The Effect of Fundamental Motor Skills Training on Cognitive Impulsivity, Motor Impulsivity and Sustained Attention in Students with ADHD Symptoms

Document Type : Research Paper


1 M.A of clinical psychology, college of psychology and education, Shiraz university, Shiraz, Iran

2 professor of clinical psychology, college of psychology and education, shiraz university, shiraz, iran

3 associate professor of physical education and sport sciences, college of psychology and education, shiraz university, shiraz, iran


Attention deficit/hyperactivity disorder (ADHD), is one of the common neurodevelopmental disorders in children, can produce several cognitive, social and educational difficulties. The purpose of this study is to investigate the effect of fundamental motor skills (FMS) on cognitive impulsivity, motor impulsivity and sustained attention in primary school children with attention deficit/hyperactivity disorder symptoms. The research method was quasi-experimental with pre-test-post-test design. The study population consists of all elementary school students of Shiraz schools. The sample used for the study was 38 students with ADHD symptoms which was selected by multi-level sampling based on SNAP-IV and randomly divided in two groups, experiment (21 subjects) and control (17 subjects). The experimental group trained for ten sessions in the FMS program and the control group dealt its daily activities. Then one session before and after of interventions all of the two groups were measured with using of continuous performance, dexterity, porteus maze and passing test. Data were analyzed by mixed repeated measures ANOVA and indicate that FMS training can have a positive effect on children performance in motor impulsivity, but there was no evidence of the effect of mentioned interventions on Cognitive impulsivity and sustained attention. According to the findings of the study, can be concluded that short term FMS training can be useful in controlling movement and impulses in children with ADHD symptoms.


1. Association D-AP. Diagnostic and statistical manual of mental disorders (5th_ed).
Arlington: American Psychiatric Publishing. 2013.
2. Biederman J, Petty CR, Clarke A, Lomedico A, Faraone SV. Predictors of persistent
ADHD: an 11-year follow-up study. Journal of psychiatric research. 2011;45(2):150-5.
3. Hart EL, Lahey BB, Loeber R, Applegate B, Frick PJ. Developmental change in attentiondeficit
hyperactivity disorder in boys: a four-year longitudinal study. Journal of abnormal
child psychology. 1995;23(6):729-49.
4. Taylor E, Chadwick O, Heptinstall E, Danckaerts M. Hyperactivity and conduct problems
as risk factors for adolescent development. Journal of the American Academy of Child &
Adolescent Psychiatry. 1996;35(9):1213-26.
5. Gittelman R, Mannuzza S, Shenker R, Bonagura N. Hyperactive boys almost grown up: I.
Psychiatric status. Archives of General Psychiatry. 1985;42(10):937-47.
6. Jimenez ME, Wade R, Schwartz-Soicher O, Lin Y, Reichman NE. Adverse Childhood
Experiences and ADHD Diagnosis at Age 9 Years in a National Urban Sample. Academic
pediatrics. 2017;17(4):356-61.
7. Cadman T, Findon J, Eklund H, Hayward H, Howley D, Cheung C, et al. Six-year followup
study of combined type ADHD from childhood to young adulthood: Predictors of
functional impairment and comorbid symptoms. European Psychiatry. 2016;35:47-54.
8. González-Castro P, Rodríguez C, Cueli M, García T, Alvarez-García D. State, trait
anxiety and selective attention differences in Attention Deficit Hyperactivity Disorder
(ADHD) subtypes. International Journal of Clinical and Health Psychology.
9. Smoot L, Boothby L, Gillett R. Clinical assessment and treatment of ADHD in children.
International journal of clinical practice. 2007;61(10):1730-8.
10. Imeraj L, Antrop I, Sonuga-Barke E, Deboutte D, Deschepper E, Bal S, et al. The impact
of instructional context on classroom on-task behavior: A matched comparison of children
with ADHD and non-ADHD classmates. Journal of school psychology. 2013;51(4):487-
تأثیر آموزش مهارت های حرکتی بنیادی بر تکانشگری شناختی، تکانشگری حرکتی و توجه پیوسته در ... 253
11. Hudec KL, Alderson RM, Patros CH, Lea SE, Tarle SJ, Kasper LJ. Hyperactivity in boys
with attention-deficit/hyperactivity disorder (ADHD): The role of executive and nonexecutive
functions. Research in developmental disabilities. 2015;45:103-9.
12. Mayes SD, Calhoun SL. Frequency of reading, math, and writing disabilities in children
with clinical disorders. Learning and individual Differences. 2006;16(2):145-57.
