Mental imagery for addressing mechanisms underlying motor impairments in children with attention deficit hyperactivity disorder (ADHD)

Abstract

Children with attention deficit hyperactivity disorder (ADHD) exhibit various degrees of motor and cognitive impairments in fine and gross motor skills. These impairments impact social functioning, while also hindering academic achievement, self-esteem, and participation. Specifically, motor impairments are not fully addressed by current therapies. For example, approximately 50% of children with ADHD exhibit significant motor impairments, as per clinical measures, while the other 50% experience more impairments in motor planning, execution and control than do typically developed (TD) children. Such findings indicate that ADHD-specific mechanisms may be underpinning motor impairments. In this paper, we outline ADHD impairments in motor planning, execution, and control, and the potential role of two such mechanisms: internal motor representation and timing perception. Next, we suggest mental imagery as an approach for treating ADHD motor impairments, potentially through addressing internal motor representation and timing perception.

Keywords: ADHD; cognition; internal motor representation; mental imagery; motor imagery; motor impairments; timing.

Figure 1

A metaphorical representation of ADHD population’s subgroups, based on clinical and motor control tests. Throw’s outcome represents clinical tests’ (e.g., M-ABC-2) scores: hit = ≥16th percentile, partial miss = 5th–15th percentile, complete miss = <5th percentile; Ball trajectory represents motor control (i.e., accuracy, response time) impairments: smooth = no impairments, jerky = impairments; (A) ADHD with significant motor impairments and motor control impairments (complete miss and jerky trajectory), (B) ADHD with probable/mild to moderate motor impairments with motor control impairments (partial miss and jerky trajectory), (C) ADHD without motor impairments and with motor control impairments (hit with jerky trajectory), (D) Typically developed (hit with smooth trajectory). Subgroups (A,B) are also labeled “ADHD with clinically detected motor impairmentsˮ and subgroup (C) is also labeled “ADHD with no clinically detected motor impairmentsˮ (Drawn by Eric Franklin).

Figure 2

A metaphorical model of suggested cognitive-motor mechanisms underlying ADHD motor impairments. , DCD co-occurrence; , Executive Functions; , ADHD Core Symptoms; , Timing; , Mental Representations (Drawn by Eric Franklin).