What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? Systematic review of the literature.
Most kids with ADHD move poorly, and meds leave many still behind—so test and treat motor skills too.
01Research in Context
What this study did
The team pulled every paper they could find on motor skills in kids with ADHD. They looked at balance, handwriting, sports skills, and how meds change those skills.
They only kept studies that used clear tests and control groups. In the end they had a big pile of data on children aged 5–18.
What they found
More than half of kids with ADHD scored low on motor tests. Even with pills, only about one in three to two in three reached the normal range.
That leaves a lot of kids who still stumble, drop things, or write poorly after meds kick in.
How this fits with other research
Cheng et al. (2022) show the same kids also struggle to plan and edit writing. Motor plus writing gaps stack up, so you need to test both.
Lee et al. (2014) found 60 % of Taiwanese kids with ADHD wrote below the 25th percentile. The motor review adds the missing piece: weak hands and fingers may drive those messy letters.
Koegel et al. (2014) looked at kids with DCD, not ADHD, and saw no link between poor motor scores and poor executive function. This warns us: in ADHD, motor problems can ride along with attention issues, but they are not the same thing.
Why it matters
Screen motor skills at intake, even if the referral is for behavior. Use quick tools like the Movement ABC or a simple handwriting sample. If the child fails, add motor goals to the behavior plan—pills alone will not fix clumsy hands. Partner with OT for fine-motor drills or adapt the classroom (pencil grips, slant boards, extra time). Targeting both attention and movement gives the child a better shot at seatwork, sports, and social play.
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02At a glance
03Original abstract
This article presents a review of the studies that have analysed the motor skills of ADHD children without medication and the influence of medication on their motor skills. The following two questions guided the study: What is the evidence of impairment of motor skills and aspects of motor control among children with ADHD aged between 6 and 16 years? What are the effects of ADHD medication on motor skills and motor control? The following keywords were introduced in the main databases: attention disorder and/or ADHD, motor skills and/or handwriting, children, medication. Of the 45 articles retrieved, 30 described motor skills of children with ADHD and 15 articles analysed the influence of ADHD medication on motor skills and motor control. More than half of the children with ADHD have difficulties with gross and fine motor skills. The children with ADHD inattentive subtype seem to present more impairment of fine motor skills, slow reaction time, and online motor control during complex tasks. The proportion of children with ADHD who improved their motor skills to the normal range by using medication varied from 28% to 67% between studies. The children who still show motor deficit while on medication might meet the diagnostic criteria of developmental coordination disorder (DCD). It is important to assess motor skills among children with ADHD because of the risk of reduced participation in activities of daily living that require motor coordination and attention.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2014.09.023