Design and Validation of a Motor Intervention Regime for Managing Co-Morbid ADHD and Developmental Co-ordination Disorder (DCD): A Descriptive Study

Background: Attention Deficit and Hyperactivity Disorder (ADHD) is a common neurobehavioral disorder. Children with ADHD, frequently experience motor difficulties. ADHD is treated with neuro-pharmacological medication and psycho-therapy; this seems to have little effect on the motor symptoms.  Studies have investigated managing comorbid ADHD and Developmental Co-ordination Disorder (DCD), using neuro-motor treatments.  However, a “gold standard” treatment, for managing co-morbid ADHD and DCD, is non-existent. This study fills this gap in the knowledge. Physical exercises have significant somatic benefits but equally important; cognitive, educational and behavioural benefits; which are produced by the increase in the cerebral blood flow and the increased release of endorphins, which in turn stabilize other neurotransmitters, such as dopamine, which enhance cognition and other executive functions. Objectives: To design and validate a motor intervention, that addresses both motor and cognitive symptoms of co-morbid ADHD and DCD. Intervention consists mainly of motor co-ordination exercises and balance exercises, which stimulate focus, attention and planning; hence also enhancing the cognitive.  Methods: A motor intervention was designed, based on 5 conceptual frameworks: 1. International Classification of Function, Disability and Health (ICF). 2. Symptoms of co-morbid ADHD and DCD. 3. Neuroanatomy and neurophysiology affected in both conditions. 4. Effect of Physical exercises. 5. Motor Interventions previously administered to children with cognitive and motor deficits. Literature and clinical experience were also considered in the design of the prototype of the motor intervention. This was validated by a three-phase, modified Delphi process (Using Likert scales and polar questions), by a total of 17 experts, namely: neuro-paediatricians, educational psychologists, physiotherapists and Occupational Therapists (OT). Results: Consensus on structure and content of the motor intervention was achieved. A well-designed, motor intervention (content, structure, frequency, duration, repetitions and equipment needed) was the result. This intervention carries clinical significance, in the management of comorbid ADHD and DCD. Conclusion: A motor intervention is presented, which is innovative (the first of its kind) and useful (a “gold-standard” treatment for comorbid ADHD and DCD, which at present, is non-existent).