Study: Fidgeting may help children with ADHD focus

A study claims that fidgeting may help children with ADHD focus on test taking.

Children with attention deficit hyperactivity disorder (ADHD) often fidget, but new research suggests intense fidgeting may actually help them focus on the task at hand.

If the research bears out, the traditional advice to encourage these children to sit still may be misguided, said lead researcher Julie Schweitzer, a professor of psychiatry and behavioral sciences at the MIND Institute of the University of California, Davis.

"Traditionally, it's recommended that kids stay still and not be disruptive," Schweitzer said.

But in her small study comparing 26 children with ADHD and 18 without the disorder, she found that when the children with ADHD were moving or fidgeting more intensely, they performed better on a test requiring attention.

Meanwhile, the movements of the children without ADHD did not affect test performance.

The study was published online June 11 in the journal Child Neuropsychology.

Why may fidgeting help the ADHD children?

"What I suspect is that kids with ADHD are moving to increase their attention by activating their arousal system," Schweitzer speculated. "Being aroused does increase attention."

The children all performed the same test, which required them to focus and to dismiss distractions. The children were asked to determine the direction of the middle arrow in a series of arrows. They needed to ignore the arrows surrounding the middle one.

The intensity of movement, but not its frequency, was linked with more correct answers in the children with ADHD. However, the research did not prove cause and effect, only a link or association.

The children in the study ranged in age from 10 to 17, and were 14 on average. Fifteen of the children with ADHD took stimulant medication, but stopped it for 24 hours before the testing.

Nearly 6 million children in the United States have a diagnosis of ADHD, according to the U.S. Centers for Disease Control and Prevention. Hyperactivity is a core symptom and one of the most observable hallmarks of the disorder, according to the researchers. The inability to sit still can cause challenges in school settings. Other symptoms include impulsivity and an inability to pay attention.

The theory of how fidgeting might help those with ADHD has been long talked about, said Brandon Korman, chief of neuropsychology at Nicklaus Children's Hospital in Miami. However, he believes the new research is one of the first studies to test the theory.

One limitation of the finding, however, was the small number of children who were involved, he said.

Korman also does not think the findings suggest fidgeting is always acceptable for these kids.

"It doesn't suggest we should let them fidget if it's disturbing the other kids," he said. He added that the researchers should look at the effect of physical activity before classwork, such as scheduling recess before academic tasks that require a lot of concentration.

Schweitzer said she would like to examine larger groups of children, to get a better idea of what is the best amount of movement for kids with ADHD.

"I'd love to tackle that in a future study, as it could guide parents and teachers," she said, "although I suspect it would be different on an individual basis, with some children needing to move more than others for the movement to improve their task performance."

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Attention issues may be helped by music therapy

Children with ADD, ADHD, and attention issues might be able to be helped by music therapy.

Focus can be a real struggle for people with learning disabilities like ADHD and ADD, but music is being found to be a powerful tool to train minds.

Middle school student Thomas Beckman has the developmental disability Down syndrome and uses music to help him focus.

He takes adapted music lessons at Rhythm & Rehab in Durham, where he gets to play his favorite instrument -- the drums -- as a form of neurologic music therapy.

"Music therapy is using music to accomplish non-musical goals," said Paula Scicluna, the founder and executive director of Rhythm & Rehab. "So, using music to improve speech skills, language, sensory motor skills, cognitive skills, social emotional skills."

At the beginning of his lesson, Thomas banged the drums loudly, looked around at his surroundings and was not focused. He was very distracted.

Encouraging him to keep in time, Scicluna patted the drums saying, "Together, together, together. Can you do it together?"

Thomas ignored instruction.

However, as the session progressed -- in a matter of minutes -- something clicked and his focus increased.

He and Scicluna then moved to the keyboard, and as they attempted to play a duet, he was more in tune to the rhythm and "making music." He intently glanced up at his song sheet and glanced down making sure he hit each key precisely.

"I don't expect him to leave here playing Chopin," said Donna Beckmann, Thomas' mother.

She said the benefits of playing music, such as hand-eye coordination, helps him in his everyday life.

"Whether he's writing something, whether he's helping in the kitchen and cutting up vegetables, it's all connected, she said.

Scicluna pointed out that the quality of Thomas' playing is not what matters, but rather he "continued to play and that he stayed with the activity until I told him to stop."

