Araştırmalar / Original Papers DOI: 10.5455/bcp.20121130091058 The Relationship between Motor Coordination and Social Behavior Problems in Adolescents with Attention-Deficit/ Hyperactivity Disorder Ayse Burcu Ayaz1, Muhammed Ayaz1, Yanki Yazgan2, Elif Akin3 ÖZET: ABS TRACT: Dikkat Eksikliği Hiperaktivite Bozukluğu The relationship between motor tanısı konulan ergenlerde motor koordinas- coordination and social behavior problems yon ve sosyal davranış sorunlarının ilişkisi in adolescents with Attention-Deficit/ Hyperactivity Disorder Amaç: Dikkat eksikliği hiperaktivite bozukluğu (DEHB) en sık görülen çocukluk çağı nörogelişimsel bozuk- Objective: Attention-deficit/hyperactivity disorder luklarından birisidir ve DEHB tanısı konulan bireylerin (ADHD) is one of the most common neurodevelopmental %30-50’sinin aynı zamanda eşlik eden motor koordi- childhood disorders and 30-50% of individuals with nasyon sorunları olduğu bildirilmektedir. Bu çalışma ADHD are reported to also have a co-morbid motor DEHB tanısı konulan çocuklarda motor koordinasyon coordination problem. This study aimed to examine becerilerini ve motor koordinasyon sorunlarının sosyal motor coordination skills, and the correlation between sorunlarla ilişkisini incelemeyi amaçlamıştır. motor coordination problems and social problems in Yöntem: Çalışmamızda vaka grubunu DEHB tanısı children with ADHD. konulan 12-15 yaş arası 64 çocuk oluşturdu. Kontrol Method: In our study, the ADHD group was composed grubu vaka grubu ile benzer yaş ve cinsiyet aralı- of 64 children between 12-15 years that were ğında bulunan 69 çocuktan meydana gelmekteydi. diagnosed with ADHD. The control group included Çocukların değerlendirilmesinde, Çivili Tahta El Beceri 69 children in a similar age and sex range to the Testi (ÇTEBT), Çocukluk Çağı Davranış Değerlendirme ADHD group. The Purdue Pegboard Test (PPT), the Ölçeği ve Okul Çağı Çocukları İçin Duygulanım Child Behavior Checklist and the Kiddie Schedule for Bozuklukları ve Şizofreni Görüşme Çizelgesi kullanıldı. Affective Disorders and Schizophrenia were used in 1 Zeka düzeyi, Wechsler Çocuklar için Zeka Ölçeği kulla- the assessment of children. IQ was assessed using the M.D., Sakarya University Research and Trainig Hospital, Child and Adolescent nılarak değerlendirildi. Wechsler Intelligence Scale for Children-Revised. Psychiatry Outpatient Clinic, Bulgular: DEHB grubunda kontrol grubuna oranla daha Results: More children in the ADHD group had motor Sakarya - Turkey 2Prof., Guzel Gunler Children’s Health çok sayıda çocuk motor koordinasyon sorunu yaşamak- coordination problems than in the control group and Center, Istanbul - Turkey taydı ve DEHB grubunda sosyal sorunlar motor bece- social problems were correlated with motor skills 3M.D., Elazig Mental Health Hospital rilerle ilişkiliydi. Kontrol grubunda, kızların erkeklere in the ADHD group. While the girls in the control Child and Adolescent Outpatient Clinic, Elazığ - Turkey oranla motor becerileri daha iyi olmasına rağmen, DEHB group had better motor skills than the boys, there grubunda cinsiyetler arasında anlamlı bir fark bulun- were no significant differences between genders in Ya zış ma Ad re si / Add ress rep rint re qu ests to: madı. DEHB grubunda kontrol grubuna oranla ÇTEBT the ADHD group. More girls in the ADHD group had M.D., Ayse Burcu Ayaz, Sakarya University Research and Trainig Hospital, baskın el, baskın olmayan el ve bileşik oturum alt test motor coordination problems than in the control group, Child and Adolescent Psychiatry puanlarına göre daha fazla sayıda kız çocuğunun motor according to the PPT dominant hand, non-dominant Outpatient Clinic, Sakarya - Turkey koordinasyon sorunu vardı, buna rağmen her iki grupta- hand, and assembly subtest scores whereas there was Elekt ro nik pos ta ad re si / E-ma il add ress: ki erkek çocuklar arasında ÇTEBT’nin hiçbir alt testinde no significant difference in any of the PPT subtest scores [email protected] anlamlı bir fark saptanmadı. DEHB grubunda ÇTEBT’de between the boys in both groups. Age was associated sadece her iki elin kullanıldığı alt testler yaş ile ilişkiliydi. only with PPT bimanual subtest scores in ADHD group. Gönderme tarihi / Date of submission: 19 Temmuz 2012 / July 19, 2012 Sonuçlar: Sonuçlarımız DEHB grubunda motor koor- Conclusions: The present results show that there is a dinasyon sorunları ile sosyal sorunlar arasında ilişkili relationship between motor coordination problems Kabul tarihi / Date of acceptance: olduğunu göstermektedir. DEHB tanısı konulan kız and social problems in an ADHD group. It is also 30 Kasım 2012 / November 30, 2012 çocuklarındaki yetersizliklerin ve eşlik eden motor koor- suggested that the impairment of girls with ADHD and dinasyon sorunlarının