| Objective:To study the clinical features of the balancing function and sensory integration function with various subtypes of attention deficit hyperactivity disorder (ADHD) in children; and to evaluate the effects of a exercise-based treatment programme (dyslexia.dyspraxia and attention-deficit treatment, DDAT) on various Subtypes of ADHD.Methods:Sex compositions, age groups, SNAP-IV scores, balancing function, sensory integration function were evaluated in 205 children with ADHD (ADHD-I93, ADHD-HI 33andADHD-C 79) who met the 4th edition of Diagnostic Statistical Manual of Mental disorder criteria(DSM-â…£, and comorbidities, intelligence quotient (IQ) and behavioral problems of those children were analysed. Standing balance functions were assessed with the Balance Master and somesthetic sensibility and vestibular balance were assessed by the Ages and Stages Questionnaires(ASQ); 91 ADHD children with standing balance dysfunction (ADHD-I43, ADHD-HI 15andADHD-C 33) were given DDAT for 6 months, the efficacy of DDAT was evaluated according to SNAP-IV, balancing function test and Conners Parents Rating Scale. Results:1. Features of balance and sensory integration function in Children with various Subtypes of ADHDThere were no significant differences on sex composition and age group among the three subtypes of ADHD; the incidences of standing balance dysfunction for ADHD-C, ADHD-HI and ADHD-I were 79.7%,75.8% and 60.2% respectively, there were significant differences among the three subtypes (P<0.05); the incidences of vestibular balance dysfunction for ADHD-C, ADHD-HI were 73.4%,69.7% and 54.8% respectively(P<0.05); most children with ADHD also had somesthetic sensibility dysfunction, but no significant differences among the three subtypes(P>0.05); the average IQ of the ADHD children with standing balance dysfunction was lower than those with normal standing balance but with no significant difference(P>0.05). the ADHD children with standing balance dysfunction were significantly more than those with normal standing balance for learning problems (LP) Implusive/hyperactive(HA),psychosomatic problems(SP) according to Conners Parent Rating Scales (P<0.05); the incidences of comorbidities such as oppositional defiant disorder(ODD) and learning disorder(LD) in the children with normal balance function were significantly lower than those with balance dysfunction(P<0.05).2. Effects of DDAT on various Subtypes of ADHD with standing balance dysfunctionThe ADHD improved for most of the children, total effective rate was 78.0%, no significant difference among the three subtypes(P>0.05). The scores of the children with ADHD were evaluated before DDAT, three, six months after the treatment and three month after end of the treatment for both inattention subscale and hyperactivity subscale of the Chinese version of the SNAP-â…£scale parent forms, there were significant improvement for the scores three months after the DDAT, the further improvements were shown six months after the treatment, even with continiuous effect three month after end of the treatment, there were significant differences for the scores among the three subtypes of ADHD before and after the interventions (P<0.05). the score of hyperactivity symptom reduced more compared to that of inattention symptom by the SNAP-IV scale parent forms, there were significant difference before and after the treatment based on Conners parent scale for activity/hyperactivity, learning problem,psychosomatic problems, conduct problem and anxiousness as well(P<0.05); the standing balance dysfunction improved for most of the children, the effective rates were 86.0%(ADHD-I),86.7%(ADHD-HI) and 90.9%(ADHD-C) respectively, no significant difference among the three subtypes(P>0.05).Conclusion:Most children with ADHD in our study had standing balance dysfunction, vestibular balance dysfunction and somesthetic sensibility dysfunction to some degree, with the highest incidences for the children with ADHD-C; the children with balance dysfunction had more comorbidities, behavioral problems, learing problems.lower intelligence quotient and worse sympotoms of impulsive/hyperactive compared to those with normal balance function. there are extensive balancing dysfunction and sensory integration dysfunction; DDAT is a safe and efficient intervention for the ADHD children with standing balance dysfunction, with better effects both on the ADHD-C and ADHD-HI groups compared to the ADHD-I group, the improvement on hyperactivity symptom is better than that on inattention symptom. Our study shows that children with ADHD have extensive dysfunctions of balance and sensory integration and a exercise-based treatment programme to cerebellum function improves symptoms of ADHD and balance function, all these results suggest that cerebellum dysfunction may play a role in pathogenesis of ADHD...
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