A simple tool to help you differentiate between ADHD and the most common overlapping comorbidities in children
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Executive function contributes flexibility and fluency to motor control. Therefore children with attention-deficit/hyperactivity disorder (ADHD) who have deficiencies in executive function may lack the ability to appropriately modulate motor responses.3
Motor speed and dynamic balance (which is involved in activities such as jumping) are generally affected in children with ADHD, as is fine motor coordination.2
Sequencing of simple motor movements into complex patterns and arrangements is frequently difficult for pediatric patients with ADHD.3 The manual dexterity involved in handwriting in particular is impacted, with ~60% of children with ADHD exhibiting poorer handwriting than non-ADHD peers.1
Deficits in motor skills have been shown to improve with pharmacologic treatment of ADHD, even normalizing in those with mild symptoms.2
Tic disorders and Tourette syndrome are more common in children with ADHD
Tic disorders and Tourette syndrome occur in up to 30% of pediatric patients with ADHD.5 The presence of tic disorders makes the treatment plan for children with ADHD more complex. Prolonged observation may be needed to differentiate “fidgeting” seen in ADHD from bouts of multiple tics.6
References: 1. Racine MB, Majnemer A, Shevell M, Snider L. Handwriting performance in children with attention deficit hyperactivity disorder (ADHD). J Child Neurol. 2008;23(4):399-406. 2. Kaiser M-L, Schoemaker MM, Albaret J-M, Geuze RH. What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? Systematic review of the literature. Res Devel Disabilities. 2015;36:338-357. 3. Barkley RA. Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull. 1997;121(1):65-94. 4. Barkley RA, Fischer M. The Milwaukee longitudinal study of hyperactive (ADHD) children. In: Hechtman L, ed. Attention Deficit Hyperactivity Disorder: Adult Outcome and Its Predictors. New York, NY: Oxford University Press; 2016:63-104. 5. Jensen CM, Steinhausen H-C. Comorbid mental disorders in children and adolescents with attention-deficit/hyperactivity disorder in a large nationwide study. Atten Defic Hyperact Disord. 2015;7(1):27-38. 6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Publishing Inc; 2013. 7. Clemow DB, Bushe C, Mancini M, Ossipov MH, Upadhyaya H. A review of the efficacy of atomoxetine in the treatment of attention-deficit hyperactivity disorder in children and adult patients with common comorbidities. Neuropsychiatr Dis Treat. 2017;13:357-371.