The influence of motor skills on the choices of action in children with attention-deficit hyperactivity disorder

Objective: The present study investigated motor skills in children with attention-deficit hyperactivity disorder （ADHD）and its influence on their choices of action, which provided basic findings for prevention of unintentional injury in their living conditions. Methods: A case-control study was performed with 51 typically developing（TD）children and 35 children with ADHD. Their motor skills were evaluated by The Movement Assessment Battery for Children―Second Edition（MABC-2）. We conducted an experimental task regarding the choices of action, in which the subjects were asked to pass through the rope by either stepping over or passing under it. We compared the scores of the MABC-2 and the performance in the experimental task among the subject groups, then identified the factors which would affect their choices of action. Results: Children with ADHD showed lower performance on their total MABC-2 score than did the TD children. In particular, their ball and gross motor skill performances were impaired compared with those of the TD children. In the experimental task, children with ADHD tried to pass under the rope set at a low height while the TD children stepped over the rope at the same level. The height of the rope that subjects chose to pass under was predicted by the attention performance of the subjects, but not by their motor skill performance. Conclusions: Japanese children with ADHD had impaired gross motor skills as well as difficulties in item-based motor skills. Moreover, their choices of action seemed inefficient, which was affected by severe inattention toward both the environment and their body schema. Thus, we should consider attention performance as well as motor skill performance in prevention of unintentional injuries.