title: Persistent Handwriting Difficulties in Children With ADHD After Treatment With Stimulant Medication.
abstract: OBJECTIVE
  Children with ADHD often present with handwriting difficulties. However, the extent to which motor and attention skills influence performance in this group has not yet been explored. The objective of this study was to examine the factors associated with change in handwriting performance.
  
  
  METHODS
  This study examines the factors associated with change in handwriting performance of 49 children newly diagnosed with ADHD (mean age = 8.4 [SD=1.3] years) prior to and 3 months following use of a stimulant medication.
  
  
  RESULTS
  Handwriting legibility and speed improved significantly at follow-up evaluation. However, most of the children with legibility difficulties at baseline continued to demonstrate difficulties when evaluated 3 months after initiation of medication. Change in handwriting legibility was best determined by improvements in visual-motor integration skills (β = 0.07-0.10; p < .001), while the change in speed did not appear to be consistently related to a single factor.
  
  
  CONCLUSIONS
  Handwriting difficulties are common in children with ADHD, and medication alone is not sufficient to resolve these challenges.
authors.affiliation: Children's National Medical Center, Washington, DC, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Brossard-Racine
authors.affiliation: McGill University, Montreal, Quebec, Canada Montreal Children's Hospital, Montreal, Quebec, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Shevell
authors.affiliation: McGill University, Montreal, Quebec, Canada Montreal Children's Hospital, Montreal, Quebec, Canada.
authors.forename: Laurie
authors.initials: L
authors.lastname: Snider
authors.affiliation: Centre Hospitalier Universitaire-Sainte-Justine, Montreal, Quebec, Canada.
authors.forename: Stacey Ageranioti
authors.initials: SA
authors.lastname: Bélanger
authors.affiliation: Centre Hospitalier Universitaire-Sainte-Justine, Montreal, Quebec, Canada.
authors.forename: Marilyse
authors.initials: M
authors.lastname: Julien
authors.affiliation: McGill University, Montreal, Quebec, Canada Montreal Children's Hospital, Montreal, Quebec, Canada annette.majnemer@mcgill.ca.
authors.forename: Annette
authors.initials: A
authors.lastname: Majnemer
mesh_terms: D001288:Attention / Q000187:drug effects*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006236:Handwriting; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000187:drug effects*; D019957:Motor Skills Disorders / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants