UKEdMag: ADHD – Improvements In Cognitive Performance by @kidscansucceed

There is a growing interest among academic researchers and the world of education into how different forms of physical exercise may influence the ways in which children learn, behave and achieve in school. Working from a perspective that seeks to combine research with its practical implications, I have been studying this field for several years, both working on a doctorate at the University of Reading (England) and as a specialist in learning differences and the role of non-medical interventions, supporting schools and families.

What is known about ADHD that might indicate that motor interventions have a role to play? If it does, which activities show indications of a potential benefit, and what is known about speed, duration and intensity?

This article originally appeared in Issue 53 of the UKEdMagazine. You can freely read the magazine by clicking here

Currently it is estimated that there is a global prevalence of ADHD of around 6% and that boys are diagnosed with this more often than girls. Research by Ludgya et al (2018) stress that early interventions should be seen as a necessity to avoid longer–term negative impact of the condition, and they explain how ADHD related deficits might be attributed to aspects of brain function, structure and chemistry.

Their research led them to consider whether physical exercise had potential as a complementary intervention for ADHD, drawing on the work of other researchers that had identified exercise-induced improvements on executive functioning (a group of inter-related mental processes including working memory and inhibitory control that is responsible for supporting skills including reasoning, problem solving and planning) and cognitive flexibility (the ability to sustain or shift attention in response to different demands). Their conclusions indicated that physical exercise possessed ‘great potential’ as a complementary intervention for ADHD, although they exercise caution in drawing conclusions based on non-ADHD studies.

Their overview of the current state of research does, however, suggest that exercise can exert an influence on skills as well as leading to fewer anxiety and depression symptoms.

They recognise that intensive research has taken place into the neurobiological aspects of ADHD, but the mechanisms by which exercise reduces the cognitive and behavioural impairments are less well developed.

There is an understanding that regular, daily, challenging exercise can contribute a complementary element in reducing impairments in executive functioning and control and behavioural deficits. However, the research does not suggest that these are a substitute for pharmacological or behavioural therapies

Yoga /Tai Chi/ Martial Arts/ Floor-Based Motor Programmes

Many motor intervention programmes tend to focus on aerobic activity, where there is less focus on being mentally present and consciously aware of the ways in which the mind and body work together as they tend to place a greater emphasis on the healthy aspects of physical activity. There is now a growing research base to support the use of a wider range of movement interventions that combine different types of activities to address specific needs.

Many yoga teachers would propose that their programmes develop flexibility of the mind as well as the body and that there are correlations between improved focus, executive function and yoga practice (Gothe et al 2013). The practice of yoga has also found to be beneficial when combined with pharmacological interventions.

What distinguishes yoga is the mental focus, with links between improved focus and executive function. Some research has indicated that two 60-minute sessions of yoga over a 20-week period found improvements in ADHD related symptoms after six weeks.

Tai Chi and martial arts programmes have been proposed as potential interventions for ADHD, based on their structured approach to combining cognitive and motor approaches to increasing attention, focus and control.

Floor-based motor programmes that focus on developmental immaturities, such as retained primitive reflexes, have also shown some potential to improve ADHD traits of inattentiveness and hyperactivity. These programmes have some evidence of improving these skills,but may benefit from being applied in conjunction with more physically challenging interventions.

Moderate Aerobic Activity

Examples: Jumping on a trampoline for 5 minutes, 15 minutes jumping and running on the spot, table tennis training.

There is evidence to suggest that this type of exercise can produce improvements in cognitive flexibility and working memory; however researchers point out that there is insufficient data relating specifically to their impact on children with ADHD. At the same time, there are suggestions that aerobic exercise sessions have the potential to improve inhibitory control temporarily when the activity takes place close to the cognitive task. The implication is that schools could benefit all their learners by integrating more physical activity in short bursts throughout the day.

Implications

‘Exercise reduces the cognitive impairments and developmentally inappropriate behaviour in children and adolescents with ADHD… Children with ADHD should be encouraged to perform aerobic exercise for a temporary enhancement of capabilities in executive functioning,’ (Ludgya et al 2018).

Regular exercise is also considered to contribute to long-term benefits for cognitive performance and behaviour in children and adolescents with ADHD.

There is a consensus that the relationship between physical activity and educational performance offers the potential to inform new practices. However, there is a concern that pseudo-science and neuromyths risk schools and parents being liable to the claims of various commercial interventions (Bailey 2018).

This implies that caution needs to be exercised when considering making financial investments in programmes that may lack credible evidence-based or peer-reviewed research.

Take Away General Strategies

  • The positive emotion of enjoyment is a strong motivation to practise physical activity. This can lead to enhancing cognitive processing when teachers understand the relevant teaching methodologies that integrate enjoyable activities based on research-led interventions. Students of all ages with ADHD and comorbid difficulties may benefit from daily physical activities to prime classroom performance.

Take Away Strategies for Parents/ Schools

  • Encourage daily exercise at 3+ intervals in the school day, that takes into account a variety of speed/duration/ intensity
  • Sessions can be 10-15 minutes and include a wide range but a balanced selection of activities.
  • Devise a daily schedule that over the week that balances out a combination of aerobic/yoga/floor-based activities.
  • Children need to enjoy the activity they are doing, but it needs to be challenging to induce cognitive improvement.
  • It can be useful to include breathing exercises (often included in yoga programmes) as a part of daily routine and selecting a time when you think you, or your child/ student feel the greatest need to relax. This should ideally be at the same time every day.
  • Use a more intensive activity (appropriate to the individual) prior to important tests requiring high cognitive control or competitions requiring tactical planning.
  • Consider martial arts as a possible activity: There is some research to suggest that the traditional forms that combine mental and motor aspects can exert an influence on aspects of ADHD weaknesses.

Mary @kidscansucceed is an author, conference speaker and trainer working internationally: dyslexia/ ADHD and developmental delays. She has extensive experience in mainstream, specialist and independent schools and her focus is on cognitive-motor-affect approaches to improving classroom performance. View her site at kidscansucceed.com

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The Editorial Account of UKEdChat, managed by editor-in-chief Colin Hill, with support from Martin Burrett from the UKEd Magazine. Pedagogy, Resources, Community.

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