Autism spectrum disorder symptoms in children with ADHD: A community-based study

This study examined the prevalence of autism spectrum disorder (ASD) symptoms in a community-based sample of children with attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls. We also examined the relationship between ASD symptoms and ADHD subtype, ADHD symptom severity and child gender. Participants were 6–10-year-old children (164 ADHD; 198 non-ADHD control) attending 43 schools in Melbourne, Australia, who were participating in the Children's Attention Project. ADHD was assessed in two stages using the parent and teacher Conners’ 3 ADHD index and the Diagnostic Interview Schedule for Children IV (DISC-IV). ASD symptoms were identified using the Social Communication Questionnaire (SCQ). Unadjusted and adjusted linear and logistic regression examined continuous and categorical outcomes, respectively. Children with ADHD had more ASD symptoms than non-ADHD controls (adjusted mean difference = 4.0, 95% confidence interval (CI) 2.8; 5.3, p < 0.001, effect size = 0.7). Boys with ADHD had greater ASD symptom severity than girls with ADHD (adjusted mean difference = 2.9, 95% CI 0.8; 5.2, p = 0.01, effect size = 0.4). Greater ADHD symptom severity was associated with greater ASD symptom severity (regression co-efficient = 1.6, 95% CI 1.2; 2.0, p < 0.001). No differences were observed by ADHD subtype. Greater hyperactive/impulsive symptoms were associated with greater ASD symptoms (regression coefficient = 1.0; 95% CI 0.0; 2.0, p = 0.04) however, this finding attenuated in adjusted analyses (p = 0.45). ASD symptoms are common in children with ADHD. It is important for clinicians to assess for ASD symptoms to ensure appropriate intervention.     

Understanding physical activity and motivations for children with Developmental Coordination Disorder: An investigation using the Theory of Planned Behavior

Developmental coordination disorder (DCD) is a neurodevelopmental condition, affecting approximately 5–6% of children. Previous research has consistently found children with DCD being less physically active compared to typically-developing (TD) children; however, the psychosocial factors associated with physical activity for children with DCD are poorly understood. The purpose of this study was to examine how theory-based physical activity cognitions impacts physical activity behaviors for children with and without DCD. Participants included a sample of boys (N = 61, M_age = 13.25 ± .46) with DCD (n = 19) and without DCD (n = 42), drawn from a larger prospective cohort study. A questionnaire with psychosocial measures was first administered, and accelerometers were used to assess their physical activity behavior over the subsequent week. Findings indicate that DCD was significantly associated with lower physical activity (F(1,58) = 6.51, p < .05), and poorer physical activity cognitions (F(4,56) Wilks Lambda = 2.78, p < .05). Meditational analyses found attitudes (B = .23, p < .05) and subjective norms (B = .31, p < .05) partially mediating the relationship between DCD and physical activity. Overall, this study further confirms that the activity deficit that exists among boys with DCD, and that the relationship is partially mediated through some physical activity cognitions. Interventions should target the perceived approval of influential people, and the personal evaluations of physical activity for boys with motoric difficulties. These findings further emphasizes the discrepancy in physical activity that exist between boys with DCD and TD boys, and highlight the need to better understand the psychological factors related to physical activity for children with DCD.     

Assessment of physical fitness and exercise tolerance in children with developmental coordination disorder

