ADHD and motor interventions

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Mary Mountstephen looks at the value of physical exercise in contributing to improvements in cognitive performance and concentration for children with ADHD

There is growing interest among academic researchers and the world of education in how different forms of physical exercise may influence the ways in which children learn, behave and achieve in school. In this article, I will look at what is known about ADHD that might indicate that motor interventions have a role to play in promoting learning, and which activities might show indications of potential benefit.

It is estimated that there is a global prevalence of ADHD of around five or six per cent and that boys are diagnosed with this more often than girls. Ludyga et al. (2018) stress that early interventions should be seen as a necessity to avoid a longer-term negative impact of the condition. They seek to understand how ADHD related deficits might be attributed to aspects of brain function, structure and chemistry. 

Their research considers whether physical exercise has potential as a complementary intervention for ADHD, drawing on the work of other researchers that had identified exercise-induced improvements on executive functioning and cognitive flexibility. Their conclusions indicated that physical exercise possessed “great potential” as a complementary intervention for ADHD, although they urge caution in drawing conclusions based on non-ADHD studies. 

Their overview of the current state of research does however suggest that exercise can exert an influence on skills, as well as leading to fewer symptoms of anxiety and depression.

They recognise that intensive research has taken place into the neurobiological aspects of ADHD, but the mechanisms by which exercise reduces the cognitive and behavioural impairments is less well developed. There is an understanding that regular, daily, challenging exercise can contribute a complementary element in reducing impairments in executive functioning and control and behavioural deficits. The research does not however, suggest that this is a substitute for pharmacological or behavioural therapies. 

Martial arts and floor-based programmes

Many motor intervention programmes tend to focus on aerobic activity, where there is less emphasis on being mentally present and consciously aware of the ways in which the mind and body work together. Instead, they tend to place a greater emphasis on the healthy aspects of physical activity. There is now a growing research base (Meeusen et al., 2018) to support the use of a wider range of movement interventions that combine different types of activities to address specific needs.  

Many yoga teachers would propose that their programmes develop flexibility of the mind as well as the body, and that there are correlations between improved focus, executive function and yoga practice (Gothe et al., 2013). The practice of yoga has also been found to be beneficial when combined with pharmacological interventions. 

What distinguishes yoga is the mental focus, with links between improved focus and executive function. Some research (Ludyga et al., 2018) has indicated that two 60-minute sessions of yoga over a 20-week period found improvements in ADHD related symptoms after six weeks. 

Tai Chi and martial arts programmes have been proposed as potential interventions for ADHD, based on their structured approach to combining cognitive and motor approaches to increasing attention, focus and control.

Floor-based motor programmes that focus on developmental immaturities such as retained primitive reflexes have also shown some potential to improve ADHD traits of inattentiveness and hyperactivity. These programmes have some evidence of improving these skills, but may benefit from being applied in conjunction with more physically challenging interventions. (Ludyga et al., 2018)

Moderate aerobic activity

There is evidence to suggest that moderate aerobic exercise – such as jumping on a trampoline for five minutes, jumping and running on the spot for fifteen minutes or table tennis training – can produce improvements in cognitive flexibility and working memory (Ludyga et al., 2018); however researchers point out that there is insufficient data relating specifically to their impact on children with ADHD. At the same time, there are suggestions that aerobic exercise sessions have the potential to improve inhibitory control temporarily when the activity takes place close to the cognitive task. The implication is that schools could benefit all their learners by integrating more physical activity in short bursts throughout the day.

Implications

As Ludyga et al. point out (2018), “Exercise reduces the cognitive impairments and developmentally inappropriate behaviour in children and adolescents with ADHD… Children with ADHD should be encouraged to perform aerobic exercise for a temporary enhancement of capabilities in executive functioning”.

Regular exercise is also thought to contribute to long-term benefits for cognitive performance and behaviour in children and adolescents with ADHD.

There is a consensus that the relationship between physical activity and educational performance offers the potential to inform new practices. However, there is a concern that pseudoscience and neuro-myths risk schools and parents being liable to the claims of various commercial interventions (Bailey, 2018). This implies that caution needs to be exercised when considering making financial investments in programmes that may lack credible evidence-based or peer-reviewed research.

The positive emotion of enjoyment is a strong motivation to practise physical activity. This can lead to enhancing cognitive processing when teachers understand the relevant teaching methodologies that integrate enjoyable activities based on research-led interventions. Students of all ages with ADHD and comorbid difficulties may benefit from daily physical activities to prime classroom performance.

Ideas for parents/schools:

  • encourage daily exercise at three-hour intervals in the school day, using activities that take into account variety in speed, duration and intensity
  • exercise sessions can be ten to 15 minutes long and include a wide range, but balanced selection, of activities
  • devise a daily schedule that over the course of a week balances out a combination of aerobic, yoga and floor-based activities
  • children should enjoy the activity they are doing, but it needs to be challenging to induce cognitive improvement
  • it can be useful to include breathing exercises (often included in yoga programmes) as part of a daily routine and selecting a time when you think you, or the child will feel the greatest need to relax; ideally, this should be at the same time every day
  • use a more intensive activity (appropriate to the individual) prior to important tests requiring high cognitive control or competitions requiring tactical planning
  • consider martial arts as a possible activity; there is some research to suggest that the traditional forms that combine mental and motor aspects can exert an influence on aspects of ADHD weaknesses.

Further Information

In addition to reviewing books for SEN Magazine, Mary Mountstephen is the founder of KidsCanSucceed, a learning differences specialist, keynote speaker and author: 
www.kidscansucceed.com

References

  • Bailey, R. (2018). Science, pseudoscience and exercise neuroscience in: Physical Activity and Educational Achievement: Insights from Neuroscience (see below), Routledge, Abingdon, Oxon.
  • Gothe, N. et al. (2013) The acute effects of yoga on executive function. Available at: https://digitalcommons.wayne.edu/cgi/viewcontent.cgi?article=1040&context=coe_khs (accessed 15/2/19)
  • Ludyga, S. et al. (2018) Exercise as a Neuroenhancer in Children with ADHD: Cognitive and Behavioural Effects, in Physical Activity and Educational Achievement: Insights from Neuroscience (see below), Routledge, Abingdon, Oxon.
  • Meeusen, R. et al. (Editor) (2018). Physical Activity and Educational Achievement: Insights from Neuroscience, Routledge, Abingdon, Oxon.
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