Tai Chi for ADHD in Children

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Disqualifiers: Intellectual disability, Autism, Neurologic disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 8

Duration: 60 months

50 Participants Needed

Trial Summary

What is the purpose of this trial?

Attention Deficit Hyperactivity Disorder (ADHD) has tremendous individual and societal impact, and the effectiveness of current standard treatments is limited. Thus, there are potential public health benefits for novel behavioral training programs that could remediate the core features of ADHD and contribute to sustained improvements in behavioral control. There is mounting evidence that children with ADHD show difficulties with motor control, and that these motor deficits are strongly associated with the core behavioral features of ADHD. Based on this information, the CNIR initiated a feasibility trial of a movement-based intervention, utilizing Tai Chi practice, targeting improved behavioral control through engagement of the motor system and results are highly promising. The investigators therefore will employ an extension of our ongoing Tai Chi programs for children with ADHD, beginning with children who have already completed one of the previous Tai Chi sessions. This program will provide the basis for studying the long-term effects of mindful movement, as well as creating a foundation for exploring the way that such interventions can be expanded into a more realistic support setting for the community. Hypothesis: After participating in the ongoing Tai Chi program, children with ADHD will show improvements in behavioral measures of motor, cognitive, and attentional control. The investigators further expect movement-based training will result in decreases in ADHD symptom severity.

Will I have to stop taking my current medications?

The trial allows children to continue taking stimulants, psychoactive medications, or no medication, so you won't have to stop your current medications.

What data supports the effectiveness of the treatment Tai Chi Training for ADHD in children?

Research suggests that Tai Chi, a practice combining movement and mental focus, may help improve attention in young adults, which is a key challenge in ADHD. A study found that Tai Chi training reduced self-reported inattention in healthy young adults, indicating potential benefits for those with ADHD. ^{1 2 3 4 5}

Is Tai Chi safe for children with ADHD?

A systematic review of Tai Chi in various studies found it to be generally safe, with few reports of adverse events (unwanted side effects). While specific data on children with ADHD is limited, Tai Chi is considered a low-risk activity for most people. ^{1 4 5 6 7}

How does Tai Chi differ from other treatments for ADHD in children?

Tai Chi is a unique treatment for ADHD as it combines physical movement with mental focus, which may help improve attention without the use of medication. Unlike conventional treatments that often rely on drugs, Tai Chi offers a non-pharmacological approach that integrates mind-body techniques, potentially reducing symptoms of inattention. ^{1 4 5 8 9}

Research Team

Stewart Mostofsky, MD

Principal Investigator

Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Eligibility Criteria

This trial is for children with ADHD who have previously participated in a Tai Chi feasibility study. They must meet ADHD criteria, can be on stimulants or no medication, and may also have ODD or anxiety disorders. Exclusions include neurological disorders, significant hearing loss, low reading scores or IQ below 80, and certain other diagnoses.

Inclusion Criteria

I am currently taking stimulants, psychoactive medications, or no medication at all.

My child has ADHD and met the criteria in a previous ADHD study.

Comorbid oppositional defiant disorder (ODD) and anxiety disorders are permitted

Exclusion Criteria

Documented hearing impairment ≥ 25 dB (decibel) loss in either ear

Neurologic disorder (e.g., epilepsy, cerebral palsy, traumatic brain injury, Tourette Syndrome)

A standard score below 85 on the Word Reading Subtest, regardless of IQ score

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Ongoing, continuous Tai Chi and mindful movement instruction, 1 hour, twice per week

60 months

2 visits per week (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

Data collection every 6 months

Treatment Details

Interventions

• Tai Chi Training

Trial Overview The trial tests the long-term effects of ongoing Tai Chi training on improving motor control and reducing ADHD symptoms in children. It builds upon previous studies suggesting that mindful movement can enhance behavioral control in kids with ADHD.

Participant Groups

Group I: Tai Chi Experimental Treatment 1 Intervention

Ongoing, continuous Tai Chi and mindful movement instruction, 1 hour, twice per week

Who Is Running the Clinical Trial?

Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Lead Sponsor

Trials

93

Recruited

25,200+

Findings from Research

A 15-week tai chi training program for healthy young adults showed improvements in self-reported attention, suggesting it may be an effective non-pharmacological alternative for managing ADHD symptoms.