13. Nijmeijer JS, Minderaa RB, Buitelaar JK, Mulligan A, Hartman CA, Hoekstra PJ.
Attention-deficit/hyperactivity disorder and social dysfunctioning. Clinical psychology
review. 2008;28(4):692-708.
14. Kóbor A, Takács Á, Urbán R, Csépe V. The latent classes of subclinical ADHD
symptoms: Convergences of multiple informant reports. Research in developmental
disabilities. 2012;33(5):1677-89.
15. Costello EJ, Shugart MA. Above and below the threshold: severity of psychiatric
symptoms and functional impairment in a pediatric sample. Pediatrics. 1992;90(3):359-
16. Scahill L, Schwab-Stone M, Merikangas KR, Leckman JF, Zhang H, Kasl S.
Psychosocial and clinical correlates of ADHD in a community sample of school-age
children. Journal of the American Academy of Child & Adolescent Psychiatry.
17. Patros CHG, Alderson RM, Kasper LJ, Tarle SJ, Lea SE, Hudec KL. Choice-impulsivity
in children and adolescents with attention-deficit/hyperactivity disorder (ADHD): A metaanalytic
review. Clinical Psychology Review. 2016;43:162-74.
18. Shin SH, Cook AK, Morris NA, McDougle R, Groves LP. The different faces of
impulsivity as links between childhood maltreatment and young adult crime. Preventive
Medicine. 2016;88:210-7.
19. Bernedo IM, Salas MD, Fuentes MJ, García-Martín MÁ. Foster children's behavior
problems and impulsivity in the family and school context. Children and Youth Services
Review. 2014;42:43-9.
20. Lozano JH, Gordillo F, Pérez MA. Impulsivity, intelligence, and academic performance:
Testing the interaction hypothesis. Personality and Individual Differences. 2014;61–
21. Etain B, Mathieu F, Liquet S, Raust A, Cochet B, Richard JR, et al. Clinical features
associated with trait-impulsiveness in euthymic bipolar disorder patients. Journal of
Affective Disorders. 2013;144(3):240-7.
22. Barnhart WR, Buelow MT. Assessing impulsivity: Relationships between behavioral and
self-report measures in individuals with and without self-reported ADHD. Personality and
Individual Differences. 2017;106:41-5.
23. Jakubczyk A, Klimkiewicz A, Topolewska-Wochowska A, Serafin P, Sadowska-Mazuryk
J, Pupek-Pyzioł J, et al. Relationships of impulsiveness and depressive symptoms in
alcohol dependence. Journal of Affective Disorders. 2012;136(3):841-7.
254 رشد و یادگیری حرکتی _ ورزشی، دورة 10 ، شمارة 2، تابستان 1397
24. Sanches M, Scott-Gurnell K, Patel A, Caetano SC, Zunta-Soares GB, Hatch JP, et al.
Impulsivity in children and adolescents with mood disorders and unaffected offspring of
bipolar parents. Comprehensive Psychiatry. 2014;55(6):1337-41.
25. Verdejo-García AJ, Perales JC, Pérez-García M. Cognitive impulsivity in cocaine and
heroin polysubstance abusers. Addictive Behaviors. 2007;32(5):950-66.
26. Dantas-Duarte A, Morais-de-Jesus M, Nunes AP, Miranda-Pettersen K, Araújo-de-Freitas
L, Netto LR, et al. Risk-taking behavior and impulsivity among HCV-infected patients.
Psychiatry Research. 2016;243:75-80.
27. Kovácsová N, Lajunen T, Rošková E. Aggression on the road: Relationships between
dysfunctional impulsivity, forgiveness, negative emotions, and aggressive driving.
Transportation Research Part F: Traffic Psychology and Behaviour. 2016;42, Part 2:286-
28. Faraone SV, Biederman J, Spencer TJ, Aleardi M. Comparing the efficacy of medications
for ADHD using meta-analysis. Medscape General Medicine. 2006;8(4):4.
29. Solanto MV, Marks DJ, Wasserstein J, Mitchell K, Abikoff H, Alvir JMJ, et al. Efficacy
of meta-cognitive therapy for adult ADHD. American Journal of Psychiatry.
30. Halperin JM, Healey DM. The influences of environmental enrichment, cognitive
enhancement, and physical exercise on brain development: Can we alter the
developmental trajectory of ADHD? Neuroscience & Biobehavioral Reviews.
31. O’Neill S, Berwid O, Bédard A. The exercise–cognition interaction and ADHD. Exercise-
Cognition Interaction San Diego: Academic. 2016:375-98.
32. Vanhelst J, Béghin L, Duhamel A, Manios Y, Molnar D, De Henauw S, et al. Physical
Activity Is Associated with Attention Capacity in Adolescents. The Journal of Pediatrics.
