Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterized by persistent patterns of inattention and/or hyperactivity-impulsivity. While these features are the defining symptoms, research indicates a significant co-occurrence between ADHD and difficulties with physical coordination and motor skills. However, these motor issues can affect a person’s daily life, self-esteem, and participation in activities.
Understanding the Link Between ADHD and Motor Skills
The relationship between ADHD and motor skill deficits is well-established in scientific literature, suggesting it is a common co-occurring feature. Studies show that between 30% and 60% of individuals with ADHD experience some form of motor skill impairment, with prevalence rates sometimes exceeding 60% in clinical samples.
These difficulties manifest across a spectrum of motor functions, affecting both large and small muscle movements. Individuals with ADHD often demonstrate deficits in fine motor skills, such as dexterity, handwriting speed, and complex hand-eye coordination. Gross motor skills are also affected, including problems with balance, postural control, and movement sequencing. They may exhibit poorer performance in tasks requiring ball skills or maintaining stability while standing.
Developmental Coordination Disorder and ADHD
The most recognized clinical diagnosis for coordination issues co-occurring with ADHD is Developmental Coordination Disorder (DCD), sometimes referred to as dyspraxia. DCD is characterized by motor skills substantially below the level expected for an individual’s age, which significantly impacts daily functioning. The co-occurrence rate between ADHD and DCD is high, estimated to affect up to 50% of children with ADHD.
Gross motor manifestations include clumsiness, such as frequent tripping or bumping into objects, or struggling to learn complex physical activities like riding a bicycle. Deficits in fine motor skills often present as poor handwriting and difficulty with self-care tasks, such as buttoning a shirt. These challenges stem from a delay in the ability to plan and execute coordinated movements, not an underlying medical condition.
Executive Function and Motor Planning
The underlying reason for this common overlap is neurological, rooted in shared brain pathways that govern both attention and movement. Executive functions (EF), including working memory, planning, and inhibitory control, are impaired in ADHD. These cognitive processes are essential for effective motor planning—the brain’s ability to conceive, organize, and execute a sequence of movements.
Deficits in EF directly interfere with motor execution. Poor working memory makes it difficult to hold a multi-step sequence of movements in mind, such as the steps for a new dance. Difficulties with inhibition can lead to poorly timed, impulsive movements, resulting in a lack of smoothness and precision during physical tasks. This disruption makes it challenging to quickly adapt movements to new demands or monitor physical performance in real-time. The resulting movements often appear uncoordinated because the planning and execution stages are disorganized.
Supporting Coordination Development
Targeted interventions can help manage coordination difficulties associated with ADHD. Occupational Therapy (OT) is a primary resource, focusing on improving fine motor skills and independence in daily activities. An occupational therapist may use strategies like breaking down complex tasks into smaller steps to improve motor planning and sequencing. They also incorporate exercises to enhance hand strength, dexterity, and visual-motor integration, which are necessary for tasks like handwriting and using utensils.
Physical Therapy (PT) addresses gross motor skills, focusing on balance, strength, and overall coordination. Physical therapists often employ dynamic activities, such as balance beam exercises and movement games, to improve postural control and motor proficiency. Task-oriented interventions involve repetitive practice of specific functional movements like catching a ball or climbing to build skill and confidence. Modifying the physical environment or using adaptive tools can also support the development and practice of new motor skills.