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

BACKGROUND AND AIM: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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).