Fundamental movement skills and associated physical activity experiences of children with ADHD ...

232 Pages·2012·11.07 MB·English

Fundamental movement skills and associated physical activity
experiences of children with ADHD
William J. Harvey
Department of Kinesiology and Physical Education
McGill University, Montreal
February, 2006
A thesis submitted to McGill University in partial fulfillment of the requirements for the degree
ofDoctor ofPhilosophy in Kinesiology and Physical Education
©William J. Harvey, 2006
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Abstract
Excessive activity has been a prominent feature in the symptomatology of attention-deficit
hyperactivity disorder (ADHD) for more than four decades. While overactivity has helped to
identify persons with ADHD, the movement skill proficiency and physical activity experiences
of children with ADHD have been overlooked (Harvey & Reid, 1997). This dissertation is a
series of four original manuscripts that explore relationships between adapted physical activity
(APA) and ADHD. The fust manuscript, a review paper, discusses important issues related to
ADHD. It suggests many children with ADHD experience poor levels ofphysical fitness and
movement skill difficulties when compared to children without ADHD (Harvey & Reid, 2003).
Numerous reference citations for seminal review articles on ADHD were provided. The second
manuscript, another review paper, explored research methods used in movement performance
studies about ADHD. Twenty new APA research questions about ADHD were posed (Harvey &
Reid, 2005). Issues surrounding identification of ADHD, data collection procedures, and
strategies to improve AP A research about ADHD were also provided. The two review papers,
when combined, are a substantial and original contribution to the ADHD literature. The third
manuscript is a study about the effects of stimulant medication on the fundamental movement
skill performance for 22 children with ADHD and a comparison oftheir movement skills to age
and gender-matched peers without ADHD. Multivariate statistical analyses revealed no
significant effect ofmethylphenidate on the performance criteria of the TGMD-2 (Ulrich, 2000)
for the children with ADHD. Significant differences between the children with and without
ADHD were found on both locomotor skills and object control skills. A movement skill profile
was developed for each group and they are unique contributions to the movement performance
literature. The fourth manuscript is a study that explores the lived physical activity experiences
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of six boys with and without ADHD. Semi-structured interviews revealed sorne similarities
among both groups about their physical activity experiences. However, qualitative differences
were apparent on key aspects ofskill proficiency. It is concluded that more in-depth APA
research about people with ADHD is necessary to gain a clearer understanding of the children's
unique physical activity needs.
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Résumé
L'activité excessive est une caractéristique marquante dans la symptomatologie du trouble
d'attention avec hyperactivité (TDAH) depuis plus de quatre décennies. Si toutefois
l'hyperactivité a aidé à identifier les personnes atteintes de TDAH, la capacité motrice et
l'activité physique des enfants atteints de TDAH ont été négligées (Harvey & Reid, 1997). Cette
dissertation est une série de quatre manuscrits originaux qui explorent les relations entre
l'activité physique adaptée (APA) et le TDAH. Le premier manuscrit, un article de révision,
discute de sujets importants reliés au TDAH. Il suggère que plusieurs enfants atteints du TDAH
ne sont pas en bonne forme physique et vivent des difficultés avec la capacité motrice lorsqu'on
compare à des enfants non-atteints du TDAH (Harvey & Reid, 2003). Plusieurs citations de
référence portant des articles de révision sur le IDAH ont été fournies. Le deuxième manuscrit,
un autre article de révision, explore les méthodes de recherche utilisées pour réaliser des études
sur la capacité motrice sur le TDAH. Vingt nouvelles questions de recherche sur l'APA ont été
posées (Harvey & Reid, 2005). Les points entourant l'identification du TDAH, les procédures
de collecte des données et les stratégies pour améliorer la recherche sur l' AP A et le IDAH ont
également été apportées. Les deux articles, lorsque combinés, sont une contribution substantielle
et originale à la littérature sur le IDAH. Le troisième manuscrit décrit une étude sur les effets
des médicaments stimulants sur la performance fondamentale de la capacité motrice pour 22
enfants atteints du IDAH, et une comparaison de leur capacité motrice à un groupe d'enfants du
même âge et du même sexe qui sont non-atteints du TDAH. Des analyses statistiques
comportant plusieurs variantes n'ont démontré aucun effet significatif de la méthylphénidate sur
le critère du TGMD-2 (Ulrich, 2000) pour les enfants atteints du TDAH. Des différences
significatives entre les enfants atteints et non-atteints du IDAH ont été retrouvées sur les
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habiletés locomotrices et le contrôle d'objet. Un profil de capacité motrice a été développé pour
chaque groupe et ils sont une contribution unique à la littérature de la performance du
mouvement. Le quatrième manuscrit est une étude qui explore les expériences d'activité
physique vécues de six garçons atteints et non-atteints du TDAH. Des entrevues semi
structurées ont démontré quelques similitudes entre les deux groupes portant sur leurs
expériences d'activité physique. Toutefois, des différences qualitatives étaient apparentes lors
des aspects clés sur les habiletés. TI a été conclu qu'une recherche plus approfondie sur l'APA et
sur les personnes atteintes d'un TDAH est nécessaire pour bénéficier d'une meilleure
compréhension des besoins uniques de l'activité physique chez les enfants.
