Beyond the medication: Structured physical exercise can help children and adolescents with ADHD excel in life and in school

Beyond the medication: Structured physical exercise can help children and adolescents with ADHD excel in life and in school

It is not news that physical exercise is beneficial to our physical and mental health (Chan et al., 2019). What is news is that physical activity can help reduce ADHD symptoms in children and teens, which can help them excel in school (Jeyanthi et al., 2021). Attention Deficit Hyper-Active Disorder (ADHD) is a neuropsychiatric disorder that affects approximately 6% of children throughout their lifetime (Neudecker et al., 2019). There is a wide range of symptoms that impact the lives of those with ADHD including inattention, hyperactivity, impatience, inability to follow directions, and impaired executive functioning (Neudecker et al., 2019; Sibbick et al., 2022). Additionally, those diagnosed with ADHD are frequently diagnosed with depression and anxiety disorders as well (LaCount et al., 2022). With all of this in mind, it is not difficult to determine that ADHD is often associated with decreased academic performance (Jeyanthi et al., 2021), which makes finding a suitable treatment incredibly important. A six-week, school-based study showed that a structured exercise program can improve attention, hyperactivity, and physical fitness in children with ADHD (Jeyanthi et al., 2021). These results are supported by many other studies that explore the impact of additional forms of exercise on children and teens with ADHD (Nazarova et al., 2022; Neudecker et al., 2019; Sibbick et al., 2022). This is important because the leading form of treatment used today is medication, which is associated with many downsides and negative side effects (Nazarova et al., 2022). Structured, physical exercise is an effective treatment option for children and adolescents with ADHD that not only decreases symptoms but can improve academic performance and should therefore decrease the reliance on pharmacology as the primary form of treatment.

Exercise has been shown to produce several benefits for children and adolescents with ADHD. One study in particular shows the effects that exercise has on ADHD symptoms and school performance (Jeyanthi et al., 2021). This study took advantage of a school’s physical education class and measured the attention, hyperactivity, and physical fitness levels of 10 boys with ADHD and 10 boys without, before and after running the structured exercise program. The program involved strength exercises, fine motor training, and attention training tasks. The results showed that by the end of the six-week program the children had significant improvements in attention and physical fitness and decreased levels of hyperactivity. The results of this study are important because not only did the boys report enjoying the program, but the decrease in ADHD symptoms led to improvements in their academic performances as well (Jeyanthi et al., 2021). A structured exercise program that is administered within the school system is easily accessible, enjoyable, and can help children excel academically (Jeyanthi et al., 2021), which suggests that they should be used as a primary form of treatment for children and teens with ADHD.

Even though this study was done with a small group of children (Jeyanthi et al., 2021), the results are supported by many other studies. The six-week structured program focused on specific exercises such as single leg hops, medicine ball throws, and the nine-hole peg test (Jeyanthi et al., 2021). Another study examined the effects of high intensity interval training (HIIT) on ADHD symptoms (LaCount et al., 2022). This study found that children and teens experience improvements in sustained attention and processing speed after a session of HIIT.Participating in HIIT can also decrease depressive symptoms in those with ADHD (LaCount et al., 2022). A review of 21 additional studies found long-term improvements in behavioral problems, attention, and executive functioning of children and teens after exercises including running, cycling, and sport-specific training (Neudecker et al., 2019). Another systematic review provided further support by reporting that running and cycling improve cognitive flexibility, inhibitory control, memory, and attention (Sibbick et al., 2022). While cycling and running are effective, sport-specific training provides additional benefits for children and teens including social skills and ability to follow direction. These additional skills can also have a positive impact on the daily lives and academic success of those with ADHD (Neudecker et al., 2019). Overall, it is easy to see that exercise, regardless of the form used, is an effective treatment for ADHD. What Jeyanthi and their colleagues (2021) demonstrate is that there are many benefits to running these programs through schools. It is easier to reach children with ADHD without relying on extra-curricular sports and it can be administered consistently throughout the school year in ways that the children and teens enjoy (Jeyanthi et al., 2021). This collection of evidence shows that exercise is well-tolerated and effective and should therefore be considered as an alternative to pharmacology when it comes to treating children and teens with ADHD.

