What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? Systematic review of the literature

Full text

Review
article
What
is
the
evidence
of
impaired
motor
skills
and
motor
control
among
children
with
attention
deficit
hyperactivity
disorder
(ADHD)?
Systematic
review
of
the
literature
M.-L.
Kaiser
a,d,
*,
M.M.
Schoemaker
b
,
J.-M.
Albaret
c
,
R.H.
Geuze
a
a
Clinical
and
Developmental
Neuropsychology,
University
of
Groningen,
Grote
Kruisstraat
2/1,
9712
TS
Groningen,
The
Netherlands
b
University
of
Groningen,
University
Medical
Center
Groningen,
Centre
for
Human
Movement
Science,
PO
Box
30,001,
9700
RB
Groningen,
The
Netherlands
c
University
of
Toulouse
III
–
Paul
Sabatier,
PRISSMH-EA4561,
118
Route
de
Narbonne,
F-31062
Toulouse
Cedex
9,
France
d
University
Hospital
of
Lausanne,
Pierre-Decker
5,
1011
Lausanne,
Switzerland
Contents
1.
Introduction
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
339
2.
Methodology
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
340
3.
Results
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
340
3.1.
Description
of
studies
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
340
3.2.
Motor
skills
of
ADHD
children
without
medication
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
341
Research
in
Developmental
Disabilities
36
(2015)
338–357
A
R
T
I
C
L
E
I
N
F
O
Article
history:
Received
10
July
2014
Received
in
revised
form
8
September
2014
Accepted
10
September
2014
Available
online
6
November
2014
Keywords:
Children
ADHD
DCD
Motor
skills
ADHD
medication
Systematic
review
A
B
S
T
R
A
C
T
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.
ß
2014
Elsevier
Ltd.
All
rights
reserved.
*
Corresponding
author
at:
University
Hospital
of
Lausanne,
Pierre-Decker
5,
1011
Lausanne,
Switzerland.
Tel.:
+41
79
461
76
35.
E-mail
address:
Marie-Laure.Kaiser@chuv.ch
(M.-L.
Kaiser).
Contents
lists
available
at
ScienceDirect
Research
in
Developmental
Disabilities
http://dx.doi.org/10.1016/j.ridd.2014.09.023
0891-4222/ß
2014
Elsevier
Ltd.
All
rights
reserved.

3.2.1.
Motor
skills
of
children
with
ADHD
without
medication:
differences
among
ADHD
subtypes
.
.
.
.
.
.
.
.
.
.
347
3.3.
Motor
control
aspects
of
non-medicated
ADHD
children.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
348
3.4.
Effect
of
medication
on
motor
skills
of
children
with
ADHD
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
349
3.5.
Effect
of
medication
on
motor
control
aspects
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
352
4.
Discussion
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
352
4.1.
Hypothesis
of
explanation
of
impairment
of
motor
skills
among
children
with
ADHD
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
353
4.1.1.
Comorbidity
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
353
4.1.2.
The
hypothesis
of
a
deficit
of
attention
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
353
4.1.3.
The
hypothesis
of
lack
of
inhibition
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
354
5.
Limitations
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
354
6.
Conclusion
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
354
References
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
354
1.
Introduction
ADHD
children
encounter
difficulties
in
their
daily
living,
such
as
participation
at
school
with
a
higher
risk
of
school
failure
and
more
difficulties
in
social
life.
In
fact,
they
are
more
often
excluded
by
peers
and
show
poor
self-esteem
(Harpin,
2005).
They
may
demonstrate
difficulties
in
activities
that
require
motor
coordination
(Fliers
et
al.,
2008;
Harvey
&
Reid,
2003;
Karatekin,
Markiewicz,
&
Siegel,
2003)
such
as
handwriting
(Brossard-Racine,
Majnemer,
Shevell,
Snider,
&
Belanger,
2011;
Tseng,
Henderson,
Chow,
&
Yao,
2004;
Tucha
&
Lange,
2001)
or
the
use
of
tools
(Scharoun,
Bryden,
Otipkova,
Musalek,
&
Lejcarova,
2013).
Several
studies
have
found
that
children
with
ADHD
perform
poorly
on
motor
skills
tests
(Brossard-
Racine,
Shevell,
Snider,
Belanger,
&
Majnemer,
2012;
Fliers,
Franke,
et
al.,
2010;
Lavasani
&
Stagnitti,
2011;
Pitcher,
Piek,
&
Hay,
2003;
Watemberg,
Waiserberg,
Zuk,
&
Lerman-Sagie,
2007).
The
articles
of
this
systematic
review
describe
children
with
ADHD
who
are
most
often
diagnosed
on
the
basis
of
the
DSM-IV-TR
criteria.
These
criteria
are:
(A)
Persistent
pattern
of
inattention
and/or
hyperactivity-impulsivity
that
is
more
frequently
displayed
and
is
more
severe
than
is
typically
observed
in
individuals
at
comparable
level
of
development.
(B)
Some
hyperactive-impulsive
or
inattentive
symptoms
must
have
been
present
before
seven
years
of
age.
(C)
Some
impairment
from
the
symptoms
must
be
present
in
at
least
two
settings.
(D)
There
must
be
clear
evidence
of
interference
with
developmentally
appropriate
social,
academic
or
occupational
functioning.
(E)
The
disturbance
does
not
occur
exclusively
during
the
course
of
a
Pervasive
Developmental
Disorder,
Schizophrenia,
or
other
Psychotic
Disorders
and
is
not
better
accounted
for
by
another
mental
disorder
(American
Psychiatric
Association,
2000).
The
following
subtypes
are
described
in
the
DSM-IV-TR
(2000,
p.
85):
(1)
attention-deficit/hyperactivity
disorder
predominantly
inattentive
(ADHD-I);
(2)
attention-deficit/hyperactivity
disorder
predominantly
hyperactive-impulsive
(ADHD-H)
and,
(3)
attention-deficit/hyperactivity
disorder
combined
type
(ADHD-C).
The
diagnosis
is
made
most
of
the
time
by
a
medical
doctor.
Moreover,
a
questionnaire
such
as
the
Conner’s
rating
scale
(Conners,
2001),
is
given
to
the
parents
and/or
the
teacher
of
the
child
in
order
to
establish
that
the
symptoms
of
ADHD
have
an
interference
in
the
daily
living
of
the
child.
ADHD
affects
from
5.9
to
11.4%
of
the
school
age
children
(Willcutt,
2012).
The
prevalence
varies
with
age,
with
11.4%
during
the
period
of
6–12
years,
decreasing
to
8%
in
13–18
years-old
and
further
to
5%
from
19
years
into
adulthood.
The
ratio
male:
female
differ
slightly
across
childhood
(2.3:1)
and
adolescence
(2.4:1).
The
prevalence
is
highest
for
the
ADHD-I,
with
5.1%
during
the
age
of
6–12
years,
5.7%
during
the
age
of
13–18
years-
and
2.4%
for
over
19
years
of
age.
Lower
prevalence
rates
are
observed
for
the
ADHD-C
(from
3.3%
to
1.1%)
and
the
ADHD-H
(from
2.9%
to
1.6%)
children
over
this
age
range.
For
the
ADHD-C
children,
the
ratio
male:
female
is
higher
during
the
age
range
of
13–18
years
(5.6:1)
than
during
the
age
range
of
6–12
years
(3.6:1)
compared.
Similar
findings
are
described
for
ADHD-H,
going
from
2.3:1
to
5.5:1.
For
the
ADHD-I,
the
male:
female
ratio
is
stable
with
a
ratio
of
2.2:1
during
the
period
of
6–12
years,
and
a
ratio
of
2:1
during
the
period
of
13–18
years
(Willcutt).
There
are
many
hypotheses
to
explain
the
aetiology
of
ADHD.
Structural
differences
in
the
brain
have
been
described.
Cortese
(2012)
listed
the
brain
anatomy
abnormalities
such
as
the
frontostriatal
areas,
the
tempoparietal
lobes,
the
basal
ganglia,
the
corpus
callosum,
the
cerebellum,
the
thalamus
or
the
amygdala.
Depue,
Burgess,
Bidwell,
Willcutt,
&
Banich
(2010)
found,
among
ADHD
adults,
that
the
decrease
of
the
grey
matter
in
the
right
prefrontal
cortex
was
correlated
with
more
difficulty
to
inhibit
motor
response.
Sharma
and
Couture
(2014)
also
mentioned
that
the
prefrontal
cortex,
caudate
and
the
cerebellum
have
a
delay
in
maturation.
These
areas
seem
to
show
activity
or
a
volume
which
develop
slower
than
in
TD
children.
These
areas
are
known
to
play
a
role
in
attention
and
organisation
of
thoughts
as
well
as
motor
planning
(Cortese,
2012).
A
clear
understanding
of
how
such
structural
differences
may
explain
the
heterogeneity
of
symptoms
in
children
with
ADHD
has
not
yet
been
reached,
however.
Other
hypotheses
explain
ADHD
symptoms
from
deficits
in
neurotransmitters.
As
described
by
Sharma
&
Couture
(2014,
p.
10),
the
activity
of
the
prefrontal
cortex
area
is
primarily
maintained
by
neurotransmitters
(NTs)
dopamine
(DA)
and
norepinephrine
(NE).
As
the
dopamine
levels
seem
to
be
reduced
in
children
with
ADHD,
medication
given
to
these
children,
such
as
methylphenidate,
enhances
the
level
of
dopamine
in
the
prefrontal
cortex.
The
medication
is
assumed
to
improve
the
control
of
inhibition
and
the
executive
control
of
attention
(Sharma
&
Couture,
2014).
Moreover,
methylphenidate
has
been
reported
to
improve
motor
skills
(Leitner
et
al.,
2007;
Pedersen,
Surburg,
Heath,
&
Koceja,
2004;
Rubia,
Noorloos,
Smith,
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
339

Gunning,
&
Sergeant,
2003;
Tucha
&
Lange,
2001;
Wade,
1976).
It
is
difficult
to
state
if
the
medication
influences
the
motor
skills
directly
(Stray,
Ellertsen,
&
Stray,
2010)
or
indirectly
(Bart,
Podoly,
&
Bar-Haim,
2010).
ADHD
children
often
show
comorbidity
with
psychiatric
disorders
such
as
autism
spectrum
disorder
(Taurines
et
al.,
2010)
or
tic
disorders
(Kadesjo
&
Gillberg,
2001)
as
well
with
neurodevelopmental
disorders
such
as
dyslexia
(Germano,
Gagliano,
&
Curatolo,
2010)
or
DCD
(Fliers
et
al.,
2008;
Sergeant,
Piek,
&
Oosterlaan,
2006).
Moreover,
Kadesjo
and
Gillberg
(1998)
found
that
more
than
50%
of
the
ADHD
children
had
DCD
and
that
more
than
half
of
the
DCD
children
also
met
the
criteria
of
ADHD.
Even,
when
the
ADHD
children
do
not
meet
the
criteria
of
DCD,
they
show
weaker
motor
skills
than
TD
children
(Pitcher,
Piek,
&
Barrett,
2002;
Schoemaker,
Ketelaars,
van
Zonneveld,
Minderaa,
&
Mulder,
2005).
Moreover,
the
ADHD
children
overestimated
their
motor
competences
when
they
have
mild
impairment
of
motor
skills
(Fliers,
de
Hoog,
et
al.,
2010;
Fliers,
Franke,
et
al.,
2010).
Cantell,
Smyth,
and
Ahonen
(1994)
described
that
most
of
the
children
with
DCD
diagnosed
at
five
years
old
still
showed
motor
skills
impairments
at
age
15,
and
had
less
social
leisure
and
lower
academic
performance.
Therefore,
it
seems
important
to
identify
motor
deficits
in
order
to
prevent
further
consequences.
It
is
of
high
interest
to
review
articles
on
the
motor
skills
of
children
with
ADHD
and
the
influence
of
medication
on
motor
skills
to
understand
the
relationship
between
the
symptoms
of
ADHD
and
motor
deficits.
To
date,
there
is
no
systematic
review
of
the
motor
problems
of
children
with
ADHD.
A
systematic
review
on
this
topic
could
add
to
an
understanding
of
possible
mechanisms
that
underlie
the
relationship
between
motor
skill
deficits
and
deficits
in
attention,
hyperactivity
and
impulsivity.
Two
pertinent
questions
guided
this
study.
What
is
the
evidence
of
an
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
in
children
with
ADHD?
2.
Methodology
The
systematic
review
was
conducted
by
the
first
author
during
March
2014
on
the
following
databases:
Web
of
Science,
Medline-PubMed
and
PsycARTICLES.
The
first
search
addressed
the
topic
of
motor
skills
and
motor
control
aspects
of
children
with
ADHD
using
the
following
search
items:
attention
disorder
and/or
ADHD,
motor
skills
and/or
handwriting,
children.
Inclusion
criteria
were
as
follows:
(1)
the
abstract
and
the
article
were
published
in
English
in
a
peer-review
journal;
(2)
participants
were
school-aged
children
with
a
diagnosis
ADHD;
(3)
an
objective
assessment
of
motor
skills
had
been
used;
(4)
a
control
group
of
typically
developing
(TD)
children
was
included
for
comparison;
(5)
children
with
ADHD
were
not
on
medication
when
the
assessment
of
motor
skills
and/or
aspects
of
motor
control
was
conducted.
The
second
search
focused
on
the
influence
of
medication
on
motor
skills
and/or
aspects
of
motor
control
of
children
with
ADHD.
The
following
terms
were
introduced
in
the
same
databases:
attention
disorder
and/or
ADHD,
motor
skills
and/or
handwriting,
children
and
medication.
The
criteria
for
inclusion
were
as
follows:
(1)
the
abstract
and
the
article
were
published
in
English
in
a
peer-review
journal;
(2)
participants
were
school-aged
children
with
ADHD;
(3)
an
objective
assessment
of
motor
skills
had
been
used
as
an
outcome
measure.
If
one
of
the
criteria
was
not
met,
the
article
was
rejected.
The
first
author
assessed
the
articles
and
rejected
articles
that
did
not
meet
the
criteria.
The
three
other
authors
received
the
list
of
the
accepted
and
rejected
articles
and
based
on
their
expertise,
they
could
complete
the
lists
and
they
did
for
one
article
(Slaats-Willemse,
de
Sonneville,
Swaab-Barneveld,
&
Buitelaar,
2005).
The
references
of
the
articles
that
were
retained
were
scanned
in
order
to
ensure
that
no
relevant
study
was
missed.
One
article
was
then
added
(Leung
&
Connolly,
1998).
No
case
report
studies
or
descriptive
reports
were
found
with
the
criteria
of
search.
The
period
retained
was
from
1970
until
2014.
Of
the
56
articles
identified,
45
met
the
criteria
of
which
30
articles
addressed
the
first
question
and
15
articles
addressed
the
second
question
(Fig.
1).
Eleven
articles
identified
to
address
the
first
question
were
rejected
for
various
reasons,
such
as
(1)
no
analysis
comparing
the
ADHD
and
TD
groups
was
performed
(Dewey,
Cantell,
&
Crawford,
2007;
Konicarova,
Bob,
&
Raboch,
2014;
Williams,
Omizzolo,
Galea,
&
Vance,
2013);
(2)
a
portion
of
the
children
were
on
medication
(Piek,
Pitcher,
&
Hay,
1999);
(3)
only
subjective
measures
were
used
(Harvey
et
al.,
2009;
Karatekin
et
al.,
2003;
Tervo,
Azuma,
Fogas,
Falls,
&
Fiechtner,
2002);
(4)
some
of
the
children
had
had
brain
surgery
(Buderath
et
al.,
2009);
(5)
validation
of
a
sensory-motor
battery
(Finch,
Davis,
&
Dean,
2010);
(6)
no
TD
group
was
included
(Harvey
&
Reid,
1997;
Polderman,
van
Dongen,
&
Boomsma,
2011).
As
five
articles
described
the
motor
skills
of
the
ADHD
children
both
before
medication
and
while
on
medication,
their
results
are
presented
in
both
parts
of
the
review
(Brossard-Racine
et
al.,
2012;
Klimkeit,
Mattingley,
Sheppard,
Lee,
&
Bradshaw,
2005;
Leitner
et
al.,
2007;
Pedersen
et
al.,
2004;
Rubia
et
al.,
2003).
3.
Results
3.1.
Description
of
studies
With
the
exception
of
one
study
(Chen
et
al.,
2013),
the
majority
of
the
participants
in
the
studies
were
male.
In
fact,
fifteen
studies
included
only
boys.
When
studies
included
both
genders,
the
ratio
of
male
and
female
varied
from
one
study
to
another.
When
considering
the
usual
ratio
of
2.3
boys
to
1
female
during
childhood,
some
studies
have
a
higher
ratio,
for
example
6
males
to
1
female
(Tseng
et
al.,
2004)
or
a
lower
ratio
with
1
male
to
1.5
females
in
the
study
of
Klimkeit
et
al.
(2005).
No
specific
gender
analysis
was
done
in
these
studies.
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
340

