Children with ADHD move twice as much when learning, brain tests show

Children with attention deficit hyperactivity disorder may fidget, tap and swivel around in a chair much more than normally developing children because it helps them to learn complex material, psychologists have found. 

ADHD is often perceived as a behavioural problem because it can result in symptoms such as inattention, impulsivity, and hyperactivity that can affect social interaction and learning. Scientists increasingly recognize ADHD as a brain disorder that affects about five per cent of the school-age population. 

Now brain tests show children with ADHD tend to learn less when sitting still compared to when they're moving. 

It is not for lack of motivation, says Prof. Mark Rapport, a child psychopathology researcher who focuses on ADHD at the University of Central Florida in Orlando.

• CBC Radio's The Current | Is the public school system working for kids with special needs?
• Children with ADHD have some smaller brain regions, study shows

Rapport and his colleagues set out to test an observation made by many parents — that children with ADHD can pay attention if they are doing an activity they enjoy.

You can give them one instruction and it's no problem... But if you give them too many, it actually collapses the whole system and they end up not remembering anything.- Jennifer Crosbie, Hospital for Sick Children

They put 32 boys aged eight to 12 with ADHD and 30 of their peers who are not affected by the disorder through a battery of memory and other tests. Participants watched two videos on separate days: an instructional math lesson without performing the calculations, and a scene from Star Wars Episode 1 — The Phantom Menace.

During the Star Wars movie, the boys with ADHD did not squirm more than other children, but when asked to concentrate on the math lesson, there was a difference between the two groups.

"All children and all people in general, moved more when they were engaged in a working memory task. Kids with ADHD move about twice as much under the same conditions," Rapport said.

The findings indicate that much of the inattentiveness children with ADHD show in the classroom is related to underdeveloped working memory abilities, the researchers said in the Journal of Abnormal Child Psychology.

"These kids are lagging in development," Rapport said.

For example, if you put a 10-year-old child with ADHD in a class with 10-year-olds who are developing typically, Rapport said it's like a 7½-year-old is sitting there trying to compete. That's one reason those with ADHD tend to have so much difficulty academically.

Rapport's team previously showed that when children with ADHD moved the most, they did their best cognitively. In contrast, moving too much interferes with cognitive functioning in children who are developing typically. 

The brain's frontal area has several slow wave and fast wave activities in terms of brain connectivity and functioning, Rapport said.

In children with ADHD, "they have more slow wave activity than fast wave activity, so what they have to do is move more in order to generate the arousal necessary for the task."

Benefits of movement

Rapport's latest study adds a scientific perspective to anecdotes from parents, teachers and researchers about how children with ADHD can pay attention. It also supports the benefits of movement for individuals with the disorder, said Jennifer Crosbie, a psychologist in the psychiatry department at Sick Kids Hospital in Toronto.

Other strategies for children with ADHD include frequent reminders and simple instructions, Crosbie said.  

"It's a bit like a cognitive house of cards. You can give them one instruction and it's no problem, they're able to do it, they pay attention. But if you give them too many, it actually collapses the whole system and they end up not remembering anything."

Current understanding is that in ADHD, systems in the brain don't fire consistently. Medication can help smooth out those functions, assisting people to pay attention to a task when needed, Crosbie said.

Moving around helps some children with ADHD to let off excess energy to stay on task, she said.  

Use the body to help learn

Jane Arbour's son Emmet, 10, has ADHD. Arbour said she's always supported his need for extra movement and fidgeting. She sees the benefits on his ability to focus.

"I think that a lot of children unfortunately are shamed for, or punished even sometimes, for trying to use their bodies to help learn with their brains," Arbour said.

Teachers also have strategies to help children with ADHD, including visual schedules, yoga balls fixed into a chair, calm breakout rooms with dim lighting and Play-Doh. Any of these tools can be used during a lesson to accommodate a child's needs, said Robyn Posen, a special education co-ordinator with the Toronto District School Board. 

"I think it's very important for us to recognize when a child is spacing out and is quiet, as much as we're paying attention to a child who is getting up and playing with another child's material on someone else's desk," said Posen.

• Mental health disorders disrupt children's transition to adulthood, study finds

Crosbie said adults with ADHD usually don't have hyperactivity but there can still be impairments in their working memory abilities.

Looking to the future, Sick Kids researchers are testing whether a video game helps working memory and executive function in those with the disorder.