ERG SES D 08, Health and Education
Attention Deficit Hyperactivity Disorder (ADHD) is currently the diagnostic label assigned to children who exhibit severe and pervasive symptoms of inattention, hyperactivity and impulsivity (American Psychiatric Association, 2013). The World Health Organisation (1993) prefers to use the term Hyperkinetic Disorder (HD) but adheres to similar diagnostic guidelines. While ADHD is one of the most common childhood disorders in the United States (Merikangas et al., 2010), it is also established in many other countries, including Canada, Australia, Norway, Denmark, Sweden, and the United Kingdom (Senior, 2009). In Ireland, the Health Service Executive’s Fifth Annual Child and Adolescent Mental Health Service Report 2012-2013 highlighted ADHD as the most frequently assigned primary presentation among children. In the United States, and increasingly in Europe, psychostimulants are first line treatments for ADHD (Singh, 2008) and since the 1950s, medications for ADHD have been used (Kewley, 2011). For many children, ADHD medications reduce a child’s symptoms, improve their ability to focus, work and learn (National Institute of Mental Health, 2008). However, to extinguish undesirable behaviour in children with ADHD, medication alone is an insufficient treatment (Daniel and Cooper, 1999). Thus, there is a need to explore complementary approaches to treatment for ADHD. There have been suggestions that physical activity is particularly beneficial for children with ADHD. According to Ratey (2004), physical exercise contributes to increased levels of dopamine in the brain, and therefore having a similar effect to that achieved by the taking of stimulant medication. In many academic fields, including psychology, cognitive, behavioural and molecular science, there is evidence to support the benefits of physical activity for the brain (Sattelmair and Ratey, 2009). Physical activity causes children to be less impulsive and more receptive to learning (Ratey and Hagerman, 2008) and findings from several studies support the potential for physical activity to mitigate ADHD symptoms in children (e.g. Smith et al., 2013; Verret et al., 2012; Pontifex et al., 2013).
This PhD research employed a randomized controlled trial (RCT) to explore the effects of an eight week school-based structured physical activity intervention on behaviour and executive functioning (EF) in children presenting with ADHD. Eligible participants (n = 28) were identified using parent and teacher ratings on the Conners’ 3 Behavioural Rating Scales (Conners, 2008). This behavioural screening tool comprises of five subscales, inattention, hyperactivity/impulsivity, learning problems/executive functioning, defiance/aggression, and peer relations. A total of two urban-based primary schools were recruited to participate in this study. These schools were randomly assigned to receive the intervention or serve as a control school using the toss of a coin. Children in the intervention group (n = 13) engaged in an exercise circuit for thirty minutes, three times per week in the school gymnasium during lunch time, whereas their peers in the control group (n = 15) did not receive the intervention. This presentation outlines the research design employed in the current study. Findings from behavioural measures administered throughout different stages of the study (e.g. weeks 1, 3, 5, 8) are also discussed.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC: American Psychiatric Association. Connors, K.C. (2008). Connors manual. Canada: Multi-Health Systems, Inc. Daniel, S. and Cooper, P. (1999). Teachers classroom strategies for dealing with students with ADHD: an empirical study. In P. Cooper and K. Bilton (eds.) (1999) ADHD: research, practice and opinion. London: Whurr Publishers, pp. 203 – 222. Goldstein, S. and Goldstein, M. (1998). Managing attention deficit disorder in children. New York: John Wiley and Sons. Health Service Executive (2013). Fifth annual child & adolescent mental health service report 2012-2013. Dublin: Health Service Executive. Kewley, G. (2011). Attention deficit hyperactivity disorder: what can teachers do? UK. Routledge. Merikangas, K.R., He, J., Brody, D., Fisher, P.W., Bourdon, K. and Koretz, D.S. (2010).Prevalence and treatment of mental disorders among U.S. children in the 2001-2004 NHANES. Pediatrics, 125, (1), 75-81. National Institute of Mental Health (2008). Attention deficit hyperactivity disorder (ADHD). USA: National Institute of Mental Health. Pontifex, M.B., Saliba, B.J., Raine, L.B., Picchietti, D.L. and Hillman, C.H. (2013). Exercise improves behavioral, neurocognitive, and scholastic performance in children with Attention-Deficit/Hyperactivity Disorder. Journal of Pediatrics, 162, (3), 543-551. Ratey, J. and Hagerman, E. (2008). Spark: the revolutionary new science of exercise and the brain. New York: Little, Brown and Company. Ratey, J. (2004). The neurobiology of ADHD. Paper presented at the Sixth International ADDISS Conference, Liverpool, England, March, 2004. Sattelmair, J. and Ratey, J. (2009). Physically active play and cognition: an academic matter? American Journal of Play, 1, (3), 365-374. Senior, J. (2009). ADHD: inclusion or exclusion in mainstream Irish schools? In S. Drudy (eds.) (2009) Education in Ireland: challenge and change. Dublin: Gill & McMillan, 103 – 122. Singh, I. (2008). Beyond polemics: science and ethics of ADHD. Nature Reviews Neuroscience, 9, (12), 957-964. Smith, A.L., Hoza, B., Linnea, K., McQuade, J.D., Tomb, M., Vaughin, A., Shoulberg, E.K. and Hook, H. (2013). Pilot physical activity intervention reduces severity of ADHD symptoms in young children. Journal of Attention Disorders, 17, (1), 70-82. Verret, C., Guay, M-C., Berthiaume, C., Gardiner, P. and Béliveau, L. (2012). A physical activity program improves behavior and cognitive functions in children with ADHD: an exploratory study. Journal of Attention Disorders, 16, (1), 71-80. World Health Organisation (1993). The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. Switzerland: World Health Organisation.
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