The
intellectual
quotients
(IQs)
of
the
participants
were
reported
in
29
of
the
articles.
Of
the
30
studies
on
motor
skills
and
motor
control,
22
articles
mentioned
measurement
of
IQ.
The
studies
on
the
influence
of
medication
less
often
reported
the
IQs
of
the
participants.
In
fact,
seven
studies
among
the
fifteen
studies
measured
IQ.
The
IQ
cut-off
of
80
was
clearly
mentioned
in
8
studies
and
in
7
studies,
no
cut-off
was
mentioned
but
the
means
and
SD’s
make
it
very
likely
that
IQ
was
higher
than
80.
In
3
studies
only
the
verbal
IQ
was
assessed
with
a
cut-off
of
80.
In
almost
all
of
the
studies,
the
medical
diagnoses
of
ADHD
were
established
on
the
basis
of
the
DSM-IV
criteria
combined
with
information
from
parents.
In
two
studies,
the
diagnoses
were
based
on
the
DSM-III
criteria.
Questionnaire
information
from
teachers
was
used
to
a
lesser
extent.
While
some
studies
excluded
children
with
comorbidity,
the
types
of
comorbid
disorders
that
were
excluded
varied
from
one
study
to
another.
Some
only
excluded
DCD
(Langmaid,
Papadopoulous,
Johnson,
Phillips,
&
Rinehart,
2013;
Schoemaker,
Ketelaars,
van
Zonneveld,
Minderaa,
&
Mulder,
2005),
others
excluded
autistic
disorders
(Papadopoulos,
Rinehart,
Bradshaw,
&
McGinley,
2013),
Tourette
or
Asperger
syndrome
(Stray
et
al.,
2010);
neurologic
or
orthopaedic
disorders
such
as
cerebral
palsy,
neuropathic
diseases,
limb
fractures,
head
trauma
(Shorer,
Becker,
Jacobi-Polishook,
Oddsson,
&
Melzer,
2012)
or
learning
disabilities
(Tucha
&
Lange,
2001).
Among
studies
that
investigated
motor
skills
of
ADHD
children
who
were
without
medication,
six
studies
investigated
whether
these
children
met
the
diagnostic
criteria
for
developmental
coordination
disorder
(DCD).
The
diagnosis
for
DCD
was
made
on
the
basis
of
the
DSM-IV-TR
criteria
(2000):
(1)
a
delay
in
motor
coordination
based
on
the
results
of
a
motor
skills
test
that
are
well
below
average.
The
cut-off
mentioned
in
the
recommendations
for
diagnosis,
assessment
and
intervention
of
the
European
Academy
of
Childhood
and
Disability
is
a
score
on
a
motor
coordination
test
that
is
15th
percentile
(Blank,
2012).
(2)
The
impairment
of
motor
coordination
impacts
daily
activities.
(3)
No
medical
conditions
explain
the
motor
impairment.
(4)
If
mental
retardation
is
present,
the
motor
deficit
is
more
important
than
those
usually
associated
with
it.
The
term
‘probable
DCD’
is
used
when
only
the
first
criterion
has
been
assessed
(Coverdale
et
al.,
2012).
When
the
score
of
the
MABC
is
between
the
5th
and
the
15th
percentiles,
various
labels
are
used
to
describe
the
diagnosis
such
as
moderate
motor
difficulties
(Schoemaker,
Lingam,
Jongmans,
van
Heuvelen,
&
Emond,
2013),
probable
DCD
(Lingam
et
al.,
2010)
or
borderline
DCD
(Geuze,
Jongmans,
Schoemaker,
&
Smits-Engelsman,
2001).
To
assess
gross
motor
skills
and
fine
motor
skills,
in
13
studies,
a
standardised
battery
such
as
the
Movement
Assessment
Battery
for
Children
(MABC;
Henderson
&
Sugden,
2000),
the
Bruininks-Oseretsky
Test
of
Motor
Performance
(BOTMP;
Bruininks,
1978)
or
the
Test
of
Gross
Motor
Development-2
(TGMD-2;
Ulrich,
2000)
was
administered.
Three
studies
used
a
neurodevelopmental
examination
such
as
the
Zurich
Neuromotor
Assessment
(Largo,
Fischer,
&
Caflisch,
2002)
or
the
Physical
and
Neurological
Examination
for
Subtle
Signs
(PANESS,
Denckla,
1985).
Finally,
the
remaining
studies
assessed
one
particular
motor
component
such
as
balance
or
sequential
opposition
of
thumb-fingers.
The
majority
of
the
studies
used
parametric
tests
such
as
an
ANOVA
or
t-test,
and
15
studies
reported
effect
size
or
partial
effect
size
(Table
1).
3.2.
Motor
skills
of
ADHD
children
without
medication
Among
samples
of
children
with
ADHD,
the
prevalence
of
children
who
present
a
probable
risk
of
DCD
with
a
score
below
the
15th
percentile
on
the
MABC
varies
as
follows:
51.5%
(Pitcher
et
al.,
2003),
65%
(Fliers,
de
Hoog,
et
al.,
2010;
Fliers,
Franke,
et
al.,
2010)
and
73.5%
(Brossard-Racine
et
al.,
2012).
In
this
last
study,
if
the
5th
percentile
had
been
applied,
the
proportion
56 arti
cles foun
d
41 art
icles on
motor
skills and
motor
con
trol
15 art
icles on the
influen
ce of
med
ication
on motor skill
s and
motor con
trol
11
art
icles on
motor
skills and
motor con
trol
rejected
30
art
icles on
motor
skills and
motor con
trol
retaine
d
15 art
icles on the
influen
ce of
med
ication
on motor skill
s and
motor con
trol retained
45 arti
cles i
nclud
ed
in the rev
iew
Fig.
1.
Process
of
selection
of
the
review.
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
341

Table 1
Studies on motor skills and aspects of motor control among ADHD children.
Studies Sample Mean age
(SD)
Gender IQ (SD) Diagnosis of
ADHD comorbidity
Motor test Data analysis Results of ADHD children
compare to those of TD
children for motor skills and
motor control
Whitmont and
Clark (1996)
24 ADHD
24TD
9.1 (1.3)
9.22 (0. 9)
19M; 5F
18M; 6F
103 (20)
101 (16)
-Medical Diagnosis (MD) on
DSM-III criteria
-Conners’ Rating Scale – Parent
-Comorbidity NR
-Fine motor composit of
the Bruininks–Oseretsky
Test of Motor
Proficiency (BOTMP)
Kinaesthetic Acuity Test
(KAT)
t-test Poorer fine motor skills on the
BOTMP and at the KAT (errors
and precision)
Carte et al.
(1996)
43 ADHD
31 TD
9.6 (1.9)
9 (2)
Only M 110 (17)
119 (16)
VIQ
-MD diagnosis
-Conners’ parents Q
-Child Behaviour Checklist
(CBCL) parents
-Parent ratings on a DSMIII-TR
symptoms checklist
-Inclusion if oppositional
defiant disorder
Time To Do 20 (TDD-20)
with legs and arms
ANCOVA
MANCOVA
Effect size
TDD-20 with legs differentiate
the two groups but not the TDD-
20 with arms
Leung and
Connolly (1998)
20 ADHD-H
12 ADHD + CD
18 CD
22 TD1
7.7 (0.4)
7.8 (0.4)
7.8 (0.4)
7.8 (0.4)
Only M 107 (11)
110 (15)
101 (12)
108 (13)
IQ>80
-Diagnosis on DSM-IV
-Conners’ teachers Q
-Parents and teacher strengths
Questionnaires (PACS)
-Exclusion if autistic, physical or
neurological disorders. Conduct
disorder included
Choice reaction time on
a keyboard
-Response initiation
time:
-Variability of response
initiation time
Movement time
-Variability of
movement time
MANOVA No difference between groups on
any measures
Steger et al.
(2001)
22 ADHD
20 TD
10.9
10.6
19M; 3F
17M; 3F
IQ >80 -Interview based on DSM-II-TR
-CBCL parents and teacher
-No comorbid disorders except
oppositional defiant disorder
-Neuromotor
Assessment Battery
(NAB)
-Reaction time test with
pinch used of index-
thumb
ANCOVA
Regression analysis
-Sequential opposition thumb-
fingers slower
-No difference in RT and peak
force
-Longer time from force onset to
force peak
-In bilateral condition; greater
variability of peak force
Pitcher et al.
(2002) part 1
50 ADHD-I
16 ADHD-H
38 ADHD-C
39 TD
10 (1.2)
9.9 (1.2)
10.2 (1.3)
10.3 (1.3)
Only M 101 (20)
100 (20)
100 (19)
111 (18)
VIQ only
tested
Australian disruptive
behaviours scale (ADBS)
parents or guardian
No information about
comorbidity
-MABC (15th
percentile)
-Tapping apparatus with
index finger
ANOVA
Effect size
-ADHD-I and ADHD-C: greater
RT and peak force
-ADHD-H greater RT variability
Pitcher et al.
(2002) part 2
49 ADHD
55 ADHD + DCD
31 TD
9.9 (1.3)
10.2 (1.2)
10.2 (1.4)
Only M 103 (18)
98 (20)
111 (18)
VIQ only
tested
Australian disruptive
behaviours scale (ADBS)
parents or guardian
-MABC (15th
percentile)
-Tapping apparatus with
index finger
ANOVA
Effect size
-ADHD children: greater
variability of peak force
-DCD children: difficulties in
force control
Yan and
Thomas (2002)
10 ADHD
10 TD
9.6 (1.6)
9.8 (1.3)
Only M Not
Reported
(NR)
MD diagnosis of ADHD
Exclusion if neurologic or
psychiatric diagnosis
Pursuit task MANOVA -No difference in RT between
groups in simple movements
-Slower in complex movement;
more variable in movement
timing; more jerky movements
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
342

Pitcher et al.
(2003)
50 ADHD-I
16 ADHD-H
38 ADHD-C
39 TD
10 (1.2)
9.1 (1)
10.2 (1.4)
10.4 (1.4)
Only M 102 (20)
99 (20)
99 (19)
111 (18)
VIQ only
tested
Australian disruptive
behaviours scale (ADBS)
parents or guardian
Comorbidity NR
-MABC (15th
percentile)
-Purdue Pegboard Test
(PPB)
ANCOVA
Chi-square test
Effect size
-ADHD-I and ADHD-C: poorer
results in MABC and in manual
dexterity and ball skills than
ADHD-H
-ADHD-I: weaker results at PPB
compare to the two other
subtypes
Rubia et al.
(2003)
13 ADHD
11 TD
8 (2)
9.4 (2)
Only M IQ>80 -MD diagnosis on DSM-IV
criteria
-CBCL
-Teacher Report form
No comorbid disorder except
conduct disorder
-Free tapping
-Synchronised tapping
task
-Sensorimotor
anticipation task
Planned t-tests
Effect size
More variable on a synchronised
tapping task
Tseng et al.
(2004)
42 ADHD-C
42 TD
8.2 (1.2)
8.3 (1.1)
36M; 6F
36M; 6F
25 (6)
24 (11)
Raven’s
coloured
Progressive
Matrices
-MD on DSM-IV criteria
-Activity level Rating Scales
completed by parents and
teachers
Exclusion if comorbid mood or
anxiety disorders, conduct
disorders, or oppositional defiant
disorder
BOTMP t-test Correlation
Stepwise
regression analysis
Poorer fine and gross motor skills
Eliasson
et al. (2004)
25 ADHD
25 TD
11.6 (1.1)
NR
Only M IQ: 73–122 -Multidisciplinary team
diagnosis on DSM-III criteria
-Yale children inventory based
on DSM-IV
Exclusion if neurological
symptoms, reading difficulties
and behavioural symptoms
-MABC (<10th
percentile)
-Tracking target task
ANOVA -More absolute and variable
errors but not constant errors
-No difference in movement
time with visual feed-back
-Slower MT without visual feed-
back
Pedersen
et al. (2004)
16 ADHD-C
19 TD
12.8 (NR)
12.6 (NR)
Only M VIQ>80 -MD diagnosis on DSM-IV-TR
criteria
-Interview with parents and
teachers
Exclusion of DCD
-Lower limb apparatus
with Electromyography
Mixed ANOVA
Effect size
Significant difference in
premotor time but not in
movement time
Klimkeit
et al. (2005)
15 ADHD
15 TD
9.3 (1.6)
9.3 (1.5)
10M; 15F
10M; 5F
IQ >80 MD on DSM-IV criteria
Inclusion of children with
disruptive behaviour disorder,
learning disorder, anxiety
disorder
Selective reaching task ANOVA Effect size -Longer RT in the reach and no
reach condition
-No difference in movement
time
Schoemaker
et al. (2005)
16 ADHD
20 TD
8.4 (1.1)
8.4 (1.2)
11M; 5F
NR
IQ >80 -MD on DSM-IV criteria
If DCD excluded
Graphic task on a tablet
on 4 and 6 mm
conditions
ANOVA -Less accurate in 6 mm condition
than in 4 mm condition
-No difference between groups
in RT; in movement time
-Axial pen pressure higher in
6 mm condition
Slaats-Willemse
et al. (2005)
25 ADHD
25 non
affected
sibling
48 TD
12.2 (2.2)
12.1 (2.9)
12.1 (2.5)
23M; 2F
7M; 18F
14M; 34F
101 (13)
100 (11)
102 (14)
-Conners’ parents and teachers
Q
-Parents and teacher strengths
Questionnaires (PACS)
Inclusion of children with
anxiety disorders, oppositional
defiant disorder, mood disorders,
16% tic disorders
Two computerised
tasks: tracking and
pursuit tasks
ANCOVA
Effect size
-No difference for movement
completion
-Poorer accuracy and stability of
the movement
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
343

