Handwriting assessment to distinguish comorbid learning difficulties from attention deficit hyperactivity disorder in Chinese adolescents: A case-control study

Int J Methods Psychiatr Res. 2018 Dec;27(4):e1718. doi: 10.1002/mpr.1718. Epub 2018 May 15.

Abstract

Objectives: Attention deficit hyperactivity disorder (ADHD) and learning difficulties (LDs) are proposed as 2 overlapping disorders. The objective of this study was to investigate the handwriting performance in ADHD and comorbid ADHD-LD adolescents.

Methods: The study examined the Chinese and English handwriting performance and sensorimotor skills of 32 ADHD, 12 ADHD-LD, and their matched controls.

Results: Participants with ADHD had comparable writing time and speed, but the readability was lower than their controls. Participants with ADHD-LD had lower writing speeds in both Chinese and English handwriting than their controls. The ADHD and ADHD-LD groups also showed larger variations in either speed or pen pressure than their controls. Chinese handwriting assessment effectively classified ADHD and ADHD-LD with good sensitivity and positive predictive value.

Conclusions: Clinicians should be aware of the fundamental difference between the 2 disorders and make good use of handwriting assessment as a reference to deliver effective therapies and trainings.

Keywords: ADHD; adolescent psychiatry; behavior; learning disability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / diagnosis*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / physiopathology
  • Case-Control Studies
  • Child
  • China
  • Comorbidity
  • Female
  • Handwriting*
  • Humans
  • Learning Disabilities / diagnosis*
  • Learning Disabilities / epidemiology
  • Learning Disabilities / physiopathology
  • Male
  • Motor Skills / physiology*
  • Neuropsychological Tests