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The Role of Developmental Motor Skills in Your Child’s ADHD Advice to patients

Many parents are overjoyed when their child begins to walk before crawling, excited that he or she has bypassed a stage in the developmental process. But is it really good? Could this create challenges for children, especially those who are eventually diagnosed with Attention Deficit Hyperactivity Disorder?

Kelly Kennedy, fieldwork coordinator for the occupational therapy program at the College of Allied Health Sciences at the University of Cincinnati, explains that developmental motor skills, or the general movements that children learn as they grow and grow. grow, usually emerge in a certain order. . For example, infants should be taught to hold their head up before rolling over and crawl before standing, which precedes walking. Both coarse (large movements such as jumping, crawling, standing and walking) and fine (smaller movements such as holding a pencil, using a fork, writing, using buttons or zippers while dressing ) Motor skills come into play as a child ages, she says, all of which are part of the normal development process. However, when movements are completely ignored, challenges can arise, she says.

Why motor problems are a problem

“Children with ADHD are often on the move or move so much that they can skip these skills and go from standing to running without working on walking,” she explains. The problem, she explains, is that not only can children have weaker muscles in certain areas or develop uncoordinated movements as they grow older, they can also have academic or athletic difficulties. A child who goes straight to crawling before sitting down first, she says, may not only have a weaker core and face potential balance issues, but could also have issues sitting still in class. or play sports, which could make existing ADHD difficulties worse. Likewise, buttoning issues can lead to problems later when it comes to learning handwriting.

Motor delays in childhood are so severe that E. Mark Mahone, a pediatric neuropsychologist, researcher and director of the department of neuropsychology at the Kennedy Krieger Institute in Baltimore, says it could be a telltale sign these people could develop ADHD. . .

“What often happens is that the motor problems may predate the onset of ADHD symptoms,” says Mahone. He explains that when these skills are delayed in early childhood, it can be a good predictor that ADHD symptoms might develop a few years later, around age 7. Mahone says that is why it is important “to identify early markers to recognize risks and achieve better results.”

In fact, research has found that about 50 percent of children with ADHD have a comorbid developmental coordination disorder, with fine motor skills such as tying shoelaces and writing the most common challenge.

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At the same time, Dr James McGuire, a developmental and behavioral pediatrician at Elliot Health System in Manchester, New Hampshire, clarifies that while there may be associations between delays in motor skills or coordination difficulties and ADHD, it is not a question of “cause and effect.” Delayed motor skills are not part of an ADHD diagnosis, he explains, urging people not to jump to conclusions. Further, he adds that “there are children with ADHD with superior motor skills who are really good at sports, and there are those who have delayed motor skills and coordination difficulties”, reinforcing that he there is no single standard. in this situation. “You have to look at each child individually,” he says. “You can’t assume that the challenges of ADHD and motor skills go hand in hand. “

It can also be the other way around: it is not delays in motor skills that intensify ADHD symptoms, but rather ADHD symptoms that can interfere with motor skills and coordination efforts. For example, because ADHD children may have trouble paying attention, McGuire says, there might be more coordination issues that develop indirectly.

Tips to help your ADHD child

Armed with the possibility that there are associations between motor problems and ADHD, what should affected parents do?

“If you’re a parent with a child with ADHD and you’re worried about delays in motor skills,” says McGuire, “talk to a pediatrician first. He suggests that the children have a good physical exam. Any neurological basis for delays in motor skills is rare, he says, and usually associated with health problems such as muscular dystrophy and cerebral palsy. A pediatrician should ensure that ADHD is treated effectively, which in this case may involve a referral to an occupational therapist or physiotherapist for more detailed evaluations.

Kennedy suggests that parents work with children at home, referring to something that is probably already at home: the literature on developmental stages. “Every parent usually has these kinds of books,” she says. “Use them to try and help your child stay on track. But in addition to reading such documents, she says involvement is key. Getting on the floor with kids helps them learn, as does making games that teach kids how to use zippers and buttons. If kids aren’t specifically interested in buttons, Kennedy says to think creatively, noting that similar moves like putting coins into a bank are also beneficial.

In school environments, Mahone encourages parents to ensure that classrooms or testing facilities are in place, which he says may involve reviewing an IEP or 504 plan. An IEP , or Individualized Education Program, helps ensure that elementary and secondary school children with disabilities receive specialized education and services. A 504 plan applies to children under the same circumstances, but it tends to focus more on providing accommodations such as visual aids or preferential seats. For example, ADHD children who have slow writing skills may need more time to complete tests, so these plans, according to Mahone, may allow that. Additionally, he urges parents to keep an eye out for classrooms that require excessive and “sometimes unnecessary” amounts of handwriting, especially in preschool. He feels that too much focus on handwriting takes away from activities like playing, which can help develop motor skills.

All of these experts agree that the needs of every child must be carefully considered before drawing any hasty conclusions. ADHD is different for every child, ”says Kennedy. “What works for one may not work for the other.”

Best Children’s Hospital Honor Roll


Hospital name


# 1

Boston, Massachusetts

# 2

Philadelphia, Pennsylvania

# 3

Cincinnati, Ohio

# 4

Houston, TX

# 5

Baltimore, MD

# 6

Los Angeles, CA


Chicago, Illinois


Columbus, Ohio

# 9

Pittsburgh, Pennsylvania


Washington DC

Information on the ranking of hospitals as of June 27, 2017

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