Exercise as it relates to Disease/School based physical activity to reduce hyperactivity and ADHD symptoms

This fact sheet is an analysis of the article: A Randomized Trial Examining the Effects of Aerobic Physical Activity on Attention-Deficit/Hyperactivity Disorder Symptoms in Young Children that appeared in the Journal of Abnormal Child Psychology.

What is the background to this research?
Attention Deficit Hyperactivity Disorder (ADHD) is a chronic long term neurodevelopment disorder. It is brain based believed to be caused by minor differences in the fine tuning of a "normal" brain, a slight brain dysfunction. the dysfunction of ADHD is thought to be due to imbalance in neurotransmitter chemicals found in the brain ADHD is not a illness or a sign of low intelligence With increasing age of the sufferer and progression of the disorder, ADHD tends to move away from restlessness impulse behaviour and move towards inattention, inability to sustain work out put, deficient short term memory and frustration with leaning. ADHD is a condition that often follows a child through to adulthood. it is often seen as as a "boys" problem. this is since boys are 6 times more likely to be referred for help then girls. Many girls remain undiagnosed, as by nature girls tend to be less disruptive and suffer more silently than their male counterparts. In Australia ADHD affects about 1 in 20 children.

Where is the research from?
the research is from a US study on PA on ADHD in young children. The study was conducted outside a traditional lab based setting, at study sites. the participants for the study where recruited from participating schools from 2 small US cities. further research and interpretation of the findings where conducted at:
 * Vermont University Department of Psychology Science
 * Department of Kinesiology at Michigan State University,
 * Department of Health and Kinesiology and the Department of Statistics at Purdue University
 * Department of Family, Consumer, and Human Development & Department of Health, Physical Education, and Recreation, Utah State University

What kind of research was this?
the study was a randomised controlled observation trail on how Physical activity affect ADHD based on a representative sample of a early elementary school students from a variety of culture and ethical backgrounds and schools from 2 small US cities.

Participants
The study conducted consisted of 202 early elementary school students, students from Kindergarten through to the second grade. All the participants recruited for the study came from participating schools across 2 small US cities. 54% of the participants where male, with the ages of the participants ranging from 4.44-8.9 years (mean age was 6.83 SD .96) the participants of the study where racially and ethically diverse. The breakdown of races where:
 * Caucasian (68.3%)
 * African American (7.9%)
 * Mixed Race (14.4%)
 * Asian (2.0%)
 * Other (7.4%)

Medication
At the beginning of the study non of the participants where undergoing any medication therapies for ADHD. participants where permitted to seek and start a medication program for ADHD. Parents reported during the study that 4 participants had started taking medication during the study

Method
To determine participant eligibility, researchers used a 2 step process. The first step was the Preliminary screening and informed consent was completed by the parents. Parents and Teachers of the potential participants completed a ADHD-IV rating scale questionnaire, as a preliminary measure for eligibility. Secondary Screening stage had the parents complete additional study measures about their children. An in-person screening was conducted to establish final eligibility. 2 groups where put together for the study a control group and a ADHD at risk group. medical exams where conducted on the final participants to ensure there where no underlying medical conditions. the participants from the 2 groups where randomly placed into 2 study groups, that would undergo the interventions, a group that would undergo Physical activities and a group that would undergo sedentary classroom based art projects. these two intervention groups where checked to maintain gender and age group balances.

The intervention program ran for a continuous 12 weeks while school was in session and was held every school day before school began with each session being 31 minutes long. The Program was run to a structured manual that was designed implicated for this study. Each day of the program ran the same but the activities changing in what the participants did to maintain interest. The day consisted of the following:
 * 2 minutes in a large group activity
 * 3 x 9 minute small group stations
 * 2 minutes in a large group activity

Both setting staff members where trained to use praise as effective instructions freely. Emphasis was placed on having all children attend to instructor before a set of instructions where given. as part of the program there was a simple reward system implemented using stickers for participation

Physical Activity Group

 * Continuous exercise for majority of the time
 * exercising at a level that made the children breathe hard
 * age appropriate activities that kept helped maintain interest

Sedentary Classroom Group

 * aim was to keep participants sedentary
 * engaged in classroom based art projects to maintain interest

What were the basic results?
Through out the study Participation rates where monitored, resulted in 86% of participants actively participating in their assigned group. Both Parent and Teachers reported improvements in:
 * moodiness
 * behaviour with peers
 * problematic peer functioning
 * changes in symptom severity and oppositional

How did the researchers interpret the results?
Researchers interpreted the results using reports and feedback given back to them from parents, teachers and the intervention centre staff. and then compared the results back to small scale studies of a similar nature, the studies own hypothesises and the baseline data for the study. Although the results were relatively strong, the method was based on opinion based report which meant that there could have been the potential for bias making the study less reliable

What conclusions should be taken away from this research?
The study found that PA does assist in reducing the severity of ADHD symptoms found in children. Since that this was the first large scale randomised study of this type results are inconclusive but are promising. Further studies wound need to be conducted to draw better conclusions from a variety of sources.

What are the implications of this research?
study showed that A is beneficial for children suffering from ADHD. Further support and research is needed to determine if a particular type of PA and or the duration of PA has on reducing the severity of ADHD symptoms. Further research in fully understanding ADHD and brain development is critical in order of greater understanding and implementing strategies in combating ADHD in children.