The National Institutes of Health's National Institute of Mental Health released the findings of their recent study regarding
brain maturity and ADHD on November 12, 2007. Using brain image studies, it was determined that brains of children with
ADHD reach peak thickness at age 10.5 years whereas normally developing brains reach peak thickness at 7.5 years in
age. Thus, ADHD brain development exhibits a three year lag.
Another very interesting discovery was that the frontal and temporal areas showed the greatest lag with a 5 year delay
compared to counterparts without ADHD. BUT, the motor cortex matured faster in the children with ADHD. Therefore, the
ability to make higher order decisions was delayed but the ability to perform the motor tasks matures faster hence the
possible reason for restlessness in ADHD children.
What does this mean for the delivery of occupational and physical therapy services for children with ADHD? A review on
basic brain development is necessary for this discussion. The temporal lobe is involved in auditory processing, speech and
visual processing. The hippocampus is also located here which plays a large role in memory formation. The frontal lobe
plays a role in impusle control and judgement. The motor cotex executes movement.
As therapists, we must remember this information with regards to children with ADHD. In some children, could we be fighting
something that is just not ready to change? If brain development lags 3 years behind in children with ADHD, then
therapeutic activities that work on processing, visual skills, sensory processing and integration may be all for nought.
Meaning wasted time for the children and wasted money over time which in three years the brain will mature regardless,
resulting in some children outgrowing some of the ADHD symptoms.
Is this when plasticity plays a huge role? By providing children with ADHD therapeutic activities and practice during this
window, could this help to change the brain's circuitry up until 10.5 years old? Wow, that is huge! A window that we thought
may be closing at a much younger age.
We have to hope that the latter is true. In my opinion, this plays a significant role in how as therapists we work with children
with ADHD, parents and teachers. We may be able to make greater change over a longer period of time. Educating school
staff and parents on brain development and ADHD may help staff and parents to understand the student's actions rather
than get frustrated or judgemental. It also offers hope to the children and their families that many of the symptoms of ADHD
may improve with age. ADHD continues to be a clinical diagnosis meaning we can not apply this brain development
information to every child with ADHD. This does not mean that every child with ADHD will exhibit this lag and some children
may experience larger delays in brain development.
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Retreived on November 14, 2007: Brain Matures a Few Years Late in ADHD But Follows Normal Pattern from
Brain Development and ADHD: Commentary on recent research by NIH
By: Margaret Rice PT
|Online resource for special education, pediatric occupational therapy and pediatric physical therapy