Participants who practiced tai chi experienced reduced reaction time variability, indicating enhanced attention control, while their affective bias improved, suggesting a potential benefit for cognitive function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tai chi training reduces self-report of inattention in healthy young adults. Converse, AK., Ahlers, EO., Travers, BG., et al.[2021]

Mindfulness-based interventions (MBIs) such as Mindfulness, Tai Chi, Yoga, and Qigong show a small but significant positive effect on reducing symptoms of inattention, hyperactivity, and impulsivity in individuals with ADHD, based on a systematic review and meta-analysis of randomized controlled trials.

The analysis indicated a moderate improvement in executive function (EF) as well, with effect sizes of g = -0.26 for inattention, g = -0.19 for hyperactivity/impulsivity, and g = -0.35 for EF, suggesting that MBIs can be beneficial for managing ADHD symptoms, although further research is needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effect of Meditation-Based Mind-Body Interventions on Symptoms and Executive Function in People With ADHD: A Meta-Analysis of Randomized Controlled Trials. Zhang, Z., Chang, X., Zhang, W., et al.[2023]

A feasibility trial involving 21 undergraduates with ADHD showed a high retention rate of 90% and good data quality, indicating that a larger randomized controlled trial (RCT) of Tai Chi as a non-pharmacological treatment for ADHD is feasible.

The primary outcome measure, self-reported inattention symptoms, demonstrated strong reliability, suggesting that Tai Chi could potentially help improve attention in young adults with ADHD, although further refinements in study design are needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tai Chi training for attention deficit hyperactivity disorder: A feasibility trial in college students. Converse, AK., Barrett, BP., Chewning, BA., et al.[2021]

Undergraduates with ADHD are more open to complementary and alternative medicine (CAM) therapies, indicating a potential for non-pharmacological treatments like tai chi.

About 32% of students with ADHD expressed a strong willingness to participate in a tai chi trial, suggesting that such interventions could be feasible and well-received in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The appeal of tai chi and complementary therapies for college students with ADHD. Sulzer, SH., Trueba, C., Converse, AK.[2023]

Tai chi (TC) is generally safe, with no serious adverse events reported in a review of 153 randomized controlled trials, primarily involving older adults, although minor musculoskeletal issues like knee and back pain were noted.

Only 33% of the trials reported adverse events, and just 12% had a clear protocol for monitoring them, indicating that the inconsistent reporting limits our understanding of TC's safety profile.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What do we really know about the safety of tai chi?: A systematic review of adverse event reports in randomized trials. Wayne, PM., Berkowitz, DL., Litrownik, DE., et al.[2022]

This study evaluated the effectiveness and safety of acupuncture for treating ADHD in children, involving 80 participants divided into two groups: one receiving acupuncture and the other on a waitlist for treatment.

The acupuncture group underwent 12 sessions over 6 weeks, with outcomes measured using the Korean ADHD-Rating Scale, aiming to provide evidence for acupuncture as a viable treatment option for ADHD symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acupuncture for attention deficit hyperactivity disorder (ADHD): study protocol for a randomised controlled trial. Hong, SS., Cho, SH.[2021]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Tai chi training reduces self-report of inattention in healthy young adults. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Subtle Motor Signs as a Biomarker for Mindful Movement Intervention in Children with Attention-Deficit/Hyperactivity Disorder. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

The Effect of Meditation-Based Mind-Body Interventions on Symptoms and Executive Function in People With ADHD: A Meta-Analysis of Randomized Controlled Trials. [2023]

4. Scotland pubmed.ncbi.nlm.nih.gov

Tai Chi training for attention deficit hyperactivity disorder: A feasibility trial in college students. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

The appeal of tai chi and complementary therapies for college students with ADHD. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

What do we really know about the safety of tai chi?: A systematic review of adverse event reports in randomized trials. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Acupuncture for attention deficit hyperactivity disorder (ADHD): study protocol for a randomised controlled trial. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Effects of taijiquan and qigong practice over behavioural disorders in school-age children: A pilot study. [2019]

9. England pubmed.ncbi.nlm.nih.gov

Pediatric tuina for the treatment of attention deficit hyperactivity disorder (ADHD) symptoms in preschool children: study protocol for a pilot randomized controlled trial. [2020]