Those with ADHD , however , find it difficult to participate in routine educational and recreational activities as they encounter problems associated with behaviour , attention , motor skills and physical endurance .
Traditionally , the management of children with ADHD has focussed primarily on problems with cognition and has been heavily dependent on pharmaceutical interventions and , to a lesser extent , on non-pharmaceutical measures .
More recently , experts have increasingly advocated the use of exercises in alleviating symptoms associated with ADHD .
The primary objective of this review was to summarize research that examined the role of exercises on deficits related to attention , motor skills and fitness in children with ADHD .