The efficacy of cognitive-motor rehabilitation on cognitive functions and behavioral symptoms of attention deficit/hyperactivity disorder (ADHD) children: Specification of near-transfer and far-transfer effects in comparison to medication

This study aimed to investigate and compare the efficacy of cognitive‑motor rehabilitation (CMR) with methylphenidate on cognitive functions and behavioral symptoms of children with attention deficit/hyperactivity disorder (ADHD) and specified the near‑transfer and far‑transfer effects.

The research was semiexperimental with posttest and follow‑up assessments, in a single‑blind design. Forty‑eight boys with ADHD, aged 9–12, were selected conveniently regarding the inclusion/exclusion criteria, matched base on severity and Intelligence quotient (IQ) and were randomly assigned to CMR (n = 16), methylphenidate medication (MED, n = 16), and placebo CMR groups (PCMR, n = 16). CMR and PCMR received 20 3‑h training sessions, and the MED group received 20 or 30 mg/day methylphenidate. Tower of London (TOL), Swanson, Nolan, and Pelham, Version IV Scale (SNAP‑IV), Wechsler’s digit span and mathematic subscales, dictation test, and restricted academic situation scale (RASS) were completed at posttest and follow‑up. The data were analyzed by repeated measures multivariate analysis of variance.

CMR outperformed PCMR on forward digit span, backward digit span, ToL score at both posttest, and follow‑up (P < 0.05). CMR scored lower than MED on ADHD‑PI and ADHD‑C at both posttest and follow‑up (P < 0.05). Moreover, CMR outperformed MED on dictation at both assessment phases (P < 0.01) and RASS at the follow‑up phase (P < 0.05). CMR outperformed PCMR on mathematics at post‑test (P = 0.038) and also, in dictation and RASS, at both post‑test (P < 0.001) and follow‑up (P < 0.05).

CMR Improves near‑transfer cognitive functions and behavior symptoms of ADHD as much as MED, but only CMR has more generalizable and endurable improvement on complex Efs and academic performance (far‑transfer effects).