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Abstract Summary Attention deficit hyperactivity disorder(ADHD) is a highly heritable neurodevelopmental disorder. It is one of the most prevalent psychiatric disorders in children and it greatly impairs social and cognitive functions in affected individuals. It is characterized by a childhood-onset pattern of hyperactivity, inattention and impulsivity, that commences in early childhood and often persists into adulthood. The current psychiatric disease classification system, DSM-5, distinguishes three subtypes: a mainly inattentive, a mainly hyperactive–impulsive and a combined subtype ADHD occurs in 8-12% of children worldwide and is more prevalent in males than females. ADHD’s onset occurs around 3 years of age in both sexes. ADHD symptoms usually lessen with age such that the rate of persistence is only 15% by age 25. Common comorbidities in children with ADHD include motor coordination problems, tic disorders, sleep disorders, specific learning disorders such as dyslexia, and child-psychiatric disorders such as depression, anxiety, oppositional defiant and conduct disorders, and autistic spectrum disorders. ADHD is best seen as a multifactorial disorder in which genes and environment play a complicated intertwined role. Multifactorial in this respect implies that the phenotype is due to Summary -87- the combination of multiple genetic as well as environmental contributors Children generally develop an amazing number of motor skills in the first years of their lives. Some of these skills, such as walking, develop naturally, whereas other skills, such as swimming and writing require a lot of practice after specific instruction. Developmental coordination disorder (DCD) is a marked impairment in motor coordination which significantly interferes with academic achievement or activities of daily living. These deficits in motor skills have been labelled in many ways over the centuries (e.g., neurological soft signs, clumsiness), but the current, dominant term is developmental coordination disorder in young children is more common than generally realized. Children under the age of 5 years may have difficulties in one or more areas of development, including speech and language, motor, socialemotional and cognitive development. Clinical studies of children with DCD have reported higher prevalence in boys. Clinical and epidemiological studies report that 30% to 50% of children with ADHD suffer from motor coordination problems. Some authors consider DCD as the lowest extreme end of a continuum of motor performance, others describe DCD as a categorical disorder, or consider it as the lightest form of cerebral palsy. Summary -88- Little is known about the etiology of DCD. It is probably best seen as a multifactorial disorder. In the following section genetic and environmental risk factors are discussed as well as some neurobiological and neuro functional deviations associated with DCD. DCD often co-occurs with other developmental disorders, most commonly attention deficit hyperactivity disorder (ADHD). Up to 50% of children with DCD have been shown also to meet criteria for ADHD. With recent evidence suggesting a genetic link between these two disorders, though it has received less attention in research. Recent clinical and experimental evidence suggests a greater role of motor factors in ADHD than was considered before. Children with (ADHD) and children with Developmental Coordination Disorder (DCD) appear to share difficulties in motor, academic, social, and emotional functioning. Children diagnosed with ADHD are frequently described as clumsy, having poor coordination, and suffering from poor fine and gross motor functioning. The type and degree of movement difficulty differed between children with ADHD-predominantly inattentive (ADHD-PI) and ADHD-combined (ADHD-C). Children with ADHD-PI had significantly poorer fine motor (FM) skills, whereas children with ADHD-C had significantly greater difficulty with gross motor (GM) skills. Interestingly, this combination is detected irrespective of ADHD severity. Studies that have followed children with DCD and ADHD (i.e., DAMP) report that these children are at risk for a number of psychiatric and personality disorders. More than half of the adolescents with DAMP had psychiatric or personality disorders. The psychiatric symptoms displayed by these adolescents ranged from affective and anxiety disorders to personality disorders. Beyond those associated with either disorder in isolation. Motor coordination problems are likely important factors mediating links between ADHD and poor physical activity outcomes. Children with ADHD tend to have more adipose tissue and poorer cardiovascular performance than controls. It remains unclear what exactly is the etiology of the combination of ADHD and motor coordination problems, although this relationship has been known to exist for many years. Neuropsychological and neuro-imaging studies have demonstrated an underlying neurological substrate for ADHD. Children with both motor problems and Attention Deficit Hyperactivity Disorder (ADHD) may require different interventions from children with ADHD only and that evaluation of gross motor issues is important in the diagnostic workup of children with attention and/or activity problems. Our study showed that Poor Motor coordination is a frequent coexisting problem in children with ADHD. Also motor incoordination is more common in inattentive type of ADHD than hyperactivity and combined type of ADHD. Motor delay was no significantly correlated with the severity of ADHD. Our results confirm previous research demonstrating a consistent relationship between ADHD and poor motor performance with high levels of motor coordination problems in ADHD. We found that motor incoordination is more common in inattentive type of ADHD than hyperactivity and combined type of ADHD |