Table 1 (Continued )
Studies Sample Mean age
(SD)
Gender IQ (SD) Diagnosis of
ADHD comorbidity
Motor test Data analysis Results of ADHD children
compare to those of TD
children for motor skills and
motor control
Meyer and
Terje (2006)
264 ADHD
264 TD
6–13 For all
group:
378M;
150F
IQ >80 -Disruptive Behaviour
-Disorders Questionnaire
teacher
Exclusion if neurological disorder
-Grooved Pegboard (GP)
-Maze Coordination
Task
-Finger Tapping Test
ANOVA Poorer performance at GP and
maze coordination; not at finger
tapping
Miyahara
et al. (2006)
11 ADHD
10 ADHD +
DCD
16 DCD
23 TD
7–13 NR NR Australian disruptive
behaviours scale (ADBS)
parents or guardian
For diagnosis of DCD:
Tracing task of MABC
Other comorbidity not reported
-Tracing task of MABC
and of BOTMP
-Dual tasks:
Counting backward,
additional noise, name
the animal shown on a
picture
ANOVA -Accuracy of drawing was not
influenced by the diagnosis of
ADHD but by the diagnosis of
DCD
-No difference for speed between
groups
Rommelse
et al. (2007)
350 ADHD
195 non
affected
sibling
271 TD
12 (2.8)
11.5 (3.6)
11.6 (3.2)
12.10 (0.5)
12.23 (0.4)
265M;
85F
88M; 107F
110M; 161F
IQ >70 -Conners’ parents and teachers
Q
-Parents and teacher strengths
Questionnaires (PACS)
Exclusion if autism, epilepsy,
learning disorders, neurologic
disorders
Two computerised
tasks: tracking and
pursuit tasks
Pairwise comparison
Mixed model
-Tracking task and pursuit task:
No difference with the dominant
hand. With the non-dominant
hand; less precise
-Regardless of the hand; faster
movement at tracking task
Adi-Japha
et al. (2007)
20 ADHD
20 TD
Only M IQ>85 MD on DSM-IV criteria
Exclusion if reading disability
Kinematic analysis of
handwriting
Mann Whitney test -More correction of letters; more
substitution or omission errors
-Longer air-time when writing
complex letter or word
-On graphic task; faster
movements but less accurate
Leitner
et al. (2007)
16 ADHD
18 TD
11.9 (1.8)
12.5 (2.1)
11M; 5F
15M; 3F
NR -MD on DSM-IV criteria for
both groups
-Conners’ parents and teachers
Q
Exclusion if learning disabilities,
neurological, orthopaedic,
psychiatric disorders
-Walking during 4 min
-Dual task:
Walk and listen to a
story and count a
specific word
-t-test
-Chi-sQuare test
-Mixed model
-ADHD: longer stride time
-On DT; reduction gait speed for
both group and for ADHD; less
variability of gait speed
Watemberg
et al. (2007)
96 ADHD 8.4 (2) 81M; 15F NR -MD diagnosis on DSM-IV
-Criteria parents and teachers
Q
Exclusion if neurological disorder
MABC (<15th
percentile)
Chi-square test Prevalence of DCD among:
ADHD = 55.2%; ADHD-I = 64.3%;
ADHD-C = 58.9%; ADHD-H = 11%
Licari and
Larkin (2008)
13 ADHD
13 DCD
10 ADHD 
DCD
15 TD
7.4 (0.9)
7.3 (0.7)
7.4 (0.8)
7.3 (0.9)
Only M NR -MD diagnosis on DSM-IV
Exclusion if an comorbidity
-McCarron Assessment
of -Neuromuscular
Development (MAND)
-Zurich Neuromotor
Assessment (ZNA)
ANOVA -No difference at the MAND and
the NZA between ADHD and TD
children
-Significant difference between
the ADHD DCD and TD
children
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
344

Fliers, de Hoog,
et al. (2010)
and Fliers,
Franke, et al.
(2010)
32 ADHD
18 non
affected
sibling
50 TD
11 (2.4)
10.2 (2.3)
9.1 (0.3)
27M; 5F
8M; 10F
29M; 21F
IQ >70 -MD diagnosis
-Conners’ parents and teachers
Q
-PACS
Exclusion if neurological or
physical disorders
MABC (<15th
percentile)
-Chi-square test
-Linear mixed model
63% ADHD scored <15th at
MABC
Lavasani and
Stagnitti (2011)
26 ADHD
29 TD
6–10 Only M NR DSM-IV criteria used for
diagnosis
Exclusion if neurological or
physical disorders
-Purdue Pegboard
-Fine motor skills test
t-test Weaker results at all the
measures with dominant hand
and non-dominant hand
Borella et al.
(2011)
15 ADHD
15 dyslexic
15 TD
9.3 (1.4)
9.3 (1.4)
9.4 (1.4)
12M; 3F
9M; 6F
12M; 3F
102 (7)
103 (9)
103 (8)
-MD diagnosis on DSM-IV
criteria
-Conners’ Rating Scale – Parent
Exclusion if neurological,
physical or psychiatric disorders
Inclusion if conduct disorder
Writing ‘le’ during 180 s ANOVA The intravariability was the
same between groups at the
beginning; then an increase is
observed for the ADHD and the
dyslexic group
Wang, Huang,
and Lo (2011)
25 ADHD
24TD
6.5 (1.2)
6.4 (1.2)
19M; 6F
18M; 6F
IQ = 82 (15)
NR
MD diagnosis on DSM-IV
Criteria
Exclusion if neurological,
physical or psychiatric disorders
Exclusion if DCD
MABC (<15th
percentile)
Non statistical
analysis
64% ADHD scored <15th at
MABC
Brossard-Racine
et al. (2012)
49 ADHD 8.4 (1.3) 39M; 10F IQ >80 -MD diagnosis based on DSM-
IV
-Parents’ Conners’ Q
-Global Index Interview with
teachers
Exclusion if neurological or
physical disorders
-MABC <15th percentile
-VMI: copying forms
Wilcoxon signed
rank test
Spearman
Simple linear
regression
73.5% ADHD scored 10 children
with MABC score <15th
percentile; 26 children with
MABC score <5th percentile
Egeland et al.
(2012)
41 ADHD-C
24 ADHD-I
60 TD
12.5 (2.3)
13.5 (1.8)
12.3 (1.9)
21M; 20F
16M; 8F
28M; 32F
97 (14)
92 (15)
100 (10)
Estimated IQ
-MD diagnosis
-Achenbach Scale for parents
and teachers
Exclusion if neurological
disorder, inclusion of psychiatric
disorders
-VMI: 3 parts
-GP
-Halstead Finger
Tapping (FT)
ANCOVA
Effect size
ADHD-C and ADHD-I: lower
score in VMI; GP and FT
Klotz et al.
(2012)
19 ADHD
16 TD
10.5 (1.6)
11.4 (1.5)
11M; 8F
10M; 6F
IQ = 103 (NR)
IQ = 109 (NR)
MD diagnosis on DSM-IV
criteria
Conners’ parents Q
Exclusion if reading disorders,
psychiatric or developmental
disorders
-Physical and
Neurological
Examination for Subtle
Signs (PANESS)
-Sequential opposition
thumb-fingers
-t-test
-Wilcoxon Signed
Rank test
-Poor results at PANESS
-Speed of sequential opposition
slower, even more in non-
dominant hand
Shorer et al.
(2012)
22 ADHD
15 TD
9.3 (1.4)
9.1 (1.7)
20M; 2F
13M; 2F
IQ >70 -MD on DSM-IV criteria for
both groups
-Conners parents and teachers
Q
Exclusion if neurological,
physical or psychiatric disorders
-Postural stability
control on platform
-Dual task:
Listening to 6 songs in
order to memorise
-t-test
-ANOVA
-Pearson correlation
-Greater sway in mediolateral
direction in single task
-On DT: lower value of sway
parameters for both groups
Chen et al.
(2013)
10 ADHD
10 TD
9.65 (1.27)
9.33 (1.54)
5M; 5F
4M; 6F
NR MD diagnosis
Comorbidity NR
Rope jumping constant
rate and variable rate on
a force place
-Mann Whitney Utest
-Effect size
More variability of time between
the movement of the arms and
the jump
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
345

Table 1 (Continued )
Studies Sample Mean age
(SD)
Gender IQ (SD) Diagnosis of
ADHD comorbidity
Motor test Data analysis Results of ADHD children
compare to those of TD
children for motor skills and
motor control
Langmaid
et al. (2013)
14 ADHD
14 TD
10.9 (2)
10.6 (2.3)
Only M 97 (12)
101 (10)
-Interview on DSM-IV criteria
-Conners’ Rating Scale – parent
Exclusion if neurological,
physical disorders
Kinematic analysis of
four l’s in cursive in
10 mm and 40 mm
conditions
t-test -In the 40 mm condition; smaller
letter and less accurate and no
variability of the production
-Faster movements and excess of
movements
Goulardins
et al. (2013)
34 ADHD
32 TD
7–11 NR NR MD diagnosis on DSM-IV-TR
Exclusion if comorbidity
Inclusion if conduct disorder
Motor Development
Scale
-t-test
-Mann Whitney Utest
12% of ADHD children had lower
score and none of the TD children
Significant difference between
groups
Papadopoulos
et al. (2013)
16 ADHD
16 TD
10.7 (1.6)
10.6 (2.6)
Only M 97 (12)
105 (16)
-MD diagnosis on DSM-IV
criteria
-Conners’ Rating Scale – Parent
Exclusion if autistic disorder
MABC-2 -t-test
-Correlation analysis
-No difference between groups
on the MABC-2
-Relationship between
inattention symptoms and
motor deficit
-poor results in ball skills is
related to inattention symptoms
Rosch et al.
(2013)
28 ADHD
23 TD
10.2 1.4)
10.8
1.3
Only M IQ>80 -MD diagnosis on DSM-IV
-Conners parents and teachers
Q
Exclusion if neurological or
psychiatric disorders
Inclusion if conduct disorder
Sequential opposition
thumb-fingers
ANOVA Speed was slower; but no
difference between hands
More variability
Scharoun
et al. (2013)
58 ADHD
58 TD
10.1 (9.11)
10.1 (9.11)
NR NR -MD on ICD-10 criteria
-The Strengths and
Difficulties Q
Comorbidity NR
Fine and gross motor
skills task
ANOVA Poor performance at most of the
items
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
346

of
DCD
children
would
have
been
53%,
which
approaches
the
55.2%
prevalence
reported
by
Watemberg
et
al.
(2007).
Goulardins,
Marques,
Casella,
Nascimento,
and
Oliveira
(2013)
found
a
lower
percentage
with
41%
of
the
ADHD
children
who
had
lower
results
than
the
mean
at
the
Motor
Development
Scale
(MDS)
developed
in
Brazil,
Searching
for
difference
between
ADHD
group
and
TD
group,
different
results
are
found.
Carte,
Nigg,
and
Hinshaw
(1996)
used
the
Time
to
do
20
battery
of
Denckla
(1974)
which
measures
motor
skills
automatization.
This
battery
requires
slapping
hand
20
times
on
the
thigh
and
then
20
times
with
alternating
pronation
and
supination
of
forearm.
The
same
procedure
is
done
for
the
foot,
with
toe-tapping
on
the
ground
and
then,
tapping
with
alternating
heel
and
toe.
They
found
that
foot
items
discriminated
better
the
ADHD
children
from
the
TD
children,
ADHD
children
being
significantly
slower.
Recently,
Papadopoulos
et
al.
(2013)
did
not
find
a
difference
at
the
MABC-2
scores
between
both
groups.
Using
the
McCarron
Assessment
of
Neuromuscular
Development
(McCarron,
1982)
and
the
Zurich
Neuromotor
Assessment
(Largo
et
al.,
2002),
Licari
and
Larkin
(2008)
did
not
find
any
difference
in
motor
scores
between
the
children
with
ADHD
without
motor
problems
and
the
TD
children.
Nevertheless,
when
the
comparison
was
conducted
between
children
with
ADHD-DCD
and
the
TD
children,
the
difference
was
significant
between
these
groups.
Without
making
a
formal
diagnosis
of
DCD,
specific
components
have
been
investigated
in
several
studies.
Some
of
these
studies,
which
used
different
assessments,
described
an
impairment
of
balance
among
ADHD
children.
Tseng
et
al.
(2004)
found
that
children
with
ADHD
scored
significantly
lower
than
the
TD
children
on
the
balance
subscore
of
the
BOTMP,
and
Harvey
et
al.
(2007)
confirmed
these
results
for
the
locomotor
part
of
the
TGMD-2.
The
results
for
fine
motor
skills
are
almost
convergent.
While
ADHD
children
performed
a
sequential
oppositional-
thumb-finger
task
more
slowly
than
the
TD
children
(Steger
et
al.,
2001),
they
were
not
slower
when
performing
a
simple
oppositional
thumb-digit
task
(Meyer
&
Terje,
2006).
The
fine
motor
subscore
of
the
BOTMP
was
significantly
lower
for
the
group
of
ADHD
children
than
for
the
group
of
TD
children
(Tseng
et
al.,
2004;
Whitmont
&
Clark,
1996).
Lavasani
and
Stagnitti
(2011),
using
a
fine
motor
assessment
that
was
validated
for
Iranian
children,
determined
that
boys
with
ADHD
performed
more
poorly
than
boys
without
ADHD.
These
results
were
confirmed
by
Scharoun
et
al.
(2013),
who
found
that
children
with
ADHD
performed
fine
motor
tasks,
such
as
spiral
tracing,
dot
filling,
tweezers
and
beads,
more
slowly
than
children
without
ADHD.
Regarding
the
quality
of
the
movement,
compared
to
TD
children,
ADHD
children
have
less
precise
and
less
stable
movements
during
a
tracking
task
(Slaats-Willemse
et
al.,
2005)
and
during
a
pursuit
task
(Rommelse
et
al.,
2007).
Consistent
with
these
results,
Yan
and
Thomas
(2002)
observed
more
online
corrections
of
the
movements
and
more
jerky
movements.
Studies
further
find
that
children
with
ADHD
have
a
less
legible
handwriting
(Tucha
&
Lange,
2001).
Compared
to
TD
children,
ADHD
children
made
more
spelling
errors,
more
insertions
and/or
deletions
of
letters
as
well
as
more
letter
corrections.
The
letters
tended
to
be
larger
(Adi-Japha
et
al.,
2007;
Shen,
Lee,
&
Chen,
2012).
The
variability
in
the
production
of
letters,
however,
is
probably
the
main
concern,
as
children
demonstrate
variability
in
the
height
of
the
letters
(Adi-Japha
et
al.),
in
letter
spacing,
in
word
spacing,
as
well
as
in
the
alignment
of
the
letters
on
the
baseline
(Tucha
&
Lange,
2001).
Moreover,
the
variability
increases
when
longer
texts
must
be
written.
This
suggests
that
ADHD
children
will
have
more
difficulty
producing
a
stable
handwriting
when
writing
for
a
long
period
of
time
(Borella,
Chicherio,
Re,
Sensini,
&
Cornoldi,
2011).
A
lack
of
accuracy
with
respect
to
handwriting
is
found
in
three
of
the
studies.
In
the
first
study,
children
had
to
write
a
cursive
‘‘l’’
in
two
conditions:
10
mm
and
40
mm.
Children
with
ADHD
were
less
accurate
than
the
TD
group
as
they
missed
the
target
(upper
line)
more
often,
but
only
in
the
condition
of
40
mm
(Langmaid
et
al.,
2013).
In
the
second
study,
a
graphic
task
was
used
under
two
conditions
(4
mm
and
6
mm).
The
results
indicated
that
children
with
ADHD
were
less
accurate
in
the
6
mm
condition
than
in
the
4
mm
condition
as
they
did
not
even
reach
the
margin
lines
when
drawing
forms
(Schoemaker
et
al.,
2005).
In
the
third
study,
children
with
ADHD
were
faster
but
less
accurate
than
the
TD
group
when
drawing
an
ellipse
(Adi-Japha
et
al.,
2007).
There
is
good
evidence
that
children
with
ADHD
have
weaker
motor
skills
than
their
peers.
Some
researchers
(Carte
et
al.,
1996;
Harvey
et
al.,
2009)
have
affirmed
that
gross
motor
skills
are
more
often
impaired
among
children
with
ADHD,
while
others
(Whitmont
and
Clark,
1996)
have
postulated
that
fine
motor
skills
are
more
affected.
When
administering
the
MABC-
2,
Brossard-Racine
et
al.
(2012)
found
that
manual
dexterity
was
more
often
below
the
normal
range.
However,
other
studies
that
used
MABC
did
not
report
the
number
of
children
who
scored
below
the
15th
percentile.
Some
studies
have
investigated
whether
children
with
various
subtypes
of
ADHD
differ
in
the
way
their
motor
skills
are
affected
(Egeland,
Ueland,
&
Johansen,
2012;
Meyer
&
Terje,
2006;
Pitcher
et
al.,
2003;
Watemberg
et
al.,
2007).
The
results
are
presented
below.
3.2.1.
Motor
skills
of
children
with
ADHD
without
medication:
differences
among
ADHD
subtypes
Two
studies
investigated
the
presence
of
probable
DCD
(a
score
between
the
5th
and
the
15th
percentile)
among
ADHD
subtypes
(Pitcher
et
al.,
2003;
Watemberg
et
al.,
2007).
The
proportion
of
probable
DCD
among
ADHD-I
children
was
the
highest,
with
58%
in
the
first
study
and
64.3%
in
the
second
study.
For
the
combined
type,
the
percentages
were
47.3%
and
58.9%.
The
children
with
ADHD-H
were
found
to
be
the
least
impaired
with
percentages
of
49%
and
11%.
Egeland
et
al.
(2012)
found
that,
compared
to
the
TD
children,
children
with
ADHD-I
scored
significantly
poorer
on
the
Grooved
Pegboard.
The
same
was
found
for
the
Purdue
Pegboard
Test.
With
respect
to
the
manual
dexterity
subscore
on
the
MABC
(Pitcher
et
al.,
2003),
while
the
ADHD-I
group
differed
from
the
TD
control
group,
no
significant
differences
were
found
between
the
three
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
347