33. Altenburg TM, Chinapaw MJM, Singh AS. Effects of one versus two bouts of moderate
intensity physical activity on selective attention during a school morning in Dutch primary
schoolchildren: A randomized controlled trial. Journal of Science and Medicine in Sport.
34. Vancampfort D, Firth J, Schuch FB, Rosenbaum S, Probst M, Ward PB, et al. Dropout
from physical activity interventions in children and adolescents with attention deficit
hyperactivity disorder: A systematic review and meta-analysis. Mental Health and
Physical Activity. 2016;11:46-52.
35. Castañer M, Camerino O, Landry P, Pares N. Quality of physical activity of children in
exergames: Sequential body movement analysis and its implications for interaction
design. International Journal of Human-Computer Studies. 2016;96:67-78.
36. Medina JA, Netto TL, Muszkat M, Medina AC, Botter D, Orbetelli R, et al. Exercise
impact on sustained attention of ADHD children, methylphenidate effects. ADHD
Attention Deficit and Hyperactivity Disorders. 2010;2(1):49-58.
تأثیر آموزش مهارت های حرکتی بنیادی بر تکانشگری شناختی، تکانشگری حرکتی و توجه پیوسته در ... 255
37. Pan C-Y, Chu C-H, Tsai C-L, Lo S-Y, Cheng Y-W, Liu Y-J. A racket-sport intervention
improves behavioral and cognitive performance in children with attentiondeficit/
hyperactivity disorder. Research in Developmental Disabilities.
2016;57(Supplement C):1-10.
38. Rommel A-S, Lichtenstein P, Rydell M, Kuja-Halkola R, Asherson P, Kuntsi J, et al. Is
physical activity causally associated with symptoms of attention-deficit/hyperactivity
disorder? Journal of the American Academy of Child & Adolescent Psychiatry.
39. Bardid F, Lenoir M, Huyben F, De Martelaer K, Seghers J, Goodway JD, et al. The
effectiveness of a community-based fundamental motor skill intervention in children aged
3–8 years: Results of the “Multimove for Kids” project. Journal of Science and Medicine
in Sport. 2017;20(2):184-9.
40. Drollette ES, Scudder MR, Raine LB, Moore RD, Saliba BJ, Pontifex MB, et al. Acute
exercise facilitates brain function and cognition in children who need it most: an ERP
study of individual differences in inhibitory control capacity. Developmental Cognitive
Neuroscience. 2014;7:53-64.
41. Sibley BA, Beilock SL. Exercise and working memory: an individual differences
investigation. Journal of Sport and Exercise Psychology. 2007;29(6):783-91.
42. Lubans DR, Morgan PJ, Cliff DP, Barnett LM, Okely AD. Fundamental movement skills
in children and adolescents. Sports medicine. 2010;40(12):1019-35.
43. Gabbard CP. Lifelong motor development: Pearson Higher Ed; 2011.
44. Cliff DP, Okely AD, Smith LM, McKeen K. Relationships between fundamental
movement skills and objectively measured physical activity in preschool children.
Pediatric exercise science. 2009;21(4):436-49.
45. Capio CM, Sit CHP, Eguia KF, Abernethy B, Masters RSW. Fundamental movement
skills training to promote physical activity in children with and without disability: A pilot
study. Journal of Sport and Health Science. 2015;4(3):235-43.
46. Bardid F, Deconinck FJA, Descamps S, Verhoeven L, De Pooter G, Lenoir M, et al. The
effectiveness of a fundamental motor skill intervention in pre-schoolers with motor
problems depends on gender but not environmental context. Research in Developmental
Disabilities. 2013;34(12):4571-81.
47. Rudd J, Farrow D, Barnett L, Berry J, Borkoles E, Polman R. A pilot study to evaluate the
efficacy of the ‘Launchpad’ gymnastics programme at developing children's motor
coordination and fundamental movement skills. Journal of Science and Medicine in Sport.
2014;18, Supplement 1:e11.
48. Hardy LL, King L, Farrell L, Macniven R, Howlett S. Fundamental movement skills
among Australian preschool children. Journal of Science and Medicine in Sport.
49. Landy J. Fundamental Motor Skills & Movement Activites for Young Children Teaching,
Remediation and Assessment. Shiraz: Navid Publishing. 2016. (In Persian).
256 رشد و یادگیری حرکتی _ ورزشی، دورة 10 ، شمارة 2، تابستان 1397
50. Kiani B, Hadianfard H. Psychometric Properties of a Persian Self-Report Version of
Swanson, Nolan and Pelham Rating Scale (version IV) for Screening Attention-
Deficit/Hyperactivity Disorder in Adolescents. Iranian Journal of Psychiatry and Clinical
Psychology. 2016;21(4):317-26. (In Persian).
