In ADHD, Meeting 24-HMB Guidelines Decreases Risk for Cognitive or Social Difficulties

Following evidence-based 24-hour movement behavior (24-HMB) guidelines associated with lower risk for cognitive and social difficulties among children and adolescents with attention-deficit/hyperactivity disorder (ADHD). These findings were published in Child and Adolescent Psychiatry and Mental Health.

The 24-HMB guidelines recommend that children should engage in 2 hours or less of noneducational screen time, a minimum of 60 minutes of moderate-to-vigorous physical activity (MVPA), and age-appropriate sleep durations every day.

For this cross-sectional study, data were sourced from the 2020 National Survey for Children’s Health (NSCH) survey collected in the United States between 2020 and 2021. A total of 42,777 primary caregivers of a child aged 6 to 17 years provided data about demographics, medical data, and asked whether their child met 24-HMB guidelines. Among the subset of children with ADHD (n=3,470), the relationships between meeting 24-HMB guidelines and cognitive and social difficulties were assessed.

Children had a mean age of 11.97 (SD, 3.48) years, 69.55% were boys, 69.18% were White, 14.95% were overweight, 14.52% had severe ADHD, and 26.27% had never received medication treatment for ADHD.

A quarter of the study population (27.56%) reported no adherence to the 24-HMB, 26.87% adhered to the sleep recommendation, 10.87% to the screen time recommendation, 4.93% to the MVPA recommendation, 5.68% to all recommendations, and the rest to a combination of 2 of the 3 recommendations.

Parents reported that 55.57% of children had serious difficulty concentrating, remembering, or making decision; 17.49% had a lot of difficulty and 36.54% had a little difficulty making or keeping friends; 3.17% bullied others almost every day, 2.73% bullied others 1 or 2 times per week, 5.16% bullied others 1 or 2 times per month, and 19.73% bullied others 1 or 2 times in the past year; and 6.93% were bullied by others almost every day, 7.40% were bullied 1 or 2 times per week, 11.15% were bullied 1 or 2 times per month, and 33.67% were bullied 1 or 2 times in the past year.

Children who followed all three 24-HMB recommendations were less likely to have difficulty concentrating, remembering, or making decisions (odds ratio [OR], 0.43; 95% CI, 0.24-0.78; P =.01) and making or keeping friends (OR, 0.46; 95% CI, 0.21-0.97; P =.04).

Meeting some of the 24-HMB recommendations were also associated with beneficial outcomes, in which the risk for cognitive difficulties was lower for children who met the screen time and physical activity recommendations (OR, 0.26; P <.001); risk for bullying others was lower for those who achieved the screen time only (OR, 0.44; P = .003), screen time and sleep (OR, 0.60; P = .02), and sleep only (OR, 0.65; P = .03) recommendations; and risk for being bullied was decreased for those who met the screen time recommendations (OR, 0.61; P = .04).

However, children who met physical activity recommendations only were at increased risk for being bullied by others (OR, 2.47; P = .03).

The major limitation of this study was the reliance on parent reporting.

Study authors concluded, “[M]eeting all three 24-HMB guidelines was associated with reduced odds of the occurrence of 1 or more negative outcomes for cognitive and social difficulties.”

This article originally appeared on Psychiatry Advisor