title: Kinematic performance of fine motor control in attention-deficit/hyperactivity disorder: the effects of comorbid developmental coordination disorder and core symptoms.
abstract: BACKGROUND
  The aims of this study were: (i) to determine whether differences exist in the fine motor fluency and flexibility of three groups (children with attention-deficit/hyperactivity disorder [ADHD], children in whom ADHD is comorbid with developmental coordination disorder [DCD] [denoted as ADHD+DCD], and a typically developing control group); and (ii) to clarify whether the degree of severity of core symptoms affects performance.
  
  
  METHODS
  The Peabody Picture Vocabulary Test-Revised, the Beery-Buktenica Development Test of Visual-Motor Integration and the Movement Assessment Battery for Children were used as prescreening tests. The Integrated Visual and Auditory+Plus test was utilized to assess subjects' attention. The redesigned fine motor tracking and pursuit tasks were administered to evaluate subjects' fine motor performance.
  
  
  RESULTS
  No significant difference was found when comparing the performance of the Children with ADHD and the typically developing group. Significant differences existed between children in whom ADHD is comorbid with DCD and typically developing children.
  
  
  CONCLUSIONS
  Children with ADHD demonstrated proper fine motor fluency and flexibility, and deficient performance occurred when ADHD was comorbid with developmental coordination disorder. Children with ADHD had more difficulty implementing closed-loop movements that required higher levels of cognitive processing than those of their typically developing peers. Also, deficits in fine motor control were more pronounced when ADHD was combined with movement coordination problems. The severity of core symptoms had a greater effect on children with ADHD's fine motor flexibility than did fluency performance. In children with pure ADHD, unsmooth movement performance was highly related to the severity of core symptoms.
authors.affiliation: Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan. iching@mail.ncku.edu.tw
authors.forename: I-Ching
authors.initials: IC
authors.lastname: Lee
authors.forename: Yung-Jung
authors.initials: YJ
authors.lastname: Chen
authors.forename: Chin-Liang
authors.initials: CL
authors.lastname: Tsai
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000523:psychology*; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills; D019957:Motor Skills Disorders / Q000150:complications* / Q000523:psychology; D011581:Psychological Tests; D012720:Severity of Illness Index; D013647:Task Performance and Analysis