Children with developmental coordination disorder (DCD) have been shown to be less physically fit when compared to their typically developing peers. The purpose of the present study was to examine the relationships among body composition, physical fitness and exercise tolerance in children with and without DCD. Thirty-seven children between the ages of 7 and 9 years participated in this study. Participants were classified according to results obtained on the Movement Assessment Battery for Children (MABC) and were divided in 2 groups: 19 children with DCD and 18 children without DCD. All children performed the following physical fitness tests: The five-jump test (5JT), the triple-hop distance (THD) and the modified agility test (MAT). Walking distance was assessed using the 6-min walking test (6MWT). Children with DCD showed higher scores than children without DCD in all MABC subscale scores, as well as in the total score (p < 0.001). Participants with DCD were found to perform significantly worse on the MAT (p < 0.001), the THD (p < 0.001) and 5JT (p < 0.05). Moreover, children with DCD had poorer performance on the 6MWT than children without DCD (p < 0.01). Our results found significant correlations among body mass index (BMI), THD (r = 0.553, p < 0.05), 5JT (r = 0.480, p < 0.05) and 6MWT (r = 0.544, p < 0.05) only in DCD group. A significant correlation between MAT and 5JT (r = −0.493, p < 0.05) was found. Similarly, THD and 5JT (r = 0.611, p < 0.01) was found to be correlated in children with DCD. We also found relationships among 6MWT and MAT (r = −0.522, p < 0.05) and the 6MWT and 5JT (r = 0.472, p < 0.05) in DCD group. In addition, we found gender specific patterns in the relationship between exercise tolerance, explosive strength, power, DCD, and BMI. In conclusion, the present study revealed that BMI was indicative of poorer explosive strength, power and exercise tolerance in children with DCD compared to children without DCD probably due to a limited coordination on motor control.     

Physical fitness and overweight in Israeli children with and without developmental coordination disorder: Gender differences

Physical fitness and overweight among children has become paramount in the general population and more so in children with developmental coordination disorder (DCD). The purpose of the current study was to examine the association between physical fitness and overweight in a sample of Israeli children in comparison to typical children, and to examine gender differences. DCD was identified through total scores on the movement assessment battery for children 2 (MABC-2) equal to or less than the 16th percentile as well as parents’ report that the child's deficits in motor skills interfered with at least two daily life activities. The sample included a group of children with DCD (n = 22, M age = 8.70 [SD = 1.36], 16 boys [73%]) and a control group of typical children (n = 47, M age = 8.90 [SD = 1.52], 34 boys [72%]). Measures included the strength subtest of the Bruininks–Oseretsky test of motor proficiency (BOT-2), the six minutes’ walk test (6MWT) with heart rate measure, BMI and the percentage of body fat. Significant differences between DCD and typical children were found on all variables of physical fitness and weight. A two-way analysis of variance (ANOVA) analysis (group/gender) also revealed significant interactions for the percentage of body fat (F = 8.51, p < .005) and BMI (F = 4.50, p < .038) meaning that less fit children are more obese. The current study supports previous findings that children with DCD are less physically fit and more overweight compared to typically developing children. Moreover, in comparing between the genders, the girls in the study sample weighed more and had a significantly higher percentage of body fat than boys, it is essential to further our understanding of the relationships between obesity, physical fitness and gender among children with and without DCD.     

Aggressive interactions during free-play at preschool of children with and without developmental coordination disorder

This aim of this study was to investigate an unexpected finding from a larger study examining the play of preschool children with and without developmental coordination disorder (DCD). We found that children with DCD were more frequently involved in aggressive incidents during free-play than their peers. Children with (n = 32) and without DCD (n = 31) were videotaped during free-play at preschool and their play was assessed using the Play Observation Scale. A post hoc analysis was conducted using a specifically developed rating instrument to examine the aggressive incidents captured on video. Videos from 18 children with DCD and 8 typically developing children without DCD were found to contain aggressive incidents. Children with DCD were significantly more often involved as both aggressor (p = .016) and victim (p = .008) than children without DCD (p = .031). This is the first study to identify victimization and aggression as being problematic for children with DCD as young as 4 years of age and needs replication. Given the negative consequences of involvement in aggression and victimization, play-based early intervention focusing on prevention needs to be developed and implemented.     

Psychometric properties of the French Version of the Social Responsiveness Scale in autism spectrum disorder with or without attention deficit hyperactivity disorder

