Assessment & Research

Brief report: children with ADHD without co-morbid autism do not have impaired motor proficiency on the movement assessment battery for children.

Papadopoulos et al. (2013) · Journal of autism and developmental disorders 2013
★ The Verdict

Pure ADHD does not impair motor skill—poor MABC-2 scores should prompt an autism screen.

✓ Read this if BCBAs doing assessments for ADHD or autism in clinic or school settings.
✗ Skip if Practitioners working with toddlers or adults; motor assessment is not the referral question.

01Research in Context

01

What this study did

Papadopoulos et al. (2013) asked a simple question: does ADHD alone hurt a child's motor skills? They gave the Movement Assessment Battery for Children-2 to two groups: kids with ADHD-CT who had no autism traits and matched neurotypical peers. The team screened out any child who showed even mild autistic behaviors so they could isolate pure ADHD effects.

02

What they found

The scores were dead even. Children with ADHD-only moved just as well as their typical classmates on every MABC-2 subtest. The authors concluded that when autism is ruled out, ADHD itself does not create motor problems.

03

How this fits with other research

This finding clashes head-on with three autism studies. Pan (2014) and Galuska et al. (2006) both report large motor deficits in youth with ASD, and Miltenberger et al. (2013) show the same for visuomotor imitation. The contradiction is solved by diagnosis: the target paper removed autism, while the others kept it. Grzadzinski et al. (2011) foreshadowed this by showing that a subgroup of kids with ADHD already carry autistic traits; if those kids had stayed in the sample, the ADHD group would likely have looked clumsy too.

04

Why it matters

Before you write 'motor delay' in an ADHD report, screen for autism. A low MABC-2 score may flag undiagnosed ASD, not ADHD. Use the SCQ or ADOS first; if autism traits are absent, look beyond the diagnosis for the real reason a child struggles to catch a ball.

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Add the SCQ to your intake packet for any child with ADHD who scores low on the MABC-2.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
32
Population
adhd, neurotypical
Finding
null
Magnitude
negligible

03Original abstract

Motor proficiency was investigated in a sample of children with Attention Deficit Hyperactivity Disorder-Combined type (ADHD-CT) without autism. Accounting for the influence of co-morbid autistic symptoms in ADHD motor studies is vital given that motor impairment has been linked to social-communication symptoms in children who have co-morbid ADHD and autistic-like symptoms. Two groups of children aged between 7-14 years were recruited; children with ADHD-CT (n = 16; mean age 10 years, 7 months [SD = 1 year, 10 months]) and a typically developing (n = 16; mean age 10 years, 6 months [SD = 2 years, 6 months]) group. Motor proficiency was measured using the Movement Assessment Battery for Children-2nd Edition, ADHD symptoms were measured using the Conner's Parent Rating Scale. Children with ADHD-CT who had been screened for co-morbid autism did not display motor difficulties on the MABC-2. Higher levels of inattention, but not hyperactivity or impulsivity were associated with poorer motor performance. These findings provide indirect evidence that the motor problems that children with ADHD experience may be related to co-occurring social responsiveness impairments.

Journal of autism and developmental disorders, 2013 · doi:10.1007/s10803-012-1687-5