Correlation Between Balance and Attention in Children With Attention Deficit Hyperactivity Disorder (ADHD)

Objective: The present study aimed to determine balance in children with attention deficit hyperactivity disorder compared to normal peers. Also, it investigated the correlation between their balance and the total percentile scores of ADHD Rating Scale-IV. Design: Cross sectional design. Methods: Sixty children participated in this study from both sexes (42 boys and 18 girls) with age ranged from 60 to 84 months. They were divided into two groups based on the ADHD Rating Scale-IV. Control group: 30 typically developed children from both sexes (20 boys and 10 girls) with mean age 67.53 ± 1.41 months. They had the total percentile scores of ADHD Rating Scale-IV ≤ 50. Study group: 30 children from both sexes (22 boys and 8 girls) suffering from attention deficit hyperactivity disorder (ADHD) with mean age 68.60 ± 4.62 months. They had the total percentile scores of ADHD Rating Scale-IV ≥ 93. Both groups were assessed for their balance by Pediatric Balance Scale (PBS).

This study was conducted to compare balance in children with attention deficit hyperactivity disorder to normal peers. Also, it aimed to explore the relation between the attention and balance in the children suffering from ADHD. The age of the children included in this study ranged from five to seven years old because it was reported that ADHD is estimated to affect between 3% and 5% of children of primary school age. The result of this study showed that there was no significant differences between the mean values of the age for both control and study groups which supported there was matching between control and study groups. Also, the results represented that boys were suffering from ADHD more than girls. Both groups were assessed by Pediatric balance scale (PBS) which is reliable measure of balance used with child with motor impairment. Also, the results of this study represented significant difference in Pediatric Balance Scale (PBS) scores in the study group (ADHD group) as compared to the control group (typically developed children group) which indicated that there was balance disturbance in children suffering from ADHD. The Pediatric balance scale scores (PBS) in the children with ADHD is lower than the typically development children by 19.42 % and 16.28% for males and females respectively. These findings come in agreement with Kim et al., who reported that the children with ADHD had disturbance of balance. Also, it was confirmed by Mao et al., who suggest that balance ability skill levels in children with ADHD were generally not as high as those of the controls in various aspects, including static and dynamic balance. It was reported that children with ADHD were showed posture and gait performance abnormalities, particularly in the movement coordination test and paced stepping task. Also, the results of this study represent there was significant negative relationship between the Pediatric balance scale score and the percentile scores of ADHD Rating Scale-IV in the study group. This finding indicates that the disturbance of the balance in the children suffering from ADHD was inversely proportional to their percentile scores of ADHD. This finding comes in agreement with Abuin-Porras et al., who stated that there was a significant relationship between attention and balance and gender differences that may condition the way to address balance issues in boys and girls. The disturbance of balance in the children suffering from ADHD can be referred to decrease in the volume of cerebrum and cerebellum in the children suffering from ADHD as compared to the healthy children. Also, there was cerebellum dysfunction in the children suffering from ADHD due to the decrease in the brain conductivity from cerebellum to the middle frontal and medial frontal gyri in those children.

The Pediatric Balance Scale (PBS) includes fourteen items. Each item of subsets scored as 4, 3, 2, 1 or 0. Finally, the total test score was calculated

The Pediatric Balance Scale (PBS) includes fourteen items. Each item of subsets scored as 4, 3, 2, 1 or 0. Finally, the total test score was calculated. Each child in both groups was examined individually, using ADHD Rating Scale-IV checklist. The child's teacher was asked to write the checklist. Then the therapist interpreted the total scores obtained from the checklist and she converted it to the percentile scores based on their total scores.

correlation between the pediatric balance scale scores and the gender, age and ADHD rating scale-IV for the study group

The Bivariate Correlations procedure computed Pearson- a parametric test, to test the relationship between Pediatric Balance Scale (PBS) score and the total percentile scores of ADHD Rating Scale-IV variables with ordered categories and their significance levels.

Inclusive criteria: Children age ranged from 60 months to 84 months. They were divided into two groups (control and study groups). Study group: Thirty children from both sexes (22 boys and 8 girls) suffering from attention deficit hyperactivity disorder (ADHD) according to the ADHD Rating Scale-I. They had the total percentile scores of ADHD Rating Scale-IV ≥ 93. They had no history of cerebral palsy, epilepsy or head trauma. Control group: Thirty typically developed children from both sexes (20 boys and 10 girls). They had the total percentile scores of ADHD Rating Scale-IV ≤ 50. Exclusive criteria: They had no history of cerebral palsy, epilepsy or head trauma. They had no auditory or visual disorders. They had no mental retardation.