subtypes
of
ADHD.
The
ADHD-I
group
also
scored
significantly
poorer
at
ball
skills
than
did
the
TD
group,
but
the
results
for
the
ADHD-I
group
did
not
differ
from
those
of
the
ADHD-C
group
(Pitcher
et
al.,
2003).
The
children
with
ADHD-C
also
tended
to
have
fine
motor
skill
deficits.
In
fact,
they
recorded
the
lowest
scores
on
the
Grooved
Pegboard
Test
in
the
study
of
Meyer
and
Terje
(2006)
and
(2)
the
Visual
Motor
Integration
Test
(VMI;
Beery,
1997)
in
the
study
of
Egeland
et
al.
(2012).
With
respect
to
the
ADHD-H
group,
Pitcher
et
al.
(2003)
did
not
find
any
difference
regarding
manual
dexterity,
ball
skills
or
balance
compared
to
the
TD
group.
Thus,
it
is
concluded
that
the
ADHD-H
group
is
less
impaired
in
terms
of
motor
skills
than
the
other
two
other
groups
as
they
demonstrate
a
more
severe
impairment
of
fine
motor
skills.
3.3.
Motor
control
aspects
of
non-medicated
ADHD
children
The
aspects
of
motor
control
that
were
analysed
involved
a
broad
spectrum
of
tasks
among
which
were
included
studies
on
balance
and
walking
followed
by
studies
on
reaction
time,
timing,
movement
time
and
the
kinematics
of
handwriting.
Balance
was
analysed
using
a
single
force
platform.
The
results
indicated
that
ADHD
children
had
significant
larger
mediolateral
excursion
of
the
centre
of
pressure
than
did
TD
children
during
a
single
task
(Shorer
et
al.,
2012).
In
dual
tasks,
children
with
ADHD
performed
better
than
their
peers
on
balance
tasks.
In
fact,
Shorer
et
al.
(2012)
showed
that
balance
parameters
improved
more
in
dual
tasks
for
the
ADHD
group
than
they
did
for
the
control
group.
Leitner
et
al.
(2007)
came
to
a
similar
conclusion
in
a
study
on
gait
analysis,
finding
that
ADHD
children
had
a
less
rhythmic
and
less
automatic
walk
in
a
single
task.
In
a
dual
task
condition,
children
with
ADHD
as
well
as
TD
children
tended
to
slow
down
and
walk
more
rhythmically
and
with
less
stride
time
variability
in
the
dual
task
condition
than
the
TD
children
(Leitner
et
al.,
2007).
Many
studies
have
investigated
reaction
time
(RT)
among
children
with
ADHD.
Reaction
time
can
be
a
measure
of
sustained
attention
in
a
model
of
attention
as
well
as
a
measure
of
the
preparation
of
the
movement
in
a
model
of
motor
control.
The
present
review
is
limited
to
articles
that
analysed
RT
from
the
perspective
of
motor
control.
Pedersen
et
al.
(2004)
used
a
lower
extremity
response
time
apparatus
that
required
the
subject,
while
in
a
sitting
position,
to
move
the
dominant
leg
to
the
right,
middle
or
left
depending
on
the
stimulus.
Using
an
EMG
analysis,
they
differentiated
the
reaction
time
in
two
parts.
The
first
one
is
the
premotor
time
that
is
defined
as
the
time
from
the
stimulus
to
the
reaction
of
the
muscle.
The
second
one
is
the
movement
time
that
is
the
time
from
the
reaction
of
the
muscle
to
the
initiation
of
the
movements.
They
found
that
children
with
ADHD
had
a
slower
movement
preparation.
With
respect
to
the
upper
limb,
when
the
movements
were
simple
such
as
a
one-finger
tapping
task
(Meyer
&
Terje,
2006;
Rubia
et
al.,
2003),
and
simple
choice
reaction
time
(Leung
&
Connolly,
1998)
or
a
simple
graphic
task
(Schoemaker
et
al.,
2005),
there
were
no
differences
between
the
ADHD
and
the
TD
groups
on
RT.
However,
when
the
movement
was
complex,
such
as
in
a
sequential
opposition
thumb
to
finger
task,
it
was
found
that
the
RT
for
the
ADHD
group
was
longer
than
it
was
for
the
TD
group
(Klotz,
Johnson,
Wu,
Isaacs,
&
Gilbert,
2012).
Similarly,
on
a
choice-reaching
task
the
ADHD
children
had
a
slower
RT
than
the
TD
children
(Klimkeit
et
al.,
2005).
Pitcher
et
al.
(2002)
analysed
the
results
of
three
groups
of
children
on
RT
and
force
peak
during
a
tapping
index
finger
task.
The
three
groups
included
children
with
ADHD
and
DCD,
children
with
ADHD
but
not
DCD
and
TD
children.
They
found
that
children
with
ADHD
but
not
DCD
did
not
differ
on
RT
from
the
TD
children,
while
children
with
ADHD-DCD
had
significantly
slower
RT
and
lower
peak
force
than
the
TD
group.
Furthermore,
both
ADHD-DCD
and
ADHD
groups
had
a
greater
inter-tap
interval
than
the
TD
group.
Based
on
the
results,
Pitcher
et
al.
(2002)
suggested
that
the
variability
of
the
speed
of
the
movement
was
more
a
characteristic
of
ADHD
whereas
poor
recruitment
of
force
and
slower
reaction
time
are
associated
more
with
DCD.
Chen
et
al.
(2013)
found
that
children
with
ADHD
encountered
more
difficulties
following
variable
rates
than
constant
rates
on
a
jump
rope
task,
and
thus,
they
concluded
that
motor
timing
performance
is
impaired
among
ADHD
children.
Yan
and
Thomas
(2002)
also
found
that
the
timing
of
movements
of
the
ADHD
group
was
more
variable
than
was
the
timing
of
the
TD
children.
When
performing
a
tapping
task,
compared
to
the
TD
children,
the
children
with
ADHD
were
slower
and
showed
greater
variability
between
the
sequences
(Rosch,
Dirlikov,
&
Mostofsky,
2013).
However,
a
difference
between
the
ADHD
group
and
the
TD
group
also
was
noted
when
they
performed
a
synchronised
taping
task,
ADHD
children
were
more
variable
(Rubia
et
al.,
2003).
Finally,
on
a
tapping
task
that
required
strength,
the
results
of
children
with
ADHD
did
not
differ
from
the
TD
children
with
respect
to
peak
force
(Steger
et
al.,
2001).
With
respect
to
movement
time,
the
results
vary.
No
differences
were
found
between
groups
of
children
with
ADHD
and
without
ADHD
on
a
lower
limb
task
(Pedersen
et
al.,
2004)
or
on
a
reaching
task
(Klimkeit
et
al.,
2005).
In
the
latter
study,
even
when
a
distractor
was
added,
the
ADHD
group
was
not
slower
than
the
TD
group.
On
a
tracking
task,
no
differences
for
the
completion
time
were
found
between
the
ADHD
children
and
the
TD
children
(Slaats-Willemse
et
al.,
2005).
Similarly,
Rommelse
et
al.
(2007)
found
that
the
speed
of
the
children
with
or
without
ADHD
did
not
differ
on
a
tracking
task
and
a
pursuit
task.
On
an
aiming
task,
however,
Yan
and
Thomas
(2002)
found
that
children
with
ADHD
were
slower
than
their
counterparts
when
the
movement
required
more
complex
motor
coordination.
This
result
was
confirmed
by
Klotz
et
al.
(2012)
who
found
that
the
speed
was
slower
for
children
with
ADHD
than
for
TD
children
on
a
sequential
opposition
of
thumb
to
fingers
task.
Eliasson,
Rosblad,
and
Forssberg
(2004)
nuanced
the
results.
In
fact,
when
the
tracking
task
was
performed
with
visual
feedback,
there
were
no
differences
between
groups
with
respect
to
movement
time.
However,
when
the
same
task
was
performed
without
visual
feedback,
a
difference
between
the
groups
was
found.
When
the
researchers
controlled
for
the
deficit
in
motor
skills,
the
ADHD
children
who
scored
below
the
10th
percentile
on
the
MABC
were
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
348

particularly
slower
than
the
control
group,
which
was
not
the
case
for
the
ADHD
children
who
scored
above
the
10th
percentile.
In
some
studies,
the
results
for
the
non-dominant
hand
have
also
been
analysed.
Rommelse
et
al.
(2007),
found
that
children
with
ADHD
were
much
slower
on
the
tracking
task
and
pursuit
task
with
the
non-dominant
hand
than
the
TD
children.
Klotz
et
al.
(2012)
also
found
a
difference
of
speed
with
the
non-dominant
hand
at
the
sequential
thumb-fingers
opposition
compare
to
TD
children.
On
the
other
hand,
Rosch
et
al.
(2013)
did
not
find
any
difference
between
hands
on
the
sequential
opposition
thumb-fingers
task
between
groups
of
children
with
ADHD
and
without
ADHD.
Regarding
the
kinematic
features
of
handwriting
products,
the
fluency
of
the
movement
did
not
differ
between
groups
of
ADHD
children
and
TD
children
on
a
handwriting
task
(Tucha
&
Lange,
2001)
or
on
a
graphic
task
(Schoemaker
et
al.,
2005).
Adi-Japha
et
al.
(2007)
compared
the
results
of
a
graphic
task
with
those
of
a
handwriting
task
and
found
that,
compared
to
TD
children,
the
ADHD
children
made
faster
movements
during
the
graphic
task
and
slower
movements
during
the
handwriting
task.
Shen
et
al.
(2012)
have
found
that
children
with
ADHD
hold
the
pen
longer
in
the
air
between
movements
than
do
TD
children.
Adi-Japha
et
al.
(2007),
however,
reported
that
the
pen
was
only
in
the
air
longer
when
ADHD
children
had
to
write
complex
letters.
This
finding
may
imply
that
the
planning
of
the
movement
takes
longer.
On
a
graphic
task
in
different
dual
task
conditions
such
as
counting
backwards
or
listening
to
a
specific
sound,
or
with
additional
noise,
no
differences
were
found
between
children
with
ADHD,
with
ADHD
and
DCD
and
TD
children
(Miyahara,
Piek,
&
Barrett,
2006).
The
results
of
these
studies
provide
sufficient
evidence
that
children
with
ADHD
tend
to
have
slower
reaction
time
when
the
movements
are
complex
and
that
they
have
difficulty
with
motor
timing.
Regarding
movement
time,
there
may
be
differences
between
children
with
and
without
ADHD
when
the
movements
are
complex
or
when
there
is
no
visual
feedback
(Table
2).
3.4.
Effect
of
medication
on
motor
skills
of
children
with
ADHD
Two
types
of
medication
are
common
in
the
treatment
of
ADHD:
stimulants
such
as
methylphenidate
and
nonstimulants
such
as
atomoxetine.
Methylphenidate
is
the
most
commonly
used
and
it
is
known
to
improve
attention
(Sharma
&
Couture,
2014).
The
nonstimulant
medication
still
needs
more
investigations
in
order
to
confirm
its
efficacy.
Nevertheless,
the
medication
has
an
influence
on
the
symptoms
of
ADHD
such
as
hyperactivity,
impulsivity,
antisocial
behaviours
and
attention
(Rubia
et
al.,
2003).
Side-effects
of
the
medication
such
as
physical
growth,
sleep
or
digestion
have
been
described
but
Sharma
and
Couture
did
not
draw
any
definitive
conclusion,
in
their
systematic
review.
We
do
not
think
that
these
side-
effects
have
a
direct
influence
on
motor
skills.
The
medication
however
could
have
an
indirect
influence
on
motor
skills
as
will
be
described
further
on.
The
results
of
studies
on
the
effects
of
methylphenidate
on
the
motor
skills
of
children
with
ADHD
are
not
homogenous.
Rather,
they
depend
on
the
tests
used
and
on
the
severity
of
the
motor
skill
deficits.
Bart,
Daniel,
Dan,
and
Bar-Haim
(2013)
tested
30
children
diagnosed
with
ADHD
and
coexisting
DCD
using
the
MABC
and
found
an
improvement
into
the
normal
range
for
67%
of
the
children
when
they
were
on
medication
compared
to
when
they
were
off
medication.
Four
children
approached
the
borderline
range,
while
six
retained
the
DCD
diagnosis.
In
an
earlier
study
of
18
children
with
comorbid
ADHD
and
DCD,
Bart
et
al.
(2010)
reported
that
among
the
18
children
with
ADHD
who
scored
below
the
5th
percentile
on
the
MABC,
five
improved
their
scores
on
the
MABC
to
above
the
15th
percentile
and
11
scored
above
the
5th
percentile.
Brossard-Racine
et
al.
(2012)
included
49
children
who
had
been
newly
diagnosed
with
ADHD
and
for
whom
medication
had
been
recommended.
Of
the
ten
children
with
scores
between
the
6th
and
15th
percentiles,
seven
improved
their
scores
to
the
normal
range
on
the
MABC
when
on
medication.
However,
among
the
26
children
with
a
total
score
below
the
5th
percentile
on
the
MABC,
only
two
children
moved
to
the
normal
range
and
six
to
the
borderline
range
while
on
medication.
With
respect
to
the
TGMD-2,
Harvey
et
al.
(2007)
found
an
improvement
to
the
normal
range
for
12
out
of
22
children
after
medication,
but
the
improvement
was
not
statistically
significant
at
the
group
level.
The
differences
in
the
results
among
these
studies
could
be
explained
by
the
differences
in
the
tests
used.
In
fact,
the
TGMD-2
contains
six
items
on
ball
skill
performance,
whereas
the
MABC
has
only
two
items,
and
the
TGMD-2
contains
six
items
on
locomotor
skills,
most
of
which
assess
balance,
whereas
the
MABC
has
three
items
that
assess
balance.
In
addition,
the
TGMD-2
is
a
test
that
evaluates
the
quality
of
movement
performance,
whereas
the
MABC
evaluates
the
outcome
of
movement.
In
the
study
of
Harvey
et
al.,
there
were
no
items
to
assess
fine
motor
skills,
whereas
the
MABC
had
three
items
on
manual
dexterity.
This
may
suggest
that
fine
motor
skills
are
more
sensitive
to
improvement
due
to
medication
than
are
ball
skills
and
balance.
The
results
for
balance
are
convergent.
After
medication,
an
improvement
in
dynamic
balance
is
found,
but
there
is
no
improvement
in
static
balance.
Wade
(1976)
found
an
improvement
in
balance
on
a
hanged
board
after
medication.
Brossard-Racine
et
al.
(2012)
found
improvement
in
the
balance
subscale
of
the
MABC,
but
these
significant
improvements
were
the
result
mainly
of
improvements
in
dynamic
balance
because
the
measure
of
balance
on
the
MABC
is
composed
of
two
items
that
assess
dynamic
balance
and
one
item
that
assesses
static
balance.
Bart
et
al.
(2010)
did
not
find
any
significant
changes
with
respect
to
the
static
balance
item
on
the
MABC.
With
respect
to
fine
motor
skills,
Brossard-Racine
et
al.
(2012)
found
that
the
most
important
improvement
was
in
manual
dexterity
of
the
MABC-2.
For
a
group
of
12
children
with
ADHD
and
DCD,
eleven
improved
their
scores
by
at
least
one
point
when
on
medication
(Flapper,
Houwen,
&
Schoemaker,
2006).
Thus,
the
influence
of
medication
on
the
quality
of
handwriting
is
not
clear.
In
one
study,
improvements
were
noted
regarding
better
legibility,
better
letter
formation,
more
regular
spacing
and
better
alignment
of
the
letters
(Tucha
&
Lange,
2001).
Conversely,
Rosenblum,
Epsztein,
and
Josman
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
349