gözardı edilmemesi gerektiği comorbid motor coordination problems should not be Bağıntı beyanı: düşünülmektedir. underestimated. A.B.A., M.A., Y.Y., E.A.: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir. Anahtar sözcükler: Dikkat eksikliği hiperaktivite Key words: Attention deficit hyperactivity hisorder, Declaration of interest: bozukluğu, motor beceriler, sosyal sorunlar motor skills, social problems A.B.A., M.A., Y.Y., E.A.: The authors reported no conflict of interest related to Kli nik Psikofarmakoloji Bülteni 2013;23(1):33-41 Bulletin of Clinical Psychopharmacology 2013;23(1):33-41 this article. Klinik Psikofarmakoloji Bülteni, Cilt: 23, Sayı: 1, 2013 / Bulletin of Clinical Psychopharmacology, Vol: 23, N.: 1, 2013 - www.psikofarmakoloji.org 33 The relationship between motor coordination and social behavior problems in adolescents with Attention-Deficit/Hyperactivity Disorder INTRODUCTION motor coordination problems and comorbid behavioral problems in ADHD remains unclear. Attention-deficit/hyperactivity disorder Children with ADHD and motor dysfunction had (ADHD) is one of the most common more severe social problems than those with ADHD neurodevelopmental childhood disorders, affecting only, based on parent and teacher observations (10). 3%-7% of school-age children (1). Deficits in Moreover, individuals with the combination of complex coordination of movement, such as during motor coordination problems and ADHD were dressing, feeding, riding a bicycle, and/or more likely to have high levels of autistic traits than handwriting, may interfere with an ADHD child’s those with ADHD alone (11). daily functioning and negatively affect his/her The aim of the present study was to examine the academic performance (2). ADHD with marked relationship between ADHD and motor coordination impairment in the development of motor via comparison of the effects of sex and age on coordination is referred to as developmental motor coordination in children with ADHD and coordination disorder (DCD), and 30-50% of healthy controls. Additionally, this study aimed to individuals with ADHD are reported to also have a examine the relationship between motor co-morbid diagnosis of DCD (3). coordination problems and social problems in It remains unclear whether the association children with ADHD. We addressed the following between motor coordination problems and ADHD questions: (1) is the relationship between ADHD is comparable for children of different ages. It has and motor coordination problems comparable for been hypothesized that the growth spurt that occurs children of different ages, (2) is the relationship during puberty, during which children tend to between ADHD and motor coordination problems become clumsier, causes an increase in the severity similar for boys and girls, and (3) is there a of problems in children with poor motor relationship between the social problems and motor coordination (4). This hypothesis was partially problems in ADHD? confirmed in a study in which children with severe The study’s hypothesis was that motor motor coordination problems continued to have coordination would be negatively affected by ADHD such problems following the pubertal growth spurt, and associated with social problems in children whereas children with mild motor coordination with ADHD. It was also hypothesized that there problems did as well as those in the control group would be an effect of age and sex on motor after the growth spurt (5). Another study reported coordination in the ADHD group. that motor coordination problems were primarily observed among younger children those aged 6-9 MATERIALS AND METHODS years in the ADHD group (6). The relationship between ADHD and gender is Participants another contentious issue. The ADHD literature is primarily based on boys, as ADHD is more frequently The ADHD group was composed of 64 children observed in boys than in girls (7); however, research aged 12-16 years that were diagnosed as ADHD, on girls with ADHD shows that their according to the Diagnostic and Statistical Manual neuropsychological functioning and behavior are of Mental Disorders, Fourth edition criteria (DSM- affected in a similar fashion as in boys with ADHD IV) (12). The ADHD group was selected from a (8). In contrast to an earlier study, a more recent population of children referred by their family study reported better motor coordination in healthy physician to the Marmara University Medical girls than in those with ADHD, according to Purdue Faculty Department of Child and Adolescent Pegboard Test (PPT) scores (9, 6). Psychiatry, Istanbul, Turkey between 2008 and 2009. Although motor skills are commonly studied in Children were classified as ADHD-hyperactive/ children with ADHD, the relationship between