Children say the darndest things: physical activity and children with attention-deficit hyperactivity disorder

Abstract

Background: Physical educators suggested that they are not well-informed about behaviors of children with disabilities, especially attention-deficit hyperactivity disorder (ADHD). Children with ADHD represent a significant number of students in school systems worldwide who often experience difficulties in performing fundamental movement skills. Reasons for these challenging movement behaviors are not clearly understood. There were no significant effects of stimulant medication on performance of the Test of Gross Motor Development-2 (TGMD-2) for 22 children with ADHD. Six boys with ADHD possessed superficial content knowledge about physical activity (PA) participation. Poor movement skills may be related to a mismatch between content knowledge and specific skill performance, which can be problematic at individual skill levels.

Purpose: To explore how children with ADHD regulate PA participation by listening to PA stories.

Participants and setting: Ten children with ADHD participated in this study. They were identified by qualified child psychiatrists from an ADHD clinic at a major mental health institute in a large urban Canadian city.

Research design: A concurrent mixed methods design explored the PA experiences of the children. The qualitative data were given a higher priority.

Data collection: The quantitative research component was individualized assessments of fundamental movement skills with the TGMD-2 and Movement Assessment Battery for Children-2. The qualitative research component included: (1) PA self-reporting where each child recorded daily experiences for a two week period and (2) concurrent scrapbook interviews that enhanced participant recall/reflection to generate rich discussions about individual PA experiences.

Data analysis: Quantitative skill assessments provided movement-related descriptions of participants. Individual skill levels were labeled with normative test descriptors linked to each respective assessment instrument. These qualitized descriptors were mixed with interview data only after all movement skill assessments and scrapbook interviews were completed. Interviews were transcribed verbatim and a within group thematic analysis was conducted.

Findings: Many of the children demonstrated movement skill problems on both tests but skill performance was worse on the TGMD-2. Three qualitative themes emerged. The participants with ADHD spoke about their PA experiences in many different individual physical activities (play theme) and various settings (context theme). All children expressed personal wishes to be included in PA with other children in the community. A range of perceived self-regulatory behaviors emerged for planning PA (organization theme). The findings suggest some of the children with ADHD chose and organized their own PA while other children performed PA that was immediately in front of them with minimal organization of their PA behaviors.

Conclusions: Children with ADHD told PA stories that many children without disabilities would tell. However, many of the children with the disorder described experiences related to exclusion from PA. They also lacked conceptual understanding of the purpose and goals related to general participation in various PA. Physical education teacher interventions, leisure counseling and community-based participatory research projects in PA are among the recommendations discussed for children with ADHD.

Keywords:

• mixed methods
• stimulated recall and reflection
• ADHD
• children
• physical activity experiences

Acknowledgements

This research project was funded through a standard research grant awarded by the Sport Canada – social Sciences and Humanities Research Council of Canada (SSHRC) Sport Participation Research Initiative Program (grant number 862-2007-0005).