Superior motor competence in children with ADHD is associated with optimized neurocognitive development of inhibitory control processing: An ERP study

Background: Neurocognitive deficits, especially inhibitory control processing, are common developmental challenges in children with attention-deficit/hyperactivity disorder (ADHD). Although previous studies have suggested that greater motor competence (MC) is associated with better inhibitory control on both behavioral and neuroelectric levels in children with ADHD, some limitations exist. Aims: To examine whether higher MC is associated with improved neurocognitive development in children with ADHD, as indexed by behavioral and neuroelectric indices of inhibitory control in a well-designed study. Methods: Sixty children with ADHD were divided into high MC (n = 30) and low MC (n = 30) groups, based on the median total composite scores from the Bruininks-Oseretsky Test of Motor Proficiency. Forty-four typically developing (TD) children were recruited as the healthy control. The Stroop task was administered to assess inhibitory control while electroencephalography was recorded to derive P3 component. Results: The TD children group demonstrated higher accuracy rate (AR), shorter reaction time (RT), and greater P3 amplitude relative to the Low MC ADHD group (ps = .02). However, the TD children group had higher AR compared to the High MC ADHD group, with no significant differences in RT (p = .927) and P3 amplitude (p = .796). Further, the High MC ADHD group demonstrated shorter RT (p = .019) and greater P3 amplitude (p = .041) regardless of congruency compared to the Low MC ADHD group while accounting for intelligence quotient and aerobic fitness. Conclusions: Superior MC in children with ADHD is associated with favorable neurocognitive development, as evidenced not only by the association of MC with enhanced inhibitory control performance and increased P3 amplitude but also by that such neurocognitive performance is comparable to those of TD children. These findings suggest that enhanced MC plays a role in