Table 2
Studies on the effect of medication.
Studies Sample Age Gender IQ Diagnosis ADHD Outcome measure Analysis Design of study Effect of medication
Wade (1976) 12 ADHD
12 TD
7.7–12 (NR) NR NR -MD diagnosis
-Conners parents rating
scale
Comorbidity NR
Rotated square
platform
ANOVA Single, fixed effects
model
Improvement of time in
balance and less
variability
Tucha and
Lange (2001)
21 ADHD
21 TD
10.7 (0.4)
10.5 (0.4)
Only M NR -MD diagnosis on DSM-IV
criteria
-Conners parents and
teachers rating scale
(CPTRS)
Exclusion if spelling or
reading disorders
Kinematic analysis
of handwriting of
‘ll’
Non parametric
test
Crossover study
7 days interval
-Improvement of
legibility; spacing
Variability of the
acceleration and of the
velocity
-Slower handwriting
Rubia et al.
(2003)
13 ADHD
11 TD
8.1 (2)
9.4 (2)
Only M IQ >80 -MD diagnosis on DSM-IV
criteria
-CBCL
-Teacher Report form
Exclusion if neurological or
psychiatric disorders
-Free taping
-Synchronised
taping
-Sensorimotor
anticipation task
-Planned t-tests
-Effect size
Double-blind;
placebo-controlled;
crossover trial
1,2 and 4 weeks
interval
Improvement of
synchronised tapping
Pedersen
et al. (2004)
16 ADHD-C
19 TD
12.8 (NR)
12.6 (NR)
Only M VIQ >80 -MD diagnosis on DSM-
IV-TR criteria
-Interview with parents
and teachers
Exclusion if neurological,
physical or learning
disorders
-Lower limb
apparatus with
Electromyography
-Mixed ANOVA
-Effect size
Randomised study
on and off
medication
One day interval
Faster premotor time
Less variability in the
movement time
Klimkeit
et al. (2005)
7 ADHD
7TD
11.2 (2.2)
11 (2.1)
Only M IQ >80 -MD on DSM-IV criteria
Inclusion if learning and
behavioural disorders
Selective reaching
task
-ANOVA
-Partial effect
sizes
Pilot trial No difference between
groups on RT and on
movement time
Flapper
et al. (2006)
12 ADHD + DCD
12 TD
9.8 (1.7)
9.7 (1.2)
11M; 1F IQ >70 -MD diagnosis on DSM-IV
criteria
-Checklist questionnaire
Exclusion if neurological,
psychiatric or learning
disorders
-For diagnosis of DCD:
MABC <15th p
-Manual dexterity
of MABC
-BHK
-Kinematic analysis
of flower trail
-Mann Whitney
U-test
Double-blind
placebo-controlled
trial
-6 children improved
the handwriting but not
speed
-Flower trail: more
accurate but less fluent
Harvey
et al. (2007)
22 ADHD
22 TD
10 children
with affective
disorder
9.7
9.8
20M; 2F
20M; 2F
IQ >70 -MD on DSM-IV criteria
for both groups
-Conners’ parents and
teachers Q
Inclusion if psychiatric
disorder
TGMD-2 -ANOVA
-MANOVA
-Effect size
Baseline
Randomised
medication and
placebo; one week
each
No effect of medication
on TGMD-2 score
Leitner
et al. (2007)
16 ADHD
18 TD
11.9 (1.8)
12.5 (2.1)
NR NR -MD diagnosis
-CPTRS
Comorbidity: refer to
Table 1
-Walking
-Dual task:
Walk and listen to a
story; count a
specific word
-Mixed effect
models for
repeated
measures
Double-blind
placebo-controlled
trial
Decrease of stride time
variability
Lufi and
Gai (2007)
19 ADHD 9.51 (1.57) 12M; 7F NR MD on DSM-IV
Comorbidity NR
Handwriting in
copy
t-test Double-blind;
placebo-controlled;
crossover trial
No difference in the
quality of handwriting
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
350

Rosenblum
et al. (2008)
12 ADHD
12 TD
8–10 10M; 2F
10M; 2F
NR -MD on DSM-IV criteria
for both groups
-Conners’ Rating Scale –
Parent
Exclusion if neurological,
physical or psychiatric
disorders
-Kinematic analysis
of a text
-Hebrew
Handwriting
Evaluation
Wilcoxon test Baseline without any
medication
Post medication after
1 month
-No improvement of
speed;
-Improvement of
legibility and spatial
arrangement
-Less time in the air
Jacobi-Polishook
et al. (2009)
24 ADHD 12 ADHD
in EG
a
:
10.6 (2.5)
12 ADHD
in CG
b
:
10.9 (3.25)
11M; 1 F
11M; 1F
IQ >70 MD diagnosis
Conners’ parent and
teacher Q
Exclusion if neurological,
physical or psychiatric
disorders
Force platform:
-Viewing an ‘‘X’’
and listening to
music
-Dual task: listening
to songs and
remembering
-Mixed effect
models for
repeated
measures
-Effect size
Blind randomised
clinical trial: 12 with
medication; 12 with
placebo
-No effect of medication
on postural sway
parameters during the
single task condition
-Medication improves
postural stability in dual
task condition
Bart et al. (2010) 18 ADHD + DCD 8.3 (2.5) 13M; 5F NR -K-SADS-PL
c
-MABC Q
Exclusion if neurological,
physical or psychiatric
disorders
MABC <15th
percentile
t-test and
effect size
Double-blind within-
subjects design; 4–
14 days interval
-5 children of 18 with a
score below the 15th
percentile improved to
normal range on the
MABC
-Except for static
balance, improvement
of all subscores of the
MABC
Stray et al. (2010) 73 ADHD 10.9 (2.7) 62M; 11F NR -MD diagnosis
-Conners’ parent and
teacher Q
Exclusion Tourette or
Asperger syndrome
Motor Function
Neurological
Assessment
(MNFU)
Mann–Whitney
U-test
Double-blind
placebo-controlled
trial; 1 day interval
The children with
moderate or severe
results at the MNFU
showed a greater
improvement after
medication than
children with a good
results at MNFU
Brossard-Racine
et al. (2012)
49 ADHD 8.4 (1.3) 39M; 10F IQ >80 -MD diagnosis based on
DSM-IV
-Parents’ Conners’ Q
-Global Index
Interview with teachers
Comorbidity: refer to
Table 1
MABC <15th
percentile
VMI: copying forms
-Wilcoxon
signed rank test
-Spearman
correlations
-Simple linear
regression
Baseline without any
medication
Post medication after
3 months
-9 children of 36 who
had a score below the
15th percentile
improved to normal
range at the MABC
-Change at MABC except
balance
-No significant change
for VMI copying forms
Bart et al. (2013) 30 ADHD + DCD 8.3 (2.5) 24M; 6F NR -MD diagnosis
-Conners’ parents rating
scales
-DCDQ
Exclusion if neurological,
physical or psychiatric
disorders
MABC-2 <15th
percentile
-Paired t-test
-Effect size
Double crossover
design
3–14 days interval
Blind assessment
20 children of 30 who
had a score below the
15th percentile
improved to normal
range at the MABC
NR, not reported; MD, medical diagnosis.
a
EG: experimental group.
b
CG: control group.
c
K-SADS-PL, schedule for affective disorders and schizophrenia for school-age children-kiddie-sads-present and lifetime version.
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
351

(2008)
found
no
improvement
with
respect
to
legibility,
a
finding
that
is
consistent
with
the
results
of
Lufi
and
Gai
(2007).
Flapper
et
al.
(2006)
found
an
intermediate
result
with
an
improvement
in
half
of
the
children
after
medication.
While
the
influence
of
medication
on
dynamic
balance
and
on
fine
motor
skills
is
well
demonstrated,
more
evidence
is
needed
to
affirm
that
medication
has
a
positive
influence
on
handwriting.
The
reason
why
the
results
are
divergent
is
perhaps
due
to
the
type
of
handwriting
assessment.
Tucha
and
Lange
(2001)
used
a
sequence
of
double
‘‘ll’’,
whereas
the
others
(Flapper
et
al.,
2006;
Lufi
&
Gai,
2007;
Rosenblum
et
al.,
2008)
required
the
subjects
to
copy
text.
3.5.
Effect
of
medication
on
motor
control
aspects
The
influence
of
medication
on
reaction
time
was
analysed
in
several
studies
wherein
the
results
of
the
same
group
of
subjects
were
compared
with
and
without
medication.
Pedersen
et
al.
(2004)
found
that
among
a
group
of
16
children
with
ADHD
using
a
lower
extremity
response
time
apparatus,
children
had
a
faster
premotor
time
and
had
less
variability
in
movement
time
when
they
were
on
medication
than
when
they
were
not.
In
a
gait
analysis
study,
Leitner
et
al.
(2007)
found
that
stride
time
variability
decreased
with
methylphenidate
in
simple
task
conditions
while
gait
speed
increased
in
dual
task
conditions.
Jacobi-Polishook,
Shorer,
and
Melzer
(2009)
did
not
find
any
differences
in
balance
parameters
on
a
force
plate
between
the
same
children
with
and
without
medication,
but
they
did
find
an
improvement
in
dual
task
conditions
after
medication.
With
regard
to
a
tapping
task,
the
children
improved
their
synchronisation
(Rubia
et
al.,
2003),
and
they
were
less
variable
in
their
movement
time
(Pedersen
et
al.,
2004).
Conversely,
on
a
selective
reaching
task,
Klimkeit
et
al.
(2005)
did
not
find
any
differences
between
groups
with
respect
to
RTs
and
movement
times.
As
the
sample
was
quite
small
(5
subjects),
this
result
should
be
taken
with
caution.
Considering
the
kinematics
of
handwriting,
Tucha
and
Lange
(2001)
described
that
the
ADHD
group,
due
to
medication,
had
an
increase
in
the
number
of
inversions
in
velocity
and
in
acceleration
compared
to
the
control
group.
Rosenblum
et
al.
(2008)
found
that
children
with
ADHD
on
medication
spent
less
time
in
the
air
with
their
pencil
than
they
did
when
they
were
not
on
medication.
These
fewer
hesitations
could
indicate
that
they
were
more
efficient
in
planning
ahead
in
their
writing.
There
is
a
good
evidence
to
indicate
that
medication
decreases
the
variability
in
reaction
time
and
movement
time.
The
influence
of
medication
on
reaction
times
and
movement
times,
however,
requires
further
investigation
as
the
reaction
times
was
faster
in
one
study
(Pedersen
et
al.,
2004)
and
showed
no
improvement
in
the
study
of
Klimkeit
et
al.
(2005).
Furthermore,
an
improvement
in
gait
speed
was
found
in
the
study
of
Leitner
et
al.
(2007),
while
Tucha
and
Lange
(2001)
reported
slower
handwriting.
4.
Discussion
From
this
review,
we
draw
the
straightforward
conclusion
that
a
majority
of
children
with
ADHD
have
poorer
motor
skills
than
their
TD
peers
and
that
both
fine
motor
skills
and
gross
motor
skills
may
be
affected.
We
further
conclude
that
the
children
with
ADHD-I
as
well
as
children
with
ADHD-C
show
more
often
an
impairment
of
motor
skills
than
children
with
ADHD-H.
During
this
period
of
school-age,
the
symptoms
of
ADHD
are
quite
stable
(Willcutt,
2012)
and
we
also
know
that
if
children
have
DCD,
it
will
stay
generally
stable
during
the
childhood
as
described
by
Cantell
et
al.
(1994).
When
children
have
a
double
diagnosis
of
ADHD
and
DCD,
the
disorders
may
share
a
common
aetiology.
In
fact,
McLeod,
Langevin,
Goodyear
and
Dewey
(2014)
described,
among
children
with
DCD
and/or
ADHD,
similarities
in
dysfunctional
brains
regions
such
as
in
bilateral
inferior
frontal
gyri,
the
right
supramarginal
gyrus,
angular
gyri,
insular
cortices,
amygdala,
putamen
and
pallidum.
While
children
with
ADHD
do
not
show
slower
reaction
time
than
their
peers
when
performing
simple
reaction
tasks,
the
reaction
times
do
increase
when
the
child
must
make
a
decision,
realise
movements
with
many
sequences
or
write
a
difficult
letter
or
word.
The
ADHD
children
required
more
time
to
plan
their
movements
and
they
need
more
online
control.
Moreover,
variability
in
the
movements
as
well
as
in
the
written
products
are
characteristic
among
children
with
ADHD.
Though
these
children
know
how
to
draw
letters,
the
parameters
of
the
production
of
the
letters
are
inconsistent,
thus
resulting
in
variability
with
respect
to
the
size
of
the
letters
and/or
the
spacing
between
letters
and
words.
In
other
words,
ADHD
children
have
difficulty
parameterising
movements
in
a
consistent
way.
The
review
shows
that
dynamic
balance
and
fine
motor
skills
improve
when
ADHD
children
are
medicated.
For
example,
with
medication
the
variability
in
walking
decreases.
The
medication
does
not
seem
to
influence
static
balance.
The
reason
may
be
that
static
balance
is
a
much
more
automatic
process
than
is
dynamic
balance
(Bart
et
al.,
2010).
The
mechanisms
by
which
the
medication
of
ADHD
improves
motor
skills
and
motor
control
is
not
yet
clear.
Further
research
is
needed
in
order
to
understand
if
the
effects
of
medication
on
neurological
dysfunction
have
a
direct
influence
on
the
performance
of
motor
skills
and
motor
control.
While
some
of
the
children
demonstrated
improvement
when
on
the
medication,
others
still
presented
moderate
to
severe
motor
deficits.
Accordingly,
three
levels
of
motor
deficits
are
distinguished
among
ADHD
children:
(1)
severe
(5th
percentile
on
a
motor
skills
test);
(2)
moderate
(between
the
5th
and
the
15th
percentile
on
a
motor
skills
test
(Brossard-
Racine
et
al.,
2012);
(3)
subnormal,
demonstrating
fine
motor
skill
deficits.
In
fact,
several
studies
excluded
DCD
among
children
with
ADHD
and
described
difficulties
in
motor
skills
such
as
a
lack
of
accuracy
in
graphic
or
handwriting
tasks
(Langmaid
et
al.,
2013;
Schoemaker
et
al.,
2005)
and
greater
variability
in
peak
force
(Pitcher
et
al.,
2002).
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
352

