Association between ADHD symptom severity and motor activity in preschool children: A cross-sectional study
Background: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Objective measurement of motor activity may complement parent-reported assessment of ADHD symptoms.
Objectives: This study aimed to examine the association between ADHD Rating Scale-5 scores and step counts, used as an objective indicator of motor activity, among children aged 4–6 years.
Methods: A cross-sectional observational study was conducted among 110 children aged 4–6 years selected through purposive sampling. ADHD symptoms were assessed using the parent-completed ADHD Rating Scale-5, while step counts were measured using a digital pedometer during a 15-minute school recess. Data normality was assessed using the Kolmogorov–Smirnov test. Pearson's product–moment correlation was used to examine the association between total ADHD Rating Scale-5 scores and step counts, whereas Spearman's rank correlation was used for the Inattention and Hyperactivity–Impulsivity domain scores.
Results: Total ADHD Rating Scale-5 scores showed a very strong positive correlation with step counts (r = .865, p < .001). At the domain level, Inattention scores showed a strong positive correlation with step counts (ρ = .756, p < .001), while Hyperactivity–Impulsivity scores showed a very strong positive correlation (ρ = .818, p < .001).
Conclusions: Higher ADHD symptom scores were strongly associated with higher motor activity, as indicated by step counts, among preschool children. Step-count measurement may provide a simple objective measure that complements parent-reported assessment of ADHD symptoms; however, it should not be interpreted as a diagnostic measure for ADHD.
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