Association between activity level and situational factors in children with attention deficit/hyperactivity disorder in elementary school

Abstract

The aim of this study was to determine whether the objective activity level of children with attention deficit/hyperactivity disorder (AD/HD) is associated with situational factors in elementary school. A total of 16 children with combined-type AD/HD (13 boys, 3 girls) and 20 controls matched for age and gender participated in the study. All the participants wore the objective measurement of activity level for 1 week while attending elementary school. The average activity levels were calculated for the morning and afternoon classes. The classes were categorized into four types: (i) in-seat classes, in which the participants were expected to learn quietly while sitting in their own seats; (ii) not-in-seat classes, in which the participants were not expected to sit in their seats; (iii) physical education classes; and (iv) lunch/recess periods. During the afternoon in-seat classes, the children with AD/HD were significantly more active than the controls. However, no significant differences based on the group (children with AD/HD or controls) were observed during the other morning or afternoon classes. These findings indicate that in naturalistic settings where the effects of situational demands involving inhibition and the effect of fatigue overlapped, the children with AD/HD exhibited an activity level that was different from that exhibited by the controls. Differences in the activity levels of children with AD/HD and normal controls were identified using an objective measurement of activity level when two situational factors overlapped.

Locomotor activity measures in the diagnosis of attention deficit hyperactivity disorder: Meta-analyses and new findings

“…We were unable to extract SMD values from seven studies (Edebol et al, 2012; Inoue et al, 1998; Kam et al, 2011; Martin-Martinez et al, 2012; O'Mahony et al, 2014; Ohashi et al, 2010; Wood et al, 2009). Two reports (Tsujii et al, 2007; Tsujii et al, 2009), appeared to be based on the same data, so we only included the former. For each of these eight exclusions, we attempted to contact authors to ask for additional data, without satisfactory results.…”

Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD

“…Boonstra et al [10] described a similar pattern in adults with ADHD, i.e., high but stable activity levels during day hours, but no evidence of significant difference at night. Daytime activity levels in children with ADHD may be more variable as differential effects between children with ADHD and control children were described to be particularly expressed when a highly demanding environment and afternoon hours overlap [44,60]. In the morning, children with ADHD showed no significant drop in activity from the 10 AM playtime to the 11 AM class condition compared to their normal classmates.…”

“…To date, several research domains have pointed to differential circadian arousal patterns in ADHD. There is evidence that subjects with ADHD show a higher eveningness preference [12,47,55], more sleep-wake disturbances [10,14,27,37,40], and more hyperactivity problems in the afternoon [3, 44,60,67]. As findings on this research topic are inconsistent [13,17,23,36], further clarification of time of day effects in arousal is critical to fully understand underlying mechanisms involved in arousal and behavioral symptoms of ADHD.…”

Altered circadian profiles in attention-deficit/hyperactivity disorder: An integrative review and theoretical framework for future studies

“…Also Tsujii et al (2007) pointed to the possibility that time of day effects are likely to be confounded by context effects. They investigated the level of activity in different naturalistic educational settings, e.g., structured in-seat classes and non-structured classes at different times of day.…”