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Acknowledgements
There are many people to thank in this doctoral dissertation. First, 1 would like to thank
aIl of the profe ssors who have served on my doctoral committees and provided much appreciated
mentorship and guidance. 1 had the distinct pleasure and honor to learn from and work with my
dissertation supervisor, Dr. Greg Reid. He has challenged me to learn and perform to the best of
my abilities each and every day. Greg patiently edited my work and, with time and teaching, he
has enabled me to become independent in my research skills and professional practice. Thank
you for your guidance, candor and friendship over these many years.
Three specific committee members have helped me enormously. They assisted in the
design of the two latter studies of the dissertation. Yet, they contributed so much more.
Dr. A.E. (Ted) Wall was an instrumental part ofmy student life by providing much guidance and
support. He always maintained high professional standards and always demanded my very best.
Dr. Carl Frederiksen opened my eyes to the beauty ofbeing a "sleuth" and maintaining a positive
focus on learning. Carl re-instilled a love for learning in me and, importantly, he re-introduced
statistics to me in a way that 1 have acquired a new found interest in the domain and a deep
respect for his teaching skills. Dr. Margaret Downey has long suffered my "5-minute" talks that
would usually last for much longer. Peggy would listen patiently, reflect and always provide
critical feedback that only a master teacher can provide. Thanks are extended to aIl of you for the
tremendous learning experiences and the opportunity to venture into a new and exciting life
journey.
1 would like to thank the foIlowing co-authors for their assistance and contributions to the
thesis. Dr. Natalie Grizenko and Dr. Ridha Joober were open-minded and allowed this physical
activity research to be included in their ADHD research program at the Douglas Hospital. In
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addition to the opportunity to observe reliably diagnosed persons with ADHD, we were able to
learn much more about research in psychiatry. Dr. Valentin Mbekou and Mrs. Marina Ter-
Stepanian, also from the Douglas Hospital, were vital for the interpretation of psychological tests
as weIl as training me to reliably conduct the required screening interviews. Dr. Gordon Bloom
and Ms. Kerri Staples from McGill University contributed to my understanding of qualitative
research with theoretical and practical feedback on important methodological issues. Thank you
to Human Kinetics for permitting two published review papers to be reproduced and placed in
this thesis. This dissertation was made special by the contributions of Kelly Norman and
Myriam Rabbat at Riverview Elementary School. A very special thank you is especially
extended to aIl participants and their parents for taking part in both studies.
Thanks to great old and new friends who played key roles in data collection (Johanne
Bellingham, Anna. Polotskaia), psychological testing (Jenn Felsher, Rebecca Simon), translation
of the abstract (Johanne Bellingham) and conceptual discussions (Andrew Chiarelli, Meghann
Llyod, Joe Nolan, & Andrea Prupas). Many thanks are also extended to aIl ofmy colleagues,
friends and family members who had the pleasure of enduring my ranting and raving about the
pros and cons of the latest physical activity studies about children with ADHD. Finally, thanks
Mom for always encouraging me and never losing faith in me. Thanks Chantal for your ongoing
support, dailyencouragement and unconditionallove. 1 dedicate this thesis to both ofyou and to
the memory ofmy late father. 1 miss him more and more every day.
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Table of Contents
page
Title page 1
Abstract 2
Résumé 4
Acknowledgements 6
Table of Contents 8
List of Figures, Appendices, and Tables 11
Introduction 13
Chapter 1 Theoretical Perspectives 16
Rationale for themy selection 16
The knowledge-based approach 17
Barkley's model ofs elf-regulation 21
Implications for ADHD research 26
References 28
Bridging Manuscripts and Contributions of Authors 32
Chapter 2 Attention-DeficitIHyperactivity Disorder: A Review of 33
Research on Movement SkiU Performance and Physical Fitness
Abstract 33
Issues 34
Definition and Symptomatology 34
Etiology 35
Nomenclature and Classification 36
Comorbidity, Treatment, & Developmental Course 37
Purpose 38
Method 38
Search Strategies 38
Categorization 39
Results and Discussion 40
Motor Processes 40
Movement Performance 42
Retrospective Views 42
Movement peiformance embedded in large descriptive studies 43
Skill Performance 46
Physical Fitness 50
Conclusions 52
References 55
Authors' Notes 67
Acknowledgements 67
Bridging Manuscripts and Contributions of Authors 68
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Table of Contents, Conf d
page
Chapter Three Attention-DeficitIHyperactivity Disorder:
APA Research Challenges 69
Abstract 69
Method 71
Discussion 73
Research Question 73
Participants 77
Sampling Design 77
Identification & Diagnosis 80
Gender Differences 82
Instruments 83
Data Collection Procedures 84
Methods of Analysis 91
Summary and Future Directions 93
References 95
Acknowledgement 103
Bridging Manuscripts and Contributions of Authors 104
Chapter Four Fundamental movement slrills and children with
attention-deficit hyperactivity disorder: Stimulant
effects and peer comparisons 105
Abstract 105
Introduction 106
Method 111
Participants 111
Assessment 114
Design and Procedures 116
Data Analysis 118
The effects ofs timulant medication 118
Children with and without ADHD 119
Results 120
Reliability 120
The effects ofs timulant medication 120
Children with and without ADHD 121
Discussion 124
The effects of stimulant medication 124
Children with and without ADHD 128
References 133
Bridging Manuscripts and Contributions of Authors 141