Association between SDQ-TR-assessed hyperactivity symptoms and step count during school activities in school-aged children
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Background: Hyperactivity is a core symptom of attention-deficit/hyperactivity disorder (ADHD) and may manifest as increased motor activity. Objectively measured step count may provide information about ambulatory movement associated with hyperactivity symptoms, while developmental differences may also influence movement patterns in children.
Objective: To examine the association between hyperactivity symptom severity and step count during school activities and to compare step count and hyperactivity scores between children aged 5 and 12 years.
Methods: This cross-sectional study included 40 children (20 males and 20 females) aged 5 and 12 years from two schools in Surakarta, Indonesia, recruited using total sampling. Hyperactivity symptoms were assessed using the hyperactivity/inattention subscale of the Strengths and Difficulties Questionnaire Teacher Report (SDQ-TR), while step count was objectively measured using a Maxfit pedometer during one school day. Spearman's rank correlation, independent-samples t-tests, and Mann–Whitney U tests were used for statistical analysis.
Results: Hyperactivity scores were strongly and positively correlated with step count (rₛ = 0.918, p < 0.001). Step count differed significantly between the age groups (p = 0.041), with higher values observed among 5-year-old children than among 12-year-old children. In contrast, hyperactivity scores did not differ significantly between the two age groups (p = 0.701).
Conclusion: Higher hyperactivity symptom severity was associated with greater step count during school activities. Step count differed between the two age groups, whereas hyperactivity scores did not. These findings suggest that objectively measured ambulatory movement and hyperactivity symptoms may capture related but developmentally distinct aspects of children's behaviour.
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