DEVELOPMENTAL COORDINATION DISORDER IN CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER: CHARACTERIZATION OF THE PROBLEM AND THE IMPACT OF PHYSICAL THERAPY INTERVENTION

Objectives: Developmental coordination disorder (DCD) is common among children with attention deficit hyperactivity disorder (ADHD). The study purposes were to: 1. Identify the percentage of children with DCD and other co-morbidities among a clinic population of ADHD patients, and 2. Evaluate the impact of physical therapy intervention on children with both ADHD and DCD.

Methods: To detect patients with DCD, all school-aged children diagnosed with ADHD in the Child Neurology clinic between September 2003 and April 2004 underwent physical therapy evaluation using the Movement Assessment Battery (MABC) for children. Patients were classified into a pure ADHD group, and an ADHD/DCD group. ADHD/DCD patients were subclassified into three groups: predominantly inattentive ADHD (ADHD-PI), mostly hyperactive-impulsive (ADHD-HI), and combined inattentiveness and hyperactivity (ADHD-C). A subgroup of ADHD/DCD children randomly received a twice weekly, eight-session physical therapy course with home training or no intervention at all. The study was carried out during the summer vacations to ensure that patients received no other ADHD related therapy.

Results: Of 96 children with ADHD, 52 (56%) had DCD according to MABC testing. Twenty-eight entered the physical therapy/no intervention phase [physical therapy (14), no intervention (14)]. MABC was re-administered to both groups at the end of the physical therapy course. DCD occurred in 64.3% of ADHD-PI-, 59% of ADHD-C-, and 11% of ADHD-HI patients. Mean MABC score prior to intervention was 1.86±1.1 for both groups. It increased to 15.21±7.12 (p=0.0010) for the physical therapy intervention group. No change was noted in the no intervention group. Based on MABC testing, over 85% of treated patients did not fulfill the criteria for DCD by the end of the treatment course.

Conclusion: DCD was highly prevalent among children with ADHD, particularly of the inattentive and combined types. A brief course of intensive physical therapy significantly improved motor function in ADHD/DCD patients, compared with children who received no treatment.