She said music helps organize the brain, and repetition is key.

"Once you add that rhythm and you add that structure, it helps actually organize the firing of the neurons. Focus, attention [and] impulse control -- all those behaviors that you see children with ADHD and ADD struggle with," Scicluna said. "That's how music therapy is helpful to those children."

So, while some may view Thomas' drumming as noise, he hears music.

"He gets a lot of feedback from heavy movements. So for him to be banging on the drums, that does something for him," his mother said. "The type of focus that this trains him in is to focus when he needs to. The therapy gives him tools to reach his goals."

Beckmann said the structure grounds him, and his instructors have high expectations.

"They know the potential. They know what these individuals are able to do, and they don't settle for less," she said. "That's why you see the phenomenal things my son can do."

Thomas was so focused, he continued to play the keyboard.

"To see him so focused and visually tracking and using the right fingers on the right keys," Scicluna said. "For those of us that don't have to really think about all of those skills independently, you think of all those skills that have to come together in order for that to happen, it's incredible."

Beckmann said, "It's working on so many different pieces of what he needs. I see a more whole child because of music therapy. It's music, it's fun."

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Language and attention gene variations in those with ADHD

A study shows that in those with ADHD, gene variations are seen specifically in language and attention.

Are deficits in attention limited to those with attention-deficit/hyperactivity disorder (ADHD) or is there a spectrum of attention function in the general population? The answer to this question has implications for psychiatric diagnoses and perhaps for society, broadly.

A new study published in the current issue of Biological Psychiatry, by researchers at Cardiff University School of Medicine and the University of Bristol, suggests that there is a spectrum of attention, hyperactivity/impulsiveness and language function in society, with varying degrees of these impairments associated with clusters of genes linked with the risk for ADHD.

Viewing these functions as dimensions or spectrums contrasts with a traditional view of ADHD as a disease category.

To answer this question, researchers led by senior author Dr. Anita Thapar used genetic data from patients with ADHD as well as data from the Avon Longitudinal Study of Parents and Children (ALSPAC). The ALSPAC is based in England and is a large, ongoing study of parents and children followed since birth in the early '90s.

They created polygenic risk scores -- a 'composite' score of genetic effects that forms an index of genetic risk -- of ADHD for 8,229 ALSPAC participants.

They found that polygenic risk for ADHD was positively associated with higher levels of traits of hyperactivity/impulsiveness and attention at ages 7 and 10 in the general population. It was also negatively associated with pragmatic language abilities, e.g., the ability to appropriately use language in social settings.

"Our research finds that a set of genetic risks identified from UK patients with a clinical diagnosis of childhood ADHD also predicted higher levels of developmental difficulties in children from a UK population cohort, the ALSPAC," said Thapar.

First author Joanna Martin added, "Our results provide support at a genetic level for the suggestion that ADHD diagnosis represents the extreme of a spectrum of difficulties. The results are also important as they suggest that the same sets of genetic risks contribute to different aspects of child development which are characteristic features of neurodevelopmental disorders such as ADHD and autism spectrum disorder."

"It may be the case that at some point polygenic risk scores may, in conjunction with other clinical information, help to identify children who will struggle in school and other demanding contexts due to attention difficulties," said Dr. John Krystal, Editor of Biological Psychiatry. "The objective of this type of early identification would be to provide children who are at risk for difficulties with support so that problems at school may be prevented."

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Children with ADHD may be unable to recognize facial expressions

Research has shown that children with ADHD may be unable to recognize specific facial expressions such as anger and happiness.

Inattention, hyperactivity, and impulsive behavior in children with ADHD can result in social problems and they tend to be excluded from peer activities. They have been found to have impaired recognition of emotional expression from other faces.

The research group of Professor Ryusuke Kakigi of the National Institute for Physiological Sciences, National Institutes of Natural Sciences, in collaboration with Professor Masami K. Yamaguchi and Assistant Professor Hiroko Ichikawa of Chuo University first identified the characteristics of facial expression recognition of children with ADHD by measuring hemodynamic response in the brain and showed the possibility that the neural basis for the recognition of facial expression is different from that of typically developing children.

The findings are discussed in Neuropsychologia.

