Effect of osteopathic manipulative therapy in the attentive performance of children with attention-deficit/hyperactivity disorder.

CONTEXT: Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral disorder most commonly affecting children and teenagers. It is characterized by the coexistence of attention problems and impulsivity and hyperactivity. Although several studies have been conducted on the efficacy of conventional and alternative therapies in children with ADHD, few studies have specifically investigated the efficacy of osteopathic manipulative therapy (OMTh). OBJECTIVE: To evaluate the efficacy of OMTh in the treatment of children with ADHD. METHODS: Children aged 5 to 15 years with a primary diagnosis of ADHD who were admitted to a single neuropsychiatry unit from November 2008 to September 2009 were randomly assigned to an intervention group (OMTh + conventional care) or a control group (conventional care only). Biancardi-Stroppa Modified Bell Cancellation Test accuracy and rapidity scores were recorded for both groups at baseline and after 10 weeks. Statistical analyses included univariate tests and multivariate linear regressions. RESULTS: A total of 28 participants were included in the study: 14 in the OMTh group and 14 in the control group. Univariate statistical analysis showed no statistically significant differences between the intervention and control groups in terms of characteristics measured at baseline, except for psychosocial intervention (P=.05). Multivariate linear regression showed that OMTh was positively associated with changes in the Biancardi-Stroppa Test accuracy (ß=7.948 points; P=.04) and rapidity (ß=9.089 points; P=.03) scores. CONCLUSION: Participants who received OMTh had greater improvement in Biancardi-Stroppa Test scores than participants who received conventional care only, suggesting that OMTh can potentially increase performances of selective and sustained attention in children with ADHD. To confirm these findings, studies of larger and more diverse populations are warranted.

The disturbing effect of irrelevant information on arithmetic problem solving in inattentive children.

Two studies explored the influence of irrelevant information on the problem-solving ability of children rated as inattentive by their teachers, on the basis of symptoms of attention deficit hyperactivity disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). In the first study, 20 inattentive children, fourth and fifth graders, and 20 control children matched for IQ, gender, and schooling were administered 12-word arithmetic problems. Four problems included only essential information necessary for the problem's solution, whereas the other problems included irrelevant information, half at the beginning of the problem and half at the end. Although the inattentive children were equal to control children in their ability to solve problems with essential information, they performed more poorly in using appropriate problem-solving procedures when problems included irrelevant information, independent of its position. The second study compared the influence of numerical and verbal irrelevant information. Nineteen inattentive children and 18 control children, selected with similar criteria as Study 1, were presented with 12 problems, 6 with irrelevant numerical-arithmetic information and 6 with irrelevant verbal information. Both kinds of information produced a greater number of procedural errors in the inattentive group, but differences in calculation errors were less evident. Furthermore, inattentive children were more disturbed when the irrelevant information was verbal than when it was numerical, suggesting that inattentive children's difficulties in problem solving are partially due to an inability to inhibit irrelevant information, especially when it conveys a rich semantic knowledge.