ObjectivesThe Social Responsiveness Scale (SRS) is an instrument that is commonly used to screen for Autism Spectrum Disorder (ASD). Attention Deficit Hyperactive Disorder (ADHD) frequently occurs with ASD and both disorders share some phenotypic similarities. In the present study, we aimed to determine the psychometric properties of the French version of the Social Responsiveness Scale (SRS) and its 5 subscales (social awareness, social cognition, social communication, social motivation, and autistic mannerisms) to discriminate between children with ADHD and those with ASD (differential diagnosis) and children with ADHD from those with a dual diagnosis of ADHD and ASD (comorbid diagnosis).MethodSRS total scores and the 5 subscores of the SRS were compared between 4 groups of children: ADHD (n = 32), ASD + ADHD (n = 30), ASD (n = 31) and typical neurodevelopment (TD; n = 30) children. The discriminant validity was estimated using the Area Under the ROC Curves (AUC).ResultsSRS Social cognition (AUC = 0.73) and Autistic mannerisms (AUC = 0.70) subscores were the most discriminating for differential diagnosis of ASD and ADHD. SRS total scores (AUC = 0.70), and Social communication (AUC = 0.66) and Autistic mannerisms (AUC = 0.75) subscores were the most discriminating for comorbid diagnosis of ASD among ADHD children.ConclusionThe SRS autistic mannerisms subscore was found to be clinically relevant for both differential diagnosis of ASD and ADHD and comorbid diagnoses of ASD among ADHD children but with a modest discriminant power.     

Postural sway patterns in children with autism spectrum disorder compared with typically developing children

Postural control is a fundamental building block of each child's daily activities. The aim of this study was to compare patterns of postural sway in children with autism spectrum disorder (ASD) with typically developing children (TD). We recruited 21 schoolchildren diagnosed with ASD aged 9–14 and 30 TD pupils aged 8–15. Postural sway parameters in composite, anteroposterior and mediolateral axis were reported. Furthermore we examined the impact of age and characteristics of autism on postural sway. Children with ASD exhibited higher amount of sway in anteroposterior range (p < 0.001), mediolateral range (p = 0.002), root mean square (p = 0.001), mean velocity (p = 0.03), and sway area (p = 0.007) compared with their TD peers. Children with ASD showed higher instability in mediolateral than anteroposterior axis though TD children demonstrated higher sway scores in anteroposterior than mediolateral direction. The rate of autism symptom severity significantly affected the postural sway in children with ASD (p < 0.05). In conclusion, patterns of postural control seem to be different in children with ASD compared with TD counterparts. This could be partially due to clinical features were underlying in ASD.     

Influence of methylphenidate on motor performance and attention in children with developmental coordination disorder and attention deficit hyperactive disorder

Individuals with attention deficit hyperactive disorder (ADHD) often have coexisting developmental coordination disorder (DCD). The positive therapeutic effect of methylphenidate on ADHD symptoms is well documented, but its effects on motor coordination are less studied. We assessed the influence of methylphenidate on motor performance in children with comorbid DCD and ADHD. Participants were 30 children (24 boys) aged 5.10–12.7 years diagnosed with both DCD and ADHD. Conners’ Parent Rating Scale was used to reaffirm ADHD diagnosis and the Developmental Coordination Disorder Questionnaire was used to diagnose DCD. The Movement Assessment Battery for Children-2 and the online continuous performance test were administrated to all participants twice, with and without methylphenidate. The tests were administered on two separate days in a blind design. Motor performance and attention scores were significantly better with methylphenidate than without it (p < 0.001 for improvement in the Movement Assessment Battery for Children-2 and p < 0.006 for the online continuous performance test scores).The findings suggest that methylphenidate improves both attention and motor coordination in children with coexisting DCD and ADHD. More research is needed to disentangle the causality of the improvement effect and whether improvement in motor coordination is directly affected by methylphenidate or mediated by improvement in attention.     

Anthropometric measures of Spanish children with autism spectrum disorder

We aimed to compare body mass index (BMI) and healthy eating index (HEI) in children with autism spectrum disorder (ASD, n = 105) and typically developing (TD, n = 495) children. They were aged 6–9 years, lived in Valencia (Spain) and came from similar cultural and socio-economic backgrounds. In this case–control study, the weight, height and BMI were measured for both groups. Three-day food records were used to assess dietary intake. Although the differences between children with ASD and TD children in raw BMI (p = 0.44), BMI z-score (p = 0.37), HEI (p = 0.43) and total energy intake (p = 0.86) were not significant, children with ASD and the boys subgroup were shorter (p = 0.01), but not the girls subgroup, compared to TD children of the same gender. Using the controls values as a reference, the BMI distribution in children with ASD became distorted, with values below the 5th percentile (11% vs. 4%, p = 0.03) and above the 95th percentile (8% vs. 5%, p = 0.04). The gender- and age-adjusted odds ratios for being underweight in the groups of all children and boys with ASD were 3.03 and 2.39, respectively, vs. TD children. Our data suggest that routine monitoring of children with ASD should include anthropometric measurements and assessment of their dietary habits.     

