Children with Attention Deficit/Hyperactivity Disorder (ADHD) Have Significant Balance Problems When compared to control children, ADHD patients fared worse in balance tests.

Boca Raton, FL -- Attention deficit/hyperactivity disorder (ADHD) affects four to nine percent of our nation's young people and four percent of adults. Symptoms of ADHD include inattention, hyperactivity, and impulsivity. Some have observed that children diagnosed with ADHD have sensory motor abnormalities, including poor visual motor skills, posture, balance, and spatial orientation.

The evidence supporting this belief comes from studies of children with learning disabilities, rather than specifically ADHD. This is because learning disorders co-exist in approximately one third of children with ADHD. Consequently, the evidence available on vestibular and/or sensory motor deficits in children with learning disabilities (LD) is contradictory, perhaps due to differences in subject selection criteria. Therefore, a team of researchers set out to determine if differences in vestibular and ocular motor function, posturography results (somatosensory and visual influences on posture and equilibrium), and balance ability exist in children with ADHD and those without.

The authors of the study, "Vestibular and Balance Function in Primary School Children with Attention Deficit Disorders," are Horst R. Konrad MD, Larry F. Hughes PhD, Marcia V. McCann, and Marian Girardi, all from the Southern Illinois University School of Medicine, Springfield, IL. Their findings will be presented at the Annual Meeting of the Triological Society http://www.triological.org/, being held May 12-14, 2002, at the Boca Raton Resort & Club, Boca Raton, FL.

Methodology: Forty children (18 with ADHD, 22 without) with an age range of six to 13 (mean age: 9.27) participated in this study. Ocular motor and vestibular function was evaluated using computer-generated eye tracking tests with infrared oculography. Balance function was measured using the Bruininks-Oseretsky Test of Motor Proficiency Balance Subtest. The Ocular Motor Testing consisted of Smooth pursuit testing, where the subject was asked to pursue a target moving in a pendular fashion at 0.1, 0.2 and 0.4 Hz. Saccades (rapid eye movement to redirect the line of sight) were elicited by asking the subject to track a target that randomly appeared, disappeared, and reappeared in another location in the visual field (from 20 to 30 degrees). Recording was performed with a two-channel infrared oculography system.

Results: Of those enrolled in the study, 94 percent with an ADHD diagnosis scored positive on the ADHD questionnaire. Ten percent (ADHD=3, Control=1) were diagnosed with a learning disability; 2.5 percent (ADHD=1) were found to have Oppositional-Defiant Disorder (ODD). No children were diagnosed with conduct, anxiety, mood or motor disorders, and seven children were unable to abstain from caffeine (ADHD=3, Control=4).

No statistically significant results were found in ocular motor testing, vestibular testing, and posturography testing, though children with ADHD tended to perform worse than control children.

Conclusions: The findings suggest that children with attention deficit/hyperactivity disorder are more likely to have deficient motor systems leading to balance difficulties. The researchers believe that more study is needed in this area to understand the full nature of deficits that children with ADHD experience. These findings study add to the literature on vestibular and balance deficits in children with ADHD.

---Combined Otolaryngological Spring Meetings

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