By prioritizing exercise as a treatment plan children and teens can avoid the various downsides and potential harms associated with the using pharmacology. It is estimated that 20% of children will experience negative side effects while using medication to treat ADHD (Jeyanthi et al., 2021). Despite this, it is still considered the most valuable treatment for children and teens (Nazarova et al., 2022). These medications increase levels of certain neurotransmitters, which decreases symptoms of ADHD (Neudecker et al., 2019). Physical exercise also increases these neurotransmitters while also releasing endorphins and increasing blood flow to the brain, all of which play a role in decreasing ADHD symptoms without the negative consequences linked to medication (LaCount et al., 2022; Neudecker et al., 2019). A few of the potential side effects of medication include sleep issues, mood disturbances, weight loss, and headaches (Sibbick et al., 2022). Other problems arise from over-prescribing medications to children, potential for misuse, and financial strain from having to commit long-term to prescriptions, otherwise the symptoms will return (Nazarova et al., 2022). The second most common treatment is behavioral therapy, and it is often used in conjunction with medication. Therapy often requires serious time commitments and effort from both children and clinicians making it difficult to commit long-term. Additionally, behavioral therapy does not address the cause of the symptoms, and like medication, when suspended the symptoms of ADHD will return (Nazarova et al., 2022). Exercise is shown to be a well-tolerated and effective form of treatment. Given the downsides and potential harm of medication and therapy, exercise should be used more often to help children and teens manage their symptoms of ADHD.

Structured, physical exercise is an effective treatment option for children and adolescents with ADHD that not only decreases symptoms but can improve academic performance and should therefore decrease the reliance on pharmacology as the primary form of treatment. Using school programs to administer this exercise is a well-tolerated and enjoyable way to engage the children consistently (Jeyanthi et al., 2021). Whether the structured exercise involves general activities, running, cycling, or is specific to sports, those diagnosed with ADHD will see a decrease in their symptoms (Jeyanthi et al., 2021; Neudecker et al., 2019; Sibbick et al., 2022). Children and teens should not be encouraged to commit to a long-term relationship with medication considering the potential for harm and side-effects. Exercise improves mental and physical health (Chan et al., 2019), decreases symptoms of ADHD, and can lead to academic success (Jeyanthi et al., 2021), all which can positively affect a child’s life. Therefore, moving away from medication as treatment and using an enjoyable and beneficial treatment for ADHD, such as a school-based structured exercise program should be a priority.

References

Chan, J. S. Y., Liu, G., Liang, D., Deng, K., Wu, J., & Yan, J. H. (2019). Special issue -Therapeutic benefits of physical activity for mood: A systematic review on the effects of exercise intensity, duration, and modality. The Journal of Psychology. 153(1), 102–125. 10.1080/00223980.2018.1470487

Jeyanthi, S., Arumugam, N., & Parasher, R. K. (2021). Effectiveness of structured exercises on motor skills, physical fitness and attention in children with ADHD compared to typically developing children - A pilot study. eNeurologicalSci. 24. 10.1016/j.ensci.2021.100357

LaCount, P. A., Hartung, C. M., Vasko, J. M., Serrano, J. W., Wright, H. A., & Smith, D. T.,(2022). Acute effects of physical exercise on cognitive and psychological functioning in college students with attention-deficit/hyperactivity disorder. Journal of Mental Health and Physical Activity. 22. 10.1016/j.mhpa.2022.100443

Nazarova, V. A., Sokolov, A. V., Cubarev, V. N., Tarasov, V. V., & Schiöth, H. B. (2022). Treatment of ADHD: Drugs, psychological therapies, devices, complementary and alternative methods as well as the trends in clinical trials. Frontiers in Pharmacology, 13. 10.3389/fphar.2022.1066988

Neudecker, C., Mewes, N., Reimers, A. K., & Woll, A. (2019). Exercise interventions in children and adolescents with ADHD: A systematic review. Journal of Attention Disorders, 23(4). 307-324. 10.1177/1087054715584053

Sibbick, E., Boat, R., Sarkar, M., Groom, M., & Cooper, S. B. (2022). Acute effects of physical activity on cognitive function in children and adolescents with attention deficit/hyperactivity disorder: A systematic review and meta-analysis. Journal of Mental Health and Physical Activity, 23. https://doi.org/10.1016/j.mhpa.2022.100469.