51. Hadianfard H NB, Shekarkan H, & Mehrabizadeh honarmand M. Construction and
Validation of the Farsi Version of the Continuous Performance Test. Iranian Journal of
Psychology. 2000:388-404. (In Persian).
52. Docter RF. Interrelationships among Porteus Maze test qualitative errors. Journal of
clinical psychology. 1960.
53. Carlozzi NE. Porteus Maze. Encyclopedia of Clinical Neuropsychology: Springer; 2011.
p. 1964-6.
54. Yancosek KE, Howell D. A Narrative Review of Dexterity Assessments. Journal of Hand
Therapy. 2009;22(3):258-70.
55. Aaron DH, Jansen CWS. Development of the Functional Dexterity Test (FDT):
Construction, validity, reliability, and normative data. Journal of Hand Therapy.
56. Hadavi F. Measurement and Assessment in Physical Education. Tehran: Tarbiat Moallem
University Publishing. 1998. (In Persian).
57. Dewi EK, Rusmawati D, Ratnaningsih IZ. The Effect of Music and Motoric Movement
Intervention to Increase Attention among Elementary School Studentsin Semarang
Central Java. Procedia Environmental Sciences. 2015;23:179-85.
58. Lambourne K, Audiffren M, Tomporowski PD. Effects of acute exercise on sensory and
executive processing tasks. Med Sci Sports Exerc. 2010;42(7):1396-402.
59. Mahon AD, Dean RS, McIntosh DE, Marjerrison AD, Cole AS, Woodruff ME, et al.
Acute exercise effects on measures of attention and impulsivity in children with attention
deficit/hyperactivity disorder. Journal of Educational and Developmental Psychology.
60. Gallotta M, Emerenziani G, Franciosi E, Meucci M, Guidetti L, Baldari C. Acute physical
activity and delayed attention in primary school students. Scandinavian journal of
medicine & science in sports. 2015;25(3).
61. Zach S, Inglis V, Fox O, Berger I, Stahl A. The effect of physical activity on spatial
perception and attention in early childhood. Cognitive Development. 2015;36:31-9.
62. Quay HC. The behavioral reward and inhibition system in childhood behavior disorder.
63. Wender PH, Reimherr FW, Wood DR. Attention deficit disorder ('minimal brain
dysfunction') in adults: a replication study of diagnosis and drug treatment. Archives of
General Psychiatry. 1981;38(4):449-56.
64. Barkley RA. Theories of attention-deficit/hyperactivity disorder. Handbook of disruptive
behavior disorders: Springer; 1999. p. 295-313.
65. Neely KA, Wang P, Chennavasin AP, Samimy S, Tucker J, Merida A, et al. Deficits in
inhibitory force control in young adults with ADHD. Neuropsychologia. 2017;99:172-8.
تأثیر آموزش مهارت های حرکتی بنیادی بر تکانشگری شناختی، تکانشگری حرکتی و توجه پیوسته در ... 257
66. Fisher T, Aharon-Peretz J, Pratt H. Dis-regulation of response inhibition in adult
Attention Deficit Hyperactivity Disorder (ADHD): An ERP study. Clinical
Neurophysiology. 2011;122(12):2390-9.
67. Tsai Y-J, Hung C-L, Tsai C-L, Chang Y-K, Huang C-J, Hung T-M. The relationship
between physical fitness and inhibitory ability in children with attention deficit
hyperactivity disorder: An event-related potential study. Psychology of Sport and
68. Smith AL, Hoza B, Linnea K, McQuade JD, Tomb M, Vaughn AJ, et al. Pilot physical
activity intervention reduces severity of ADHD symptoms in young children. Journal of
attention disorders. 2013;17(1):70-82.
69. Pontifex MB, Saliba BJ, Raine LB, Picchietti DL, Hillman CH. Exercise improves
behavioral, neurocognitive, and scholastic performance in children with attentiondeficit/
hyperactivity disorder. The Journal of pediatrics. 2013;162(3):543-51.
70. Pindus DM, Drollette ES, Scudder MR, Khan NA, Raine LB, Sherar LB, et al. Moderateto-
vigorous physical activity, indices of cognitive control, and academic achievement in
preadolescents. The Journal of pediatrics. 2016;173:136-42.
71. Caswell AJ, Morgan MJ, Duka T. Inhibitory control contributes to “motor”-but not
“cognitive”-impulsivity. Experimental psychology. 2013.
72. Ghahramani MH, Sohrabi M, Besharat MA. The effects of physical activity on impulse
control, attention, decision-making and motor functions in students with high and low
impulsivity. Biosciences Biotechnology Research Asia. 2016;13(3):1689-96.