The research group showed images of a happy expression or an angry expression to 13 children with ADHD and 13 typically developing children and identified the location of the brain activated at that time. They used non-invasive near-infrared spectroscopy to measure brain activity. Near-infrared light, which is likely to go through the body, was projected through the skull and the absorbed or scattered light was measured. The strength of the light depends on the concentration in "oxyhemoglobin" which gives the oxygen to the nerve cells working actively. The result was that typically developing children showed significant hemodynamic response to both the happy expression and angry expression in the right hemisphere of the brain.

On the other hand, children with ADHD showed significant hemodynamic response only to the happy expression but brain activity specific for the angry expression was not observed. This difference in the neural basis for the recognition of facial expression might be responsible for impairment in social recognition and the establishment of peer-relationships.

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Expensive computer programs for children with ADHD don't help their grades

Reports show that expensive computer programs and therapies for children with ADHD are not effective and do not help their grades.

Many parents spend thousands of dollars on computer-based training programs that claim to help children with ADHD succeed in the classroom and in peer relationships while reducing hyperactivity and inattentiveness. But a University of Central Florida researcher says parents are better off saving their hard-earned cash.

Psychology professor Mark Rapport's research team spent two years analyzing the data from 25 studies and found that those programs are not producing significant or clinically meaningful long-term improvements in children's cognitive abilities, academic performance or behavior.

"Parents are desperate for help," said Rapport, who runs the Children's Learning Clinic IV at UCF. "If they can afford it, they are willing to spend the money, and some parents even enroll their children in private schools because they offer these cognitive training programs. But there is no empirical evidence to show those investments are worthwhile."

Rapport initiated the study because many parents of children who have been evaluated at his clinic asked him whether they should invest in the programs. The study is featured in the December issue of Clinical Psychology Review.

His team analyzed published studies sponsored by the companies themselves as well as all independent published studies in the literature -- and he drew his conclusions based on analyzing "blinded" studies, meaning studies in which researchers and independent raters used objective measures and did not know which children were assigned to the cognitive training programs as opposed to an inactive placebo condition.

Working memory represents one of the most important core deficits in children with ADHD, and improvements in working memory are associated with improved academic performance, behavior, peer relationships and other intellectual abilities. Surprisingly, although a majority of the cognitive training programs claimed to train this important aspect of brain functioning, closer examination of their training exercises revealed that they actually train short-term memory.

Short-term memory stores information in mind for a brief interval, whereas working memory uses the stored information for accomplishing a wide range of cognitive tasks, such as reading comprehension, mental math, and multitasking.

Rapport said his conclusions do not mean that the computer-based programs cannot become a helpful tool for children with ADHD. If programs can be designed to focus on working memory, it is worth evaluating whether they can help children's cognitive abilities, academic performance and behavior, he said.

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Does your child have ADD, ADHD, or both?

This article presents many common symptoms of ADD and ADHD to help parents determine if their child should be further evaluated for these conditions.

Does your child have Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder or both?

People with ADHD show a persistent pattern of inattention or hyperactivity-impulsivity that interferes with functioning or development, according to the Center for Disease Control. If a child exhibits six or more of each of the following patterns of symptoms, they may require further evaluation by a professional, according to the CDC:

Inattention
■Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
■Often has trouble holding attention on tasks or play activities.
■Often does not seem to listen when spoken to directly.
■Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
■Often has trouble organizing tasks and activities.
■Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time, such as schoolwork or homework.
■Often loses things necessary for tasks and activities, such as pencils and books.
■Is often easily distracted.
■Is often forgetful in daily activities.

Hyperactivity and Impulsivity
■Often fidgets with or taps hands or feet, or squirms in seat.
■Often leaves seat in situations when remaining seated is expected.
■Often runs about or climbs in situations where it is not appropriate.
■Often unable to play or take part in leisure activities quietly.
■Is often "on the go" acting as if "driven by a motor".
■Often talks excessively.
■Often blurts out an answer before a question has been completed.
■Often has trouble waiting his/her turn.
■Often interrupts or intrudes on others.

Other indications of possible concerns include that several inattentive or hyperactive-impulsive symptoms were present before the child was 12, that symptoms are present in two or more settings, such as at home and school, that the symptoms interfere with socializing, school and work, and that the symptoms are not better explained by another mental disorder, according to the CDC.

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