4.1.
Hypothesis
of
explanation
of
impairment
of
motor
skills
among
children
with
ADHD
Which
are
the
explanations
for
motor
problems
associated
with
ADHD?
When
deficits
in
motor
skills
deficits
persist,
three
main
hypotheses
are
retained.
The
first
is
that
comorbidity
can
be
the
cause
of
the
motor
skills
deficits
among
ADHD
children.
The
second
hypothesis
states
that
the
deficits
in
motor
skills
are
due
to
a
lack
of
attention.
The
third
postulates
that
a
lack
of
inhibition
interferes
with
motor
control.
4.1.1.
Comorbidity
Could
the
motor
problems
associated
with
ADHD
be
due
to
a
comorbid
developmental
disorder?
Kadesjo
and
Gillberg
(2001)
reported
that
87%
of
a
sample
of
ADHD
had
at
least
one
comorbid
disorder
and
67%
two
comorbid
disorders.
One
of
the
most
frequent
comorbid
disorders
cited
by
these
authors,
was
DCD.
In
that
perspective,
Gillberg
(2003)
has
introduced
the
diagnosis
of
Deficits
in
attention,
motor
control,
and
perception
(DAMP)
that
regroups
children
with
a
diagnosis
of
ADHD
and
DCD.
Autistic
disorder
is
also
frequent
among
ADHD
children
(Taurines
et
al.,
2010)
and
there
is
some
evidence
that
this
disorder
has
an
influence
on
motor
skills.
In
fact,
Papadopoulos
et
al.
(2013)
has
shown
that
without
autistic
disorder,
the
ADHD
children
did
not
differ
from
TD
children
on
motor
skills.
Concurrently,
Dewey
et
al.
(2007)
described
that
children
with
autism
spectrum
disorders
(ASD)
scored
lower
on
motor
skills
than
the
ADHD
children
or
the
DCD
children.
They
showed
difficulties
to
imitate
movements
and
to
execute
movements
on
command.
Finally,
the
children
with
ADHD
can
have
a
co-
existing
DCD
that
may
be
diagnosed
on
the
basis
of
the
DSM
criteria
as
described
by
Brossard-Racine
et
al.
(2012)
or
Fliers,
de
Hoog,
et
al.
(2010)
and
Fliers,
Franke,
et
al.
(2010).
From
the
review,
it
is
evident
that
children
with
ADHD-DCD
have
more
severe
motor
problems
than
children
with
only
ADHD.
Apart
from
that,
children
with
ADHD
who
do
not
meet
the
criteria
for
DCD
may
still
have
motor
skill
challenges,
albeit
to
a
lesser
degree
(Langmaid
et
al.,
2013;
Schoemaker
et
al.,
2005).
The
information
above
makes
it
clear
that
motor
problems
in
ADHD
may
be
due
to
a
comorbid
disorder
like
DCD
or
one
with
associated
motor
problems
like
autism.
Whether
the
comorbid
disorder
is
an
independent
disorder,
or
shares
a
common
developmental
ground
with
ADHD
is
presently
unknown.
The
fact
that
medication
such
as
methylphenidate
improves
both
symptoms
of
ADHD
and
motor
performance
point
at
the
direction
of
some
common
grounds.
4.1.2.
The
hypothesis
of
a
deficit
of
attention
Many
arguments
support
the
hypothesis
that
a
lack
of
attention
is
the
underlying
mechanism
for
the
motor
skills
deficit.
First,
an
attention
deficit
influences
motor
skills.
Adi-Japha
et
al.
(2007)
studied
handwriting
and
reported
that
errors
such
as
omissions,
insertions
and
corrections
of
letters
are
related
to
inattention
and
are
not
the
result
of
a
deficit
in
motor
skills.
Second,
the
fact
that
children
with
ADHD
are
more
performant
on
balance
in
dual
task
conditions
led
Leitner
et
al.
(2007)
to
postulate
that
dual
tasks
raise
the
level
of
vigilance
that
influences
the
performance.
It
is
possible
that
in
single
tasks,
the
degree
of
vigilance
among
children
with
ADHD
fluctuates,
thus
leading
to
greater
variability
in
the
level
of
production,
while
on
dual
tasks
the
level
of
vigilance
is
more
stable.
Third,
there
is
a
strong
argument
that
with
medication
motor
skills
as
well
some
aspects
of
motor
control
improved.
Moreover,
the
quality
of
the
handwriting
of
those
children
with
ADHD
who
are
medicated
also
improved.
This
improvement
in
quality
likely
occurs
because
the
medicated
ADHD
child
is
better
able
to
focus
on
the
task.
Given
this
last
argument,
two
explanations
are
advanced.
The
first
is
that
methylphenidate
improves
attention,
which,
in
turn,
improves
motor
skills.
The
second
is
that
the
medication
improves
attention
and
motor
skills
independent
each
other.
With
respect
to
arguments
that
favour
the
first
hypothesis,
the
study
of
Bart
et
al.
(2013)
found
that,
with
medication,
the
improvement
in
a
continuous
performance
test
that
measures
sustained
attention
is
strongly
related
to
an
improvement
in
motor
coordination.
Furthermore,
the
reduced
variability
in
the
handwriting
product
observed
with
medication
may
also
be
interpreted
as
the
result
of
improvement
in
attention.
From
the
perspective
of
the
model
of
Paine,
Grossberg,
and
Van
Gemmert
(2004)
constant
visual
attention
is
required
to
anticipate
the
change
of
direction
between
strokes.
If
visual
attention
fluctuates,
these
changes
will
occur
too
late,
thus
contributing
of
higher
letters
and
a
lack
of
alignment
of
letters
on
the
baseline.
Third,
the
fact
that
a
number
of
children
improved
their
scores
into
the
normal
range
on
the
MABC
when
on
medication
might
be
explained
by
the
effect
of
methylphenidate,
which
improved
their
ability
to
focus
and
thus
better
meet
the
requirements
of
the
MABC.
Kaplan,
Wilson,
Dewey,
and
Crawford
(1998)
showed
that
children
with
attention
deficit
scored
more
poorly
on
the
MABC
than
did
the
TD
children.
In
fact,
the
MABC
was
more
sensitive
to
attention
deficit
than
was
the
BOTMP,
a
result
likely
due
to
feedback
not
being
allowed
during
the
MABC
whereas
it
is
permitted
during
the
BOTMP.
Alternatively,
the
possibility
that
medication
improves
motor
skills
independently
of
the
improvement
of
attentional
skills
must
be
considered.
Stray
et
al.
(2010),
in
a
retrospective
study,
found
that
ADHD
children
who
were
good
responders
to
methylphenidate
and
exhibited
a
decrease
of
ADHD
symptoms
more
often
obtained
weak
scores
on
the
Motor
Function
Neurological
Assessment
(MNFU)
before
medication,
whereas
the
ADHD
children
who
were
poor
responders
to
the
medication
obtained
normal
scores
on
the
MNFU.
Because
they
found
improvement
in
motor
skills
among
those
who
responded
well
to
the
medication,
they
suggested
that
the
medication
had
a
direct
influence
on
motor
skills.
However,
not
all
the
children
with
ADHD
improve
their
motor
skills
with
medication
to
the
normal
range.
Some
children
still
show
motor
problems,
which
implies
that
a
lack
of
attention
is
not
the
only
explanation
for
poor
motor
skills
in
children
with
ADHD.
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
353

4.1.3.
The
hypothesis
of
lack
of
inhibition
Barkley
(1997)
was
among
the
first
to
describe
the
relationship
between
the
lack
of
inhibition
and
motor
skills.
However,
prior
to
discussing
his
hypothesis,
it
is
important
to
note
that
he
made
a
clear
distinction
between
children
with
ADHD-C
and
the
inattentive
subtype.
According
to
Barkley,
the
children
with
ADHD-I
do
not
have
the
same
type
of
impairment
as
the
children
with
ADHD-C.
He
contends
that
ADHD-I
children
tend
to
daydream
and
they
demonstrate
a
deficit
with
respect
to
the
speed
of
processing
information
in
both
focused
and
selective
attention
but
not
in
behavioural
inhibition.
On
the
other
hand,
children
with
ADHD-C
suffer
from
a
lack
of
inhibition
that
includes
the
capacities
to
inhibit
the
preparation
of
a
response,
to
stop
an
ongoing
response
and
to
control
interference.
These
capacities
influence
the
executive
functions
such
as
working
memory,
self-regulation
of
affect,
motivation,
arousal,
internalisation
of
speech
and
reconstitution.
The
perturbation
of
these
executive
functions
then
interferes
with
motor
control.
From
this
perspective,
studies
have
shown
that
a
lack
of
inhibition
is
a
main
characteristic
of
ADHD
children
(Alderson,
Rapport,
&
Kofler,
2007;
de
Zeeuw
et
al.,
2008).
One
study
reported
that
the
medication
tends
to
improve
the
response
inhibition
and
thus
improve
motor
control
as
a
result
(Klimkeit
et
al.,
2005).
Nevertheless,
Klimkeit
et
al.
(2005)
also
found
that
non-medicated
ADHD
children
as
well
as
medicated
ADHD
children
performed
better
than
the
TD
children
did
when
a
distractor
was
present,
demonstrating
equal
reaction
time
and
fewer
errors
due
to
inattention.
Accordingly,
neither
of
the
ADHD
groups
(medicated
and
non-medicated)
had
difficulty
controlling
and
inhibiting
responses
due
to
interference,
as
would
be
predicted
by
Barkley’s
theory.
Furthermore,
the
fact
that
often
the
motor
deficits
are
found
in
the
ADHD-I
group
is
an
argument
against
the
lack
of
inhibition
as
an
explanation,
as
ADHD-I
do
not
have
problem
of
inhibition
according
to
Barkley.
Even
if
more
research
is
needed
to
prove
the
relationship
between
the
lack
of
inhibition
and
motor
control,
it
is
obvious
that
lack
of
inhibition
can
influence
certain
motor
skills.
In
fact,
the
child
with
ADHD
who
realises
a
goal
directed
movement
without
preliminary
reflexion
or
anticipation
of
the
effect
of
the
movements
would
fail
this
task.
Further
studies
on
motor
skills
among
ADHD
children
should
consider
the
types
of
movements
or
tasks
such
as
goal/not
goal
directed,
closed/open
looped,
and
discrete/serial/continuous
tasks
to
better
understand
the
types
of
tasks
that
are
likely
to
be
impaired.
This
is
directly
relevant
for
participation
in
daily
life.
5.
Limitations
This
review
includes
comparative
studies
that
have
been
conducted
with
limited
samples
of
participants.
As
we
did
not
realise
a
meta-analysis,
conclusions
reached
in
this
review
should
be
interpreted
with
some
caution
until
substantiated
by
further
research.
Gender
differences
have
not
been
analysed
due
to
the
fact
that
15
of
the
studies
included
had
samples
of
boys
only,
the
remaining
studies
most
often
included
only
a
minority
of
females.
The
influence
of
gender
may
be
important,
however,
as
Hasson
and
Fine
(2012)
in
their
meta-analytic
review
of
continuous
performance
tests,
found
a
moderate
effect
of
gender
with
a
larger
difference
between
ADHD
boys
and
TD
boys
than
between
ADHD
girls
and
TD
girls.
While
few
studies
have
realised
a
standardised
evaluation
of
attention
and
motor
skills,
more
research
is
needed
to
gain
an
understanding
of
the
relationship
between
motor
skills
deficits
and
attention
and
inhibition
behaviours.
6.
Conclusion
This
review
indicates
that
a
majority
of
children
with
ADHD
has
motor
skills
deficits.
When
on
medication,
the
ADHD
children
with
a
mild
motor
deficit
before
medication
tend
to
improve
their
motor
skills
to
the
normal
range,
whereas
the
ADHD
children
with
a
severe
motor
deficit
before
medication
tend
to
show
persistent
motor
skill
impairment
which
might
meet
the
diagnostic
criteria
of
DCD
as
a
comorbid
disorder.
Moreover,
the
profiles
of
ADHD
children
can
differ
so
dramatically
that
the
three
hypotheses
presented
in
this
article
may
explain
the
results
of
the
varied
profiles
of
children.
Accordingly,
more
research
among
large
samples
that
controls
for
comorbidity
is
needed
to
describe
subgroups
and
to
obtain
a
better
perspective
of
these
disorders.
This
review
confirms
the
need
to
assess
motor
skills
among
children
with
ADHD
because,
as
Davis,
Pass,
Finch,
Dean,
and
Woodcock
(2009)
have
described,
there
is
an
important
relationship
between
sensory-motor
skills
and
academic
achievement.
References
Adi-Japha,
E.,
Landau,
Y.
E.,
Frenkel,
L.,
Teicher,
M.,
Gross-Tsur,
V.,
&
Shalev,
R.
S.
(2007).
ADHD
and
dysgraphia:
Underlying
mechanisms.
Cortex,
43(6),
700–709.
http://dx.doi.org/10.1016/s0010-9452(08)70499-4
Alderson,
R.
M.,
Rapport,
M.
D.,
&
Kofler,
M.
J.
(2007).
Attention-deficit/hyperactivity
disorder
and
behavioral
inhibition:
A
meta-analytic
review
of
the
stop-signal
paradigm.
Journal
of
Abnormal
Child
Psychology,
35(5),
745–758.
http://dx.doi.org/10.1007/s10802-007-9131-6
American
Psychiatric
Association
(2000).
Diagnostic
and
statistical
manual
of
mental
disorders
(4th
ed.).
Washington,
DC:
American
Psychiatric
Press.
Barkley,
R.
A.
(1997).
Behavioral
inhibition,
sustained
attention,
and
executive
functions:
Constructing
a
unifying
theory
of
ADHD.
Psychological
Bulletin,
121(1),
65–94.
http://dx.doi.org/10.1037/0033-2909.121.1.65
Bart,
O.,
Daniel,
L.,
Dan,
O.,
&
Bar-Haim,
Y.
(2013).
Influence
of
methylphenidate
on
motor
performance
and
attention
in
children
with
developmental
coordination
disorder
and
attention
deficit
hyperactive
disorder.
Research
in
Developmental
Disabilities,
34(6),
1922–1927.
http://dx.doi.org/10.1016/j.ridd.2013.03.015
Bart,
O.,
Podoly,
T.,
&
Bar-Haim,
Y.
(2010).
A
preliminary
study
on
the
effect
of
methylphenidate
on
motor
performance
in
children
with
comorbid
DCD
and
ADHD.
Research
in
Developmental
Disabilities,
31(6),
1443–1447.
http://dx.doi.org/10.1016/j.ridd.2010.06.014
Beery,
K.
E.
(1997).
The
Beery–Buktenica
developmental
test
of
visual
motor
integration:
VMI
with
supplemental
tests
of
visual
perception
and
motor
coordination:
Administration,
scoring
and
teaching
manual.
Parsippany,
NJ:
Modern
Curriculum
Press.
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
354

