Correlation Between Balance and Attention in Children With Attention Deficit Hyperactivity Disorder
Condition: Attention Deficit Hyperactivity Disorder
MeSH terms: Hyperkinesis; Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      Objective: The present study aimed to determine balance in children with attention deficit
      hyperactivity disorder compared to normal peers. Also, it investigated the correlation
      between their balance and the total percentile scores of ADHD Rating Scale-IV.

      Design: Cross sectional design. Methods: Sixty children participated in this study from both
      sexes (42 boys and 18 girls) with age ranged from 60 to 84 months. They were divided into two
      groups based on the ADHD Rating Scale-IV. Control group: 30 typically developed children from
      both sexes (20 boys and 10 girls) with mean age 67.53 ± 1.41 months. They had the total
      percentile scores of ADHD Rating Scale-IV ≤ 50. Study group: 30 children from both sexes (22
      boys and 8 girls) suffering from attention deficit hyperactivity disorder (ADHD) with mean
      age 68.60 ± 4.62 months. They had the total percentile scores of ADHD Rating Scale-IV ≥ 93.
      Both groups were assessed for their balance by Pediatric Balance Scale (PBS).
    

Detailed description: 
      This study was conducted to compare balance in children with attention deficit hyperactivity
      disorder to normal peers. Also, it aimed to explore the relation between the attention and
      balance in the children suffering from ADHD. The age of the children included in this study
      ranged from five to seven years old because it was reported that ADHD is estimated to affect
      between 3% and 5% of children of primary school age. The result of this study showed that
      there was no significant differences between the mean values of the age for both control and
      study groups which supported there was matching between control and study groups. Also, the
      results represented that boys were suffering from ADHD more than girls. Both groups were
      assessed by Pediatric balance scale (PBS) which is reliable measure of balance used with
      child with motor impairment.

      Also, the results of this study represented significant difference in Pediatric Balance Scale
      (PBS) scores in the study group (ADHD group) as compared to the control group (typically
      developed children group) which indicated that there was balance disturbance in children
      suffering from ADHD. The Pediatric balance scale scores (PBS) in the children with ADHD is
      lower than the typically development children by 19.42 % and 16.28% for males and females
      respectively. These findings come in agreement with Kim et al., who reported that the
      children with ADHD had disturbance of balance. Also, it was confirmed by Mao et al., who
      suggest that balance ability skill levels in children with ADHD were generally not as high as
      those of the controls in various aspects, including static and dynamic balance. It was
      reported that children with ADHD were showed posture and gait performance abnormalities,
      particularly in the movement coordination test and paced stepping task.

      Also, the results of this study represent there was significant negative relationship between
      the Pediatric balance scale score and the percentile scores of ADHD Rating Scale-IV in the
      study group. This finding indicates that the disturbance of the balance in the children
      suffering from ADHD was inversely proportional to their percentile scores of ADHD. This
      finding comes in agreement with Abuin-Porras et al., who stated that there was a significant
      relationship between attention and balance and gender differences that may condition the way
      to address balance issues in boys and girls.

      The disturbance of balance in the children suffering from ADHD can be referred to decrease in
      the volume of cerebrum and cerebellum in the children suffering from ADHD as compared to the
      healthy children. Also, there was cerebellum dysfunction in the children suffering from ADHD
      due to the decrease in the brain conductivity from cerebellum to the middle frontal and
      medial frontal gyri in those children.
    

Intervention name(s): Pediatric balance scale.
Intervention type(s): Diagnostic Test
Intervention description(s): The Pediatric Balance Scale (PBS) includes fourteen items. Each item of subsets scored as 4, 3, 2, 1 or 0. Finally, the total test score was calculated.
Each child in both groups was examined individually, using ADHD Rating Scale-IV checklist. The child's teacher was asked to write the checklist. Then the therapist interpreted the total scores obtained from the checklist and she converted it to the percentile scores based on their total scores.
Other intervention name(s): ADHD Rating Scale-IV
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic