Attention-Deficit/Hyperactivity Disorder (ADHD) is the most common psychiatric disorder worldwide, and the rate of diagnosis has increased significantly over the past decade. As of 2016, an estimated 6.1 million American children had been diagnosed with ADHD.1

ADHD is correlated with lower health-related quality of life that starts in childhood and can persist into adulthood. Previous studies associate ADHD with decreased academic performance and physical activity, and increased odds of screen time, overeating, and obesity. Effective treatment requires a combination of pharmacological and nonpharmacological approaches.

The existing literature shows that regular physical activity is a beneficial adjunct treatment. Previous studies have demonstrated many benefits of exercise in children with ADHD, including improvement in core symptoms, test scores, sleep, mood, and social disorders.

The Journal of Attention Disorders recently published a study that analyzed the relationship between ADHD diagnosis and engagement in physical activity. The researchers studied data from the 2016 National Survey of Children’s Health (NSCH), a caregiver-reported survey conducted by the US Census Bureau. The final study population included 34,675 children ranging in age from 6 years to 17 years.

The study found that children diagnosed with ADHD had 21% lower odds of engaging in daily physical activity than nondiagnosed children, confirming the inverse association shown by previous studies. The researchers further qualified the relationship by studying the association between ADHD and different degrees of activity. Diagnosed children were increasingly less likely to participate in 1-3 days, 4-6 days, and 7 days per week of exercise, respectively.

The survey also analyzed several covariable factors, including the caregiver’s highest level of education, and the child’s sex, age, race, and digital media exposure. Female gender, ages 12-17 years, and increased digital media exposure were all independent risk factors for decreased physical activity.

Low levels of education, and non-English speaking households were negatively associated with physical activity. Additionally, Spanish-speaking households reported a lower rate of ADHD diagnosis than English-speaking households. This confirms existing health disparity research, which has shown that minority families are less likely to receive an ADHD diagnosis, and may therefore receive less support and resources.

This study validates the inverse relationship between ADHD diagnosis and physical activity, and emphasizes the complex societal factors at play. In addition to educating ADHD families about the importance and benefits of regular physical activity, health care providers should work with families to facilitate exercise in their home environments. Clinicians may also mitigate other risk factors for inactivity by counseling to set limits on screen time, connecting caregivers to adult education resources, and ensuring interpreter services.
 
M. May Zhang is a 2022 PharmD Candidate at the University of Connecticut in Storrs.


REFERENCES
  1. Data and Statistics About ADHD. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/adhd/data.html. Published October 15, 2019. Accessed January 8, 2020.
  2. Mercurio LY, Amanullah S, Gill N, Gjelsvik A. Children With ADHD Engage in Less Physical Activity. J Atten Disord. December 2019. doi:10.1177/1087054719887789.