Blank,
R.
(2012).
European
Academy
of
Childhood
Disability
(EACD):
Recommendations
on
the
definition,
diagnosis
and
intervention
of
developmental
coordination
disorder
(pocket
version).
German–Swiss
interdisciplinary
clinical
practice
guideline
S3-standard
according
to
the
Association
of
the
Scientific
Medical
Societies
in
Germany.
Pocket
version.
Definition,
diagnosis,
assessment,
and
intervention
of
developmental
coordination
disorder
(DCD).
Developmental
Medicine
and
Child
Neurology,
54(11),
e1–e7.
http://dx.doi.org/10.1111/j.1469-8749.2011.04175.x
Borella,
E.,
Chicherio,
C.,
Re,
A.
M.,
Sensini,
V.,
&
Cornoldi,
C.
(2011).
Increased
intraindividual
variability
is
a
marker
of
ADHD
but
also
of
dyslexia:
A
study
on
handwriting.
Brain
and
Cognition,
77(1),
33–39.
http://dx.doi.org/10.1016/j.bandc.2011.06.005
Brossard-Racine,
M.,
Majnemer,
A.,
Shevell,
M.,
Snider,
L.,
&
Belanger,
S.
A.
(2011).
Handwriting
capacity
in
children
newly
diagnosed
with
attention
deficit
hyperactivity
disorder.
Research
in
Developmental
Disabilities,
32(6),
2927–2934.
http://dx.doi.org/10.1016/j.ridd.2011.05.010
Brossard-Racine,
M.,
Shevell,
M.,
Snider,
L.,
Belanger,
S.
A.,
&
Majnemer,
A.
(2012).
Motor
skills
of
children
newly
diagnosed
with
attention
deficit
hyperactivity
disorder
prior
to
and
following
treatment
with
stimulant
medication.
Research
in
Developmental
Disabilities,
33(6),
2080–2087.
http://dx.doi.org/10.1016/
j.ridd.2012.06.003
Bruininks,
R.
H.
(1978).
Bruininks–Oseretsky
test
of
motor
proficiency.
Circle
Pines,
MN:
American
Guidance
Service.
Buderath,
P.,
Gartner,
K.,
Frings,
M.,
Christiansen,
H.,
Schoch,
B.,
Konczak,
J.,
et
al.
(2009).
Postural
and
gait
performance
in
children
with
attention
deficit/
hyperactivity
disorder.
Gait
&
Posture,
29,
249–254.
Cantell,
M.
H.,
Smyth,
M.
M.,
&
Ahonen,
T.
P.
(1994).
Clumsiness
in
adolescence:
Educational,
motor,
and
social
outcomes
of
motor
delay
detected
at
5
years.
Adapted
Physical
Activity
Quarterly,
11(2),
115–129.
Carte,
E.
T.,
Nigg,
J.
T.,
&
Hinshaw,
S.
P.
(1996).
Neuropsychological
functioning,
motor
speed,
and
language
processing
in
boys
with
and
without
ADHD.
Journal
of
Abnormal
Child
Psychology,
24(4),
481–498.
http://dx.doi.org/10.1007/bf01441570
Chen,
Y.
Y.,
Liaw,
L.
J.,
Liang,
J.
M.,
Hung,
W.
T.,
Guo,
L.
Y.,
&
Wu,
W.
L.
(2013).
Timing
perception
and
motor
coordination
on
rope
jumping
in
children
with
attention
deficit
hyperactivity
disorder.
Physical
Therapy
in
Sport,
14(2),
105–109.
http://dx.doi.org/10.1016/j.ptsp.2012.03.012
Conners,
C.
K.
(2001).
Conner’s
rating
scales-revised:
Technical
manual.
North
Tonawanda,
NY:
Multi-Health
Systems.
Cortese,
S.
(2012).
The
neurobiology
and
genetics
of
attention-deficit/hyperactivity
disorder
(ADHD):
What
every
clinician
should
know.
European
Journal
of
Paediatric
Neurology,
16(5),
422–433.
http://dx.doi.org/10.1016/j.ejpn.2012.01.009
Coverdale,
N.
S.,
O’Leary,
D.
D.,
Faught,
B.
E.,
Chirico,
D.,
Hay,
J.,
&
Cairney,
J.
(2012).
Baroreflex
sensitivity
is
reduced
in
adolescents
with
probable
developmental
coordination
disorder.
Research
in
Developmental
Disabilities,
33(1),
251–257.
Davis,
A.
S.,
Pass,
L.
A.,
Finch,
W.
H.,
Dean,
R.
S.,
&
Woodcock,
R.
W.
(2009).
The
canonical
relationship
between
sensory-motor
functioning
and
cognitive
processing
in
children
with
attention-deficit/hyperactivity
disorder.
Archives
of
Clinical
Neuropsychology,
24(3),
273–286.
http://dx.doi.org/10.1093/arclin/acp032
Denckla,
M.
B.
(1974).
Development
of
motor
coordination
in
normal
children.
Developmental
Medicine
and
Child
Neurology,
16(6),
729–741.
Denckla,
M.
B.
(1985).
Revised
neurological
examination
for
subtle
signs
(1985).
Psychopharmacology
Bulletin,
21(4),
773–779.
Depue,
B.
E.,
Burgess,
G.
C.,
Bidwell,
L.
C.,
Willcutt,
E.
G.,
&
Banich,
M.
T.
(2010).
Behavioral
performance
predicts
grey
matter
reductions
in
the
right
inferior
frontal
gyrus
in
young
adults
with
combined
type
ADHD.
Psychiatry
Research
–
Neuroimaging,
182(3),
231–237.
http://dx.doi.org/10.1016/j.pscychresns.2010.01.012
Dewey,
D.,
Cantell,
M.,
&
Crawford,
S.
G.
(2007).
Motor
and
gestural
performance
in
children
with
autism
spectrum
disorders,
developmental
coordination
disorder,
and/or
attention
deficit
hyperactivity
disorder.
Journal
of
the
International
Neuropsychological
Society,
13(2),
246–256.
http://dx.doi.org/10.1017/
s1355617707070270
de
Zeeuw,
P.,
Aarnoudse-Moens,
C.,
Bijlhout,
J.,
Konig,
C.,
Uiterweer,
A.
P.,
Papanikolau,
A.,
et
al.
(2008).
Inhibitory
performance,
response
speed,
intraindividual
variability,
and
response
accuracy
in
ADHD.
Journal
of
the
American
Academy
of
Child
and
Adolescent
Psychiatry,
47(7),
808–816.
http://dx.doi.org/10.1097/
CHI.0b013e318172eee9
Egeland,
J.,
Ueland,
T.,
&
Johansen,
S.
(2012).
Central
processing
energetic
factors
mediate
impaired
motor
control
in
ADHD
combined
subtype
but
not
in
ADHD
inattentive
subtype.
Journal
of
Learning
Disabilities,
45(4),
361–370.
http://dx.doi.org/10.1177/0022219411407922
Eliasson,
A.
C.,
Rosblad,
B.,
&
Forssberg,
H.
(2004).
Disturbances
in
programming
goal-directed
arm
movements
in
children
with
ADHD.
Developmental
Medicine
and
Child
Neurology,
46(1),
19–27.
http://dx.doi.org/10.1017/s0012162204000040
Finch,
H.,
Davis,
A.,
&
Dean,
R.
S.
(2010).
Factor
invariance
assessment
of
the
Dean–Woodcock
sensory-motor
battery
for
patients
with
ADHD
versus
nonclinical
subjects.
Educational
and
Psychological
Measurement,
70(1),
161–173.
http://dx.doi.org/10.1177/0013164409344528
Flapper,
B.
C.
T.,
Houwen,
S.,
&
Schoemaker,
M.
M.
(2006).
Fine
motor
skills
and
effects
of
methylphenidate
in
children
with
attention-deficit-hyperactivity
disorder
and
developmental
coordination
disorder.
Developmental
Medicine
and
Child
Neurology,
48(3),
165–169.
http://dx.doi.org/10.1017/
S0012162206000375
Fliers,
E.
A.,
de
Hoog,
M.
L.
A.,
Franke,
B.,
Faraone,
S.
V.,
Rommelse,
N.
N.
J.,
Buitelaar,
J.
K.,
et
al.
(2010).
Actual
motor
performance
and
self-perceived
motor
competence
in
children
with
attention-deficit
hyperactivity
disorder
compared
with
healthy
siblings
and
peers.
Journal
of
Developmental
and
Behavioral
Pediatrics,
31(1),
35–40.
Fliers,
E.
A.,
Franke,
B.,
Lambregts-Rommelse,
N.
N.
J.,
Altink,
M.
E.,
Buschgens,
C.
J.
M.,
Nijhuis-van
der
Sanden,
M.
W.
G.,
et
al.
(2010).
Undertreatment
of
motor
problems
in
children
with
ADHD.
Child
and
Adolescent
Mental
Health,
15(2),
85–90.
http://dx.doi.org/10.1111/j.1475-3588.2009.00538.x
Fliers,
E.,
Rommelse,
N.,
Vermeulen,
S.,
Altink,
M.,
Buschgens,
C.
J.
M.,
Faraone,
S.
V.,
et
al.
(2008).
Motor
coordination
problems
in
children
and
adolescents
with
ADHD
rated
by
parents
and
teachers:
Effects
of
age
and
gender.
Journal
of
Neural
Transmission,
115(2),
211–220.
http://dx.doi.org/10.1007/s00702-007-0827-
0
Germano,
E.,
Gagliano,
A.,
&
Curatolo,
P.
(2010).
Comorbidity
of
ADHD
and
dyslexia.
Developmental
Neuropsychology,
35(5),
475–493.
http://dx.doi.org/10.1080/
875656412010494748
Geuze,
R.
H.,
Jongmans,
M.
J.,
Schoemaker,
M.
M.,
&
Smits-Engelsman,
B.
C.
M.
(2001).
Clinical
and
research
diagnostic
criteria
for
developmental
coordination
disorder:
A
review
and
discussion.
Human
Movement
Science,
20(1–2),
7–47.
http://dx.doi.org/10.1016/s0167-9457(01)00027-6
Gillberg,
C.
(2003).
Deficits
in
attention,
motor
control,
and
perception:
A
brief
review.
Archives
of
Disease
in
Childhood,
88(10),
904–910.
http://dx.doi.org/10.1136/
adc.88.10.904
Goulardins,
J.
B.,
Marques,
J.
C.
B.,
Casella,
E.
B.,
Nascimento,
R.
O.,
&
Oliveira,
J.
A.
(2013).
Motor
profile
of
children
with
attention
deficit
hyperactivity
disorder,
combined
type.
Research
in
Developmental
Disabilities,
34(1),
40–45.
http://dx.doi.org/10.1016/j.ridd.2012.07.014
Harpin,
V.
A.
(2005).
The
effect
of
ADHD
on
the
life
of
an
individual,
their
family,
and
community
from
preschool
to
adult
life.
Archive
of
Disease
Childhood,
90(Suppl.
1),
i2–i7.
http://dx.doi.org/10.1136/adc.2004.059006
Harvey,
W.
J.,
&
Reid,
G.
(1997).
Motor
performance
of
children
with
attention-deficit
hyperactivity
disorder:
A
preliminary
investigation.
Adapted
Physical
Activity
Quarterly,
14(3),
189–202.
Harvey,
W.
J.,
&
Reid,
G.
(2003).
Attention-deficit/hyperactivity
disorder:
A
review
of
research
on
movement
skill
performance
and
physical
fitness.
Adapted
Physical
Activity
Quarterly,
20(1),
1–25.
Harvey,
W.
J.,
Reid,
G.,
Grizenko,
N.,
Mbekou,
V.,
Ter-Stepanian,
M.,
&
Joober,
R.
(2007).
Fundamental
movement
skills
and
children
with
attention-deficit
hyperactivity
disorder:
Peer
comparisons
and
stimulant
effects.
Journal
of
Abnormal
Child
Psychology,
35(5),
871–882.
http://dx.doi.org/10.1007/s10802-007-
9140-5
Harvey,
W.
J.,
Reid,
G.,
Bloom,
G.
A.,
Staples,
K.,
Grizenko,
N.,
Mbekou,
V.,
et
al.
(2009).
Physical
Activity
Experiences
of
Boys
With
and
Without
ADHD.
Adapted
Physical
Activity
Quarterly,
26(2),
131–150.
Hasson,
R.,
&
Fine,
J.
G.
(2012).
Gender
differences
among
children
with
ADHD
on
continuous
performance
tests:
A
meta-analytic
review.
Journal
of
Attention
Disorders,
16(3),
190–198.
http://dx.doi.org/10.1177/1087054711427398
Henderson,
S.
E.,
&
Sugden,
D.
A.
(2000).
Movement
assessment
battery
for
children.
New
York:
Psychological
Corporation/Harcourt.
Jacobi-Polishook,
T.,
Shorer,
Z.,
&
Melzer,
I.
(2009).
The
effect
of
methylphenidate
on
postural
stability
under
single
and
dual
task
conditions
in
children
with
attention
deficit
hyperactivity
disorder
–
A
double
blind
randomized
control
trial.
Journal
of
the
Neurological
Sciences,
280(1–2),
15–21.
http://dx.doi.org/
10.1016/j.jns.2009.01.007
Kadesjo,
B.,
&
Gillberg,
C.
(1998).
Attention
deficits
and
clumsiness
in
Swedish
7-year-old
children.
Developmental
Medicine
and
Child
Neurology,
40(12),
796–804.
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
355

