Physical Activity Intervention for ADHD and DBD

Objective: This study tested the feasibility and impact of an aerobic physical activity intervention for children with Attention Deficit Hyperactivity Disorder (ADHD) and Disruptive Behavior Disorders (DBD) living in an urban poor community. Method: Children were randomized to either a treatment group, an evidence-based 10-week after-school aerobic activity intervention demonstrated to improve executive function (EF) in overweight non-disruptive children, or a comparable but sedentary attention control group. Cognitive, behavioral, and academic outcomes were obtained at baseline and posttest. Results: 56 students from 35 families enrolled in the current study. Attendance, retention, heart rate, and focus group findings support the feasibility of the intervention. Findings on the primary outcome measure, the Global Executive Composite (GEC) score of the Behavioral Rating Inventory of Executive Function (BRIEF), between groups over time were null in both intent-to-treat (ITT) and per protocol (only students attending ≥ 3-days/week) analyses. Among exploratory outcomes in the ITT analysis, the treatment group evidenced greater improvements on the Internalizing subscale of the Social Skills Improvement System (SSiS) than controls. In the per protocol analysis of exploratory outcomes, after controlling for between-group differences in participant characteristics and participation indicators, trends favoring treatment were evident for Automated Working Memory Assessment System Verbal Short-Term Memory, the Internalizing Subscale of the SSiS, and Music GPA. In contrast, the Autism Spectrum Subcale of the SSiS trended in favor of controls. Conclusions: Results provide additional support for the antidepressive and anxiolytic effects of physical activity but between group differences were largely absent for neurocognitive and behavioral outcomes. Within-group effect sizes in the treatment group were comparable to or greater than previous physical activity interventions in children with ADHD and DBD, however, similar improvements were also evident in the sedentary attention control group. Findings suggest that while regular aerobic physical activity may carry independent neurocognitive benefits for children with ADHD and DBD, a substantive proportion of the benefit derived in physical activity programs stems from features of quality structured programs generally such as stable routines, engaging activities that challenge EF, behavior management strategies, interruption of antisocial influences, and interaction with prosocial peers and adults.