A Holistic Approach to ADHD

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Attention Deficit Hyperactivity Disorder affects between 3 and 7% of American children. The APA characterizes this condition as inattention, impulsiveness, and hyperactive behaviors. Furthermore, Barkley classifies ADHD as a problem with behavior disinhibition and argues that inattention, impulsiveness and hyperactivity is symptomatic of the child unable to modulate behaviors and unable to discern the saliency of incoming stimuli. While treatment can be in the form of psychostimulant medications there is some concern with the lack of evidence regarding the safety of long term use of stimulant medication during childhood.

Hopkins et al published of one of the few empirical studies on a natural treatment for the symptoms of ADHD and cite many studies that suggest physical activity as a beneficial therapeutic treatment for other mental conditions and cognitive functioning. Physical exercise used as a treatment for symptoms often associated with anxiety and depression, however there is little literature suggesting that ADHD can be treated using this holistic approach.

The researchers wished to add to the literature supporting the use of physical activity as a potential treatment for ADHD due to the belief that physical exercise alters the brain’s dopamine and norepinephrine transmission, which is believed to be related to the symptoms of ADHD. This study observed an exercise intervention using a rat model of ADHD. The researchers not only focused on the cognitive functioning of the rats (inclusive of hyperactivity, impulsivity, and inattention) but also the social interaction of the rats. The researchers note that while decreased social interaction is not considered a hallmark symptom of ADHD in humans it often is an accompanying symptom of the diagnosis.

The researchers wished to measure the effects of exercise on rat behaviors that could be associated with human ADHD. Exercise was made available by the introduction of an exercise wheel to the rats’ cages with unlimited access. Sixty-nine Spontaneously Hypertensive rats (SHR) and twenty-seven Wistar-Kyoto rats (WKR) were separated into exercising or non-exercising groups (designated by the availability of an exercise wheel). The WKR rats are genetically similar to the SHR and were used as controls, additionally there were groups of SHR that were used as controls. The SHR breed “share many characteristics associated with ADHD…and are historically used as a rat model” in non-human ADHD studies. Furthermore, the rats were separated by sex because the researchers hypothesized a sex difference with regards to ADHD symptomology as well as response to treatment options.

The rats were introduced to both a learning task and a social interaction task. The rats were only fed for one hour per day but were conditioned to expect their food when a light was turned on. The researchers placed sensors at the snout entry of the rats’ food cups to measure when the rats would attempt to eat. For the social interaction task the exercise rats were placed in a clear plastic container one at a time within view of a control rat and their interactions were recorded with a video camera. The exercise wheels were continuously available to the exercise group and the rotations of the wheel were recorded.

This study researched the voluntary exercise and attention and social behavior of Spontaneous Hypertensive Rats. SHR showed more distractible behavior when introduced to irrelevant stimuli and hyper-responsive behaviors than the control rats. The female exercise rats showed fewer distractible moments than their non-exercise controls, however the male exercise SHR and the non-exercise SHR were similar in their distractible behavior, specifically their response to environmental stimuli.

The researchers’ results were consistent to previous studies in which the female rats benefited from exercise, particularly in the rats’ social interactions. Cognitive benefits were not significant in the male rat sample. Additionally there were no significant changes between the exercising and non-exercising rats in relation to locomotor behavior, indicating that the exercise did not decrease physical hyperactivity.

Before you say “Why the heck is she writing about rats? I teach humans” think about this: the researchers further hypothesized that female humans with ADHD would benefit from exercise intervention because they are more cognitively affected (with regards to attentional function) by the disorder. With regards to diagnosis, human boys are more likely to be diagnosed with hyperactivity while girls are more likely to be diagnosed with the inattention subtype of ADHD. While hyperactivity peaks at a younger age and tapers as the child ages, inattention stretches into adulthood and has long-lasting and long-term concerns. They further hypothesize that females with ADHD are more susceptible to anxiety and depression than their male counterparts and that exercise interventions for anxiety and depression have been well documented in the literature. The literature suggests that females with ADHD have a reduced global metabolism (in relation to their non-ADHD counterparts as well as boys with ADHD). Physical exercise is known to increase global metabolism. The researchers conclude that physical exercise may be a potential benefit as a treatment for females with ADHD.

While I’d like to say “Well, duh. Everyone knows exercise if good”, I find myself wondering why this isn’t a bigger part of our culture. Is there anyone who isn’t stressed, anxious, disengaged at some point? If I know that going for a run makes a terrible day better then why wouldn’t I believe that it could help clinical depression? And, let’s not disregard the positive benefits for weight control, cardiovascular health, etc etc.

Exercise needs to be part of our every day lives. As a teacher at Eagle Hill we’ve been incorporating sports and an aerobic period of the day since our beginning in the 60′s but this year we’ve tried something new. We’re offering a morning exercise routine with personal trainers five days a week. We have forty students and six faculty partaking and anecdotally we’re noticing that kids are more engaged in classes, happier, and yes…some seem less distracted. We’re involved in a pretty rigorous study of this program and phenomenon, and anticipate that our students will show many more benefits.

Stay tuned for the results of this exciting study!

Works Cited:
Hopkins, M.E., Sharma, M., Evans, G.C., and Bucci, D.J. (2009). Voluntary Physical Exercise Alters Attentional Orienting and Social Behavior in a Rat Model of Attention-Deficit/Hyperactivity Disorder. Behavioral Neuroscience. (123); 599-606.

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