Journal of the American Academy of Child & Adolescent Psychiatry
Volume 35, Issue 3 , Pages 334-342, March 1996

Objective Measurement of Hyperactivity and Attentional Problems in ADHD

Dr. Teicher is Associate Professor of Psychiatry, Harvard Medical School, Boston; and Director, Hall-Mercer Snider Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA. Dr. Ito was a Postdoctoral Research Fellow in Psychiatry at Harvard Medical School and is currently Assistant Professor of Psychiatry, Teikyo University, Tokyo. Dr. Clod is Assistant Professor of Nursing, Northeastern University, Boston; Lecturer in Psychiatry, Harvard Medical School; and Associate Clinical Director, Developmental Biopsychiatry Program, McLean Hospital. Dr. Barter was a Predoctoral Research Fellow at Harvard Medical School and is currently Resident in Family Medicine, The Medical Center, Beaver, PA

Accepted 12 September 1995.

ABSTRACT 

Objective

To precisely describe movement abnormalities in seated children with attention-deficit hyperactivity disorder (ADHD) while they were engaged in a continuous performance task (CPT).

Method

Diagnoses were made by using structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version) and DSM-IV criteria. Movement patterns of 18 boys with ADHD (9.3 ± 2.4 years) and 11 normal controls (8.6 ± 1.8 years) were recorded using an infrared motion analysis system that tracked the position of four markers 50 times per second to a resolution of 0.04 mm.

Results

Boys with ADHD moved their head 2.3 times more often than normal children (p > .002), moved 3.4 times as far (p > .01), covered a 3.8-fold greater area (p > .001), and had a more linear and less complex movement pattern (p > .00004). They responded more slowly and with greater variability on the CRT. Complexity of head movement and variability in response latency significantly correlated with teacher ratings. A predefined composite of movement and attention discriminated 16 of 18 patients from 11 of 11 controls. Conclusions: The relative inability of boys with ADHD to sit still can be objectively verified, and “fidgeting” appears to consist of more frequent, larger amplitude, whole body movements. J. Am. Acad. Child Adolesc. Psychiatry, 1996, 35(3):334–342.

keyword:  attention-deficit hyperactivity disorder , hyperactivity , locomotor activity , continuous performance task

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 Presented at the American Psychiatric Association Annual Meeting, San Francisco, May 22–27, 1993, and American Academy of Child and Adolescent Psychiatry Annual Meeting, New Orleans, Oct 10–15, 1993.Supported, in part, by NIMH grants MH-43743 and MH-48343, the Hall-Mercer Foundation, Freund Research Fund, and Simchas family. We thank Paul Wallace and Cynthia McGreenery for their assistance on this project, and Ross J. Baldessarini, M.D., and Mina K. Dulcan, M.D., for thoughtful comments.

PII: S0890-8567(09)63464-X

doi:10.1097/00004583-199603000-00015

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 35, Issue 3 , Pages 334-342, March 1996

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