Kadesjo,
B.,
&
Gillberg,
C.
(2001).
The
comorbidity
of
ADHD
in
the
general
population
of
Swedish
school-age
children.
Journal
of
Child
Psychology
and
Psychiatry
and
Allied
Disciplines,
42(4),
487–492.
Kaplan,
B.
J.,
Wilson,
B.
N.,
Dewey,
D.,
&
Crawford,
S.
G.
(1998).
DCD
may
not
be
a
discrete
disorder.
Human
Movement
Science,
17(4–5),
471–490.
http://dx.doi.org/
10.1016/S0167-9457(98)00010-4
Karatekin,
C.,
Markiewicz,
S.
W.,
&
Siegel,
M.
A.
(2003).
A
preliminary
study
of
motor
problems
in
children
with
attention-deficit/hyperactivity
disorder.
Perceptual
and
Motor
Skills,
97(3),
1267–1280.
Klimkeit,
E.
I.,
Mattingley,
J.
B.,
Sheppard,
D.
M.,
Lee,
P.,
&
Bradshaw,
J.
L.
(2005).
Motor
preparation,
motor
execution,
attention,
and
executive
functions
in
attention
deficit/hyperactivity
disorder
(ADHD).
Child
Neuropsychology,
11(2),
153–173.
http://dx.doi.org/10.1080/092970490911298
Klotz,
J.
M.,
Johnson,
M.
D.,
Wu,
S.
W.,
Isaacs,
K.
M.,
&
Gilbert,
D.
L.
(2012).
Relationship
between
reaction
time
variability
and
motor
skill
development
in
ADHD.
Child
Neuropsychology,
18(6),
576–585.
http://dx.doi.org/10.1080/09297049.2011.625356
Konicarova,
J.,
Bob,
P.,
&
Raboch,
J.
(2014).
Balance
deficits
and
ADHD
symptoms
in
medication-naive
school-aged
boys.
Neuropsychiatric
Disease
and
Treatment,
10,
85–88.
Langmaid,
R.
A.,
Papadopoulous,
N.,
Johnson,
B.
P.,
Phillips,
J.,
&
Rinehart,
N.
J.
(2013).
Movement
scaling
in
children
with
ADHD-combined
type.
Journal
of
Attention
Disorders.
http://dx.doi.org/10.1177/1087054713493317
Largo,
R.
H.,
Fischer,
J.
E.,
&
Caflisch,
J.
A.
(2002).
Zurich
neuromotor
assessment.
Zurich:
AWE
Verlag.
Lavasani,
N.
M.,
&
Stagnitti,
K.
(2011).
A
study
on
fine
motor
skills
of
Iranian
children
with
attention
deficit/hyper
activity
disorder
aged
from
6
to
11
years.
Occupational
Therapy
International,
18(2),
106–114.
http://dx.doi.org/10.1002/oti.306
Leitner,
Y.,
Barak,
R.,
Giladi,
N.,
Peretz,
C.,
Eshel,
R.,
Gruendlinger,
L.,
et
al.
(2007).
Gait
in
attention
deficit
hyperactivity
disorder
–
Effects
of
methylphenidate
and
dual
tasking.
Journal
of
Neurology,
254(10),
1330–1338.
http://dx.doi.org/10.1007/s00415-006-0522-3
Leung,
P.
W.
L.,
&
Connolly,
K.
J.
(1998).
Do
hyperactive
children
have
motor
organization
and/or
execution
deficits?
Developmental
Medicine
and
Child
Neurology,
40(9),
600–607.
Licari,
M.,
&
Larkin,
D.
(2008).
Increased
associated
movements:
Influence
of
attention
deficits
and
movement
difficulties.
Human
Movement
Science,
27(2),
310–
324.
http://dx.doi.org/10.1016/j.humov.2008.02.013
Lingam,
R.,
Golding,
J.,
Jongmans,
M.
J.,
Hunt,
L.
P.,
Ellis,
M.,
&
Emond,
A.
(2010).
the
association
between
developmental
coordination
disorder
and
other
developmental
traits.
Pediatrics,
126(5),
E1109–E1118.
http://dx.doi.org/10.1542/peds.2009-2789
Lufi,
D.,
&
Gai,
E.
(2007).
The
effect
of
methylphenidate
and
placebo
on
eye-hand
coordination
functioning
and
handwriting
of
children
with
attention
deficit
hyperactivity
disorder.
Neurocase,
13(5),
334–341.
http://dx.doi.org/10.1080/13554790701851486
McCarron,
L.
T.
(1982).
McCarron
assessment
of
neuromuscular
development:
Fine
and
gross
motor
abilities.
Dallas,
TX:
Common
Market
Press.
McLeod,
K.
R.,
Langevin,
L.
M.,
Goodyear,
B.
G.,
&
Dewey,
D.
(2014).
Functional
connectivity
of
neural
motor
networks
is
disrupted
in
children
with
developmental
coordination
disorder
and
attention-deficit/hyperactivity
disorder.
NeuroImage:
Clinical,
4,
566–575.
http://dx.doi.org/10.1016/j.nicl.2014.03.010
Meyer,
A.,
&
Terje,
S.
(2006).
Fine
motor
skills
in
South
African
children
with
symptoms
of
ADHD:
Influence
of
subtype,
gender,
age,
and
hand
dominance.
Brain
and
Behavioral
Functions,
2(33),
1–13.
Miyahara,
M.,
Piek,
J.,
&
Barrett,
N.
(2006).
Accuracy
of
drawing
in
a
dual-task
and
resistance-to-distraction
study:
Motor
or
attention
deficit?
Human
Movement
Science,
25(1),
100–109.
http://dx.doi.org/10.1016/j.humov.2005.11.004
Paine,
R.
W.,
Grossberg,
S.,
&
Van
Gemmert,
A.
W.
(2004).
A
quantitative
evaluation
of
the
AVITEWRITE
model
of
handwriting
learning.
Human
Movement
Science,
23(6),
837–860.
http://dx.doi.org/10.1016/j.humov.2004.08.024
Papadopoulos,
N.,
Rinehart,
N.,
Bradshaw,
J.
L.,
&
McGinley,
J.
L.
(2013).
Brief
report:
Children
with
ADHD
without
co-morbid
autism
do
not
have
impaired
motor
proficiency
on
the
movement
assessment
battery
for
children.
Journal
of
Autism
and
Developmental
Disorders,
43(6),
1477–1482.
http://dx.doi.org/10.1007/
s10803-012-1687-5
Pedersen,
S.
J.,
Surburg,
P.
R.,
Heath,
M.,
&
Koceja,
D.
M.
(2004).
Fractionated
lower
extremity
response
time
performance
in
boys
with
and
without
ADHD.
Adapted
Physical
Activity
Quarterly,
21(4),
315–329.
Piek,
J.
P.,
Pitcher,
T.
M.,
&
Hay,
D.
A.
(1999).
Motor
coordination
and
kinaesthesis
in
boys
with
attention
deficit-hyperactivity
disorder.
Developmental
Medicine
and
Child
Neurology,
41(3),
159–165.
http://dx.doi.org/10.1017/s0012162299000341
Pitcher,
T.
M.,
Piek,
J.
P.,
&
Barrett,
N.
C.
(2002).
Timing
and
force
control
in
boys
with
attention
deficit
hyperactivity
disorder:
Subtype
differences
and
the
effect
of
comorbid
developmental
coordination
disorder.
Human
Movement
Science,
21(5–6),
919–945.
http://dx.doi.org/10.1016/s0167-9457(02)00167-7
Pitcher,
T.
M.,
Piek,
J.
P.,
&
Hay,
D.
A.
(2003).
Fine
and
gross
motor
ability
in
males
with
ADHD.
Developmental
Medicine
and
Child
Neurology,
45(8),
525–535.
Polderman,
T.
J.
C.,
van
Dongen,
J.,
&
Boomsma,
D.
I.
(2011).
The
relation
between
ADHD
symptoms
and
fine
motor
control:
A
genetic
study.
Child
Neuropsychology,
17(2),
138–150.
Rommelse,
N.
N.
J.,
Altink,
M.
E.,
Oosterlaan,
J.,
Buschgens,
C.
J.
M.,
Buitelaar,
J.,
De
Sonneville,
L.
M.
J.,
et
al.
(2007).
Motor
control
in
children
with
ADHD
and
non-
affected
siblings:
Deficits
most
pronounced
using
the
left
hand.
Journal
of
Child
Psychology
and
Psychiatry,
48(11),
1071–1079.
http://dx.doi.org/10.1111/
j.1469-7610.2007.01781.x
Rosch,
K.
S.,
Dirlikov,
B.,
&
Mostofsky,
S.
H.
(2013).
Increased
intrasubject
variability
in
boys
with
ADHD
across
tests
of
motor
and
cognitive
control.
Journal
of
Abnormal
Child
Psychology,
41(3),
485–495.
http://dx.doi.org/10.1007/s10802-012-9690-z
Rosenblum,
S.,
Epsztein,
L.,
&
Josman,
N.
(2008).
Handwriting
performance
of
children
with
attention
deficit
hyperactive
disorders:
A
pilot
study.
Physical
&
Occupational
Therapy
in
Pediatrics,
28(3),
219–234.
http://dx.doi.org/10.1080/01942630802224934
Rubia,
K.,
Noorloos,
J.,
Smith,
A.,
Gunning,
B.,
&
Sergeant,
J.
(2003).
Motor
timing
deficits
in
community
and
clinical
boys
with
hyperactive
behavior:
The
effect
of
methylphenidate
on
motor
timing.
Journal
of
Abnormal
Child
Psychology,
31(3),
301–313.
http://dx.doi.org/10.1023/a:1023233630774
Scharoun,
S.
M.,
Bryden,
P.
J.,
Otipkova,
Z.,
Musalek,
M.,
&
Lejcarova,
A.
(2013).
Motor
skills
in
Czech
children
with
attention-deficit/hyperactivity
disorder
and
their
neurotypical
counterparts.
Research
in
Developmental
Disabilities,
34(11),
4142–4153.
http://dx.doi.org/10.1016/j.ridd.2013.08.011
Schoemaker,
M.
M.,
Ketelaars,
C.
E.
J.,
van
Zonneveld,
M.,
Minderaa,
R.
B.,
&
Mulder,
T.
(2005).
Deficits
in
motor
control
processes
involved
in
production
of
graphic
movements
of
children
with
attention-deficit-hyperactivity
disorder.
Developmental
Medicine
and
Child
Neurology,
47(6),
390–395.
http://dx.doi.org/10.1017/
s0012162205000769
Schoemaker,
M.
M.,
Lingam,
R.,
Jongmans,
M.
J.,
van
Heuvelen,
M.
J.
G.,
&
Emond,
A.
(2013).
Is
severity
of
motor
coordination
difficulties
related
to
co-morbidity
in
children
at
risk
for
developmental
coordination
disorder?
Research
in
Developmental
Disabilities,
34(10),
3084–3091.
Sergeant,
J.
A.,
Piek,
J.
P.,
&
Oosterlaan,
J.
(2006).
ADHD
and
DCD:
A
relationship
in
need
of
research.
Human
Movement
Science,
25(1),
76–89.
http://dx.doi.org/
10.1016/j.humov.2005.10.007
Sharma,
A.,
&
Couture,
J.
(2014).
A
review
of
the
pathophysiology,
etiology,
and
treatment
of
attention-deficit
hyperactivity
disorder
(ADHD).
Annals
of
Pharmacotherapy,
48(2),
209–225.
http://dx.doi.org/10.1177/1060028013510699
Shen,
I.
H.,
Lee,
T.
Y.,
&
Chen,
C.
L.
(2012).
Handwriting
performance
and
underlying
factors
in
children
with
attention
deficit
hyperactivity
disorder.
Research
in
Developmental
Disabilities,
33(4),
1301–1309.
http://dx.doi.org/10.1016/j.ridd.2012.02.010
Shorer,
Z.,
Becker,
B.,
Jacobi-Polishook,
T.,
Oddsson,
L.,
&
Melzer,
I.
(2012).
Postural
control
among
children
with
and
without
attention
deficit
hyperactivity
disorder
in
single
and
dual
conditions.
European
Journal
of
Pediatrics,
171(7),
1087–1094.
http://dx.doi.org/10.1007/s00431-012-1695-7
Slaats-Willemse,
D.,
de
Sonneville,
L.,
Swaab-Barneveld,
H.,
&
Buitelaar,
J.
(2005).
Motor
flexibility
problems
as
a
marker
for
genetic
susceptibility
to
attention-
deficit/hyperactivity
disorder.
Biological
Psychiatry,
58(3),
233–238.
http://dx.doi.org/10.1016/j.biopsych.2005.03.046
Steger,
J.,
Imhof,
G.,
Coutts,
E.,
Gundelfinger,
R.,
Steinhausen,
E.
C.,
&
Brandeis,
D.
(2001).
Attentional
and
neuromotor
deficits
in
ADHD.
Developmental
Medicine
and
Child
Neurology,
43(3),
172–179.
http://dx.doi.org/10.1017/s0012162201000330
Stray,
L.
L.,
Ellertsen,
B.,
&
Stray,
T.
(2010).
Motor
function
and
methylphenidate
effect
in
children
with
attention
deficit
hyperactivity
disorder.
Acta
Paediatrica,
99(8),
1199–1204.
http://dx.doi.org/10.1111/j.1651-2227.2010.01760.x
Taurines,
R.,
Schmitt,
J.,
Renner,
T.,
Conner,
A.
C.,
Warnke,
A.,
&
Romanos,
M.
(2010).
Developmental
comorbidity
in
attention-deficit/hyperactivity
disorder.
Attention
Deficit
Hyperactivity
Disorder,
2(4),
267–289.
http://dx.doi.org/10.1007/s12402-010-0040-0
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
356

Tervo,
R.
C.,
Azuma,
S.,
Fogas,
B.,
Falls,
S.,
&
Fiechtner,
H.
(2002).
Children
with
ADHD
and
motor
dysfunction
compared
with
children
with
ADHD
only.
Developmental
Medicine
and
Child
Neurology,
44(6),
383–390.
Tseng,
M.
H.,
Henderson,
A.,
Chow,
S.
M.
K.,
&
Yao,
G.
(2004).
Relationship
between
motor
proficiency,
attention,
impulse,
and
activity
in
children
with
ADHD.
Developmental
Medicine
and
Child
Neurology,
46(6),
381–388.
http://dx.doi.org/10.1017/s0012162204000623
Tucha,
O.,
&
Lange,
K.
W.
(2001).
Effects
of
methylphenidate
on
kinematic
aspects
of
handwriting
in
hyperactive
boys.
Journal
of
Abnormal
Child
Psychology,
29(4),
351–356.
http://dx.doi.org/10.1023/a:1010366014095
Ulrich,
D.
A.
(2000).
Test
of
gross
motor
development
(2nd
ed.).
Texas:
PRO-ED.
Wade,
M.
G.
(1976).
Effects
of
methylphenidate
on
motor
skill
acquisition
of
hyperactive
children.
Journal
of
Learning
Disabilities,
9,
443–447.
Wang,
H.-Y.,
Huang,
T.-H.,
&
Lo,
S.-K.
(2011).
Motor
ability
and
adaptive
function
in
children
with
attention
deficit
hyperactivity
disorder.
Kaohsiung
Journal
of
Medical
Sciences,
27(10),
446–452.
http://dx.doi.org/10.1016/j.kjms.2011.06.004
Watemberg,
N.,
Waiserberg,
N.,
Zuk,
L.,
&
Lerman-Sagie,
T.
(2007).
Developmental
coordination
disorder
in
children
with
attention-deficit-hyperactivity
disorder
and
physical
therapy
intervention.
Developmental
Medicine
Child
Neurology,
49(12),
920–925.
http://dx.doi.org/10.1111/j.1469-8749.2007.00920.x
Whitmont,
S.,
&
Clark,
C.
(1996).
Kinaesthetic
acuity
and
fine
motor
skills
in
children
with
attention
deficit
hyperactivity
disorder:
A
preliminary
report.
Developmental
Medicine
and
Child
Neurology,
38(12),
1091–1098.
Willcutt,
E.
G.
(2012).
The
prevalence
of
DSM-IV
attention-deficit/hyperactivity
disorder:
A
meta-analytic
review.
Neurotherapeutics,
9(3),
490–499.
Williams,
J.,
Omizzolo,
C.,
Galea,
M.
P.,
&
Vance,
A.
(2013).
Motor
imagery
skills
of
children
with
attention
deficit
hyperactivity
disorder
and
developmental
coordination
disorder.
Human
Movement
Science,
32(1),
121–135.
Yan,
J.
H.,
&
Thomas,
J.
R.
(2002).
Arm
movement
control:
Differences
between
children
with
and
without
attention
deficit
hyperactivity
disorder.
Research
Quarterly
for
Exercise
and
Sport,
73(1),
10–18.
M.-L.
Kaiser
et
al.
/
Research
in
Developmental
Disabilities
36
(2015)
338–357
357