Effects of methylphenidate and physiotherapeutic treatment on graphomotor movements in children with ADHD

Abstract

In addition to the core symptoms defining ADHD, affected children often experience motor problems; in particular, graphomotor movements including handwriting are affected. However, in clinical settings, there is little emphasis on standardized and objective diagnosing and treatment of those difficulties. The present study investigated for the first time the effects of methylphenidate as well as physiotherapeutic treatment on objectively assessed graphomotor movements compared to a control condition, i.e. parental psychoeducation, in 58 children (mean age: 9.52 ± 1.91 years) newly diagnosed with ADHD in an outpatient clinic for child and adolescent psychiatry. Families were invited to join one of the treatment groups. Before and after 8 weeks of treatment, children performed six different tasks on a digitizing tablet which allowed the objective analysis of three important kinematic parameters of graphomotor movements (fluency, velocity, and pen pressure) in different levels of visual control and automation. Graphomotor movement fluency and velocity improves over time across the groups, especially in tasks with eyes closed. We did not find clear evidence for beneficial effects of methylphenidate or physiotherapeutic treatment on children’s overall graphomotor movements suggesting that treatments need to be better tailored towards specific and individual deficits in graphomotor movements.

Is There a Deficit in Product and Process of Handwriting in Children with Attention Deficit Hyperactivity Disorder? A Systematic Review and Recommendations for Future Research

“…An intriguing question, even if it is out of the scope of our review, lies in the putative beneficial effects of methylphenidate on the handwriting skills of children with ADHD. At best, medication seems effective for a portion of children (e.g., [22]) while, at worst, there is no impact on quality but rather on speed, which is often slowed down, and a change in process for some children (e.g., [49,59]). Again, such equivocal results highlight inter-individual variability regarding the mechanisms which underpin handwriting disturbances.…”