Comparison of change detection performance and visual search patterns among children with/without ADHD: Evidence from eye movements

BackgroundADHD participants showed poorer change detection performance compared to participants without any diagnosis. The difficulty to detect changes in ADHD children might be due to their voluntary eye movement control and attentional deficits.AimsTo evaluate change detection performance and visual search patterns of children with ADHD and compare their performances with typically developing (TD) children.Methods and procedures48 children (n_ADHD = 24, n_TD = 24) participated (M_age = 8 years, 10 months). Flicker paradigm was used to evaluate change detection performance, while eye movements were recorded during the experiment.ResultsChange detection accuracies of TD children were higher compared to ADHD children. TD groups made longer fixations on the changed area and their first fixation duration was also longer than ADHD children which showed that TD children had longer fixation maintenance than ADHD children.ConclusionsThe change detection performance, which is associated with visual attention and memory, was found to be worse in ADHD children than TD children and these children made shorter fixations on the changed area than TD children. The findings were found to be in line with the difficulty to sustain attention in ADHD children that is necessary for encoding the scene properties and goal-oriented behavior.     

Objective measurement of weekly physical activity and sensory modulation problems in children with attention deficit hyperactivity disorder

This study aimed to objectively compare the daily physical activity (PA), as indicated by moderate-to-vigorous physical activity (MVPA) during a week and metabolic equivalents (METs) per minute, between children with attention deficit hyperactivity disorder (ADHD) and typically developing children. Moreover, sensory modulation problems were examined using behavioral and physiological measures. Twenty boys with ADHD (mean age 8.64 ± 2.57 years), and 20 matched typically developing boys (mean age 9.10 ± 1.79 years) participated in our study. Each child wore a PA monitor for 14 h a day, seven days a week. All participants’ parents were asked to fill out daily activity logs for their children. The problems of sensory modulation were detected using sensory profile (SP) questionnaires and Sensory Challenge Protocol that measured electrodermal response (EDR) to repeated sensory stimulation. Compared with the controls, the children with ADHD had a generally higher level of PA (1.48 ± 0.10 vs. 1.60 ± 0.12 METs/min; p = 001), and tended to spend more time in MVPA on weekdays (35.71%) and the weekend (57.14%). However, when analyzing hourly recorded PA, the group differences were obvious only for certain hours. Our data suggested that children with ADHD were more hyperactive in structure-free than structured settings. The ADHD group showed their sensory modulation problems on the SP but not on the EDR. We found some correlations between sensory modulation problems and hyperactivity in children with ADHD.     

Treating individuals with social anxiety disorder and at-risk drinking: Phasing in a brief alcohol intervention following paroxetine

Paroxetine alone is not sufficient to decrease alcohol use in socially anxious alcoholics seeking anxiety treatment. We tested the hypothesis that adding a brief-alcohol-intervention (BI) to paroxetine would decrease alcohol use. All subjects (N = 83) had a diagnosis of social anxiety disorder, endorsed drinking to cope with anxiety, were NIAAA-defined at-risk drinkers, and were randomized to either paroxetine alone, or paroxetine plus BI. Both groups showed significant improvement in both social anxiety severity (F(5,83) = 61.5, p < 0.0001) and drinking to cope (e.g. F(4,79) = 23, p < 0.0001) and these two constructs correlated with each other (B = 3.39, SE = 0.696, t(71) = 4.88, p < 0.001). BI was not effective at decreasing alcohol use (e.g. no main effect of group, all p values >0.3). Paroxetine decreased social anxiety severity in the face of heavy drinking and decreasing the anxiety was related to a concurrent decrease in coping related drinking. BI was not effective at decreasing drinking or drinking to cope.     

High risk for obesity in children with a subtype of developmental coordination disorder

The purpose of this study was to compare the prevalence of overweight and obesity in typically developing (TD) children, children with developmental coordination disorder (DCD) and balance problems (DCD-BP), and children with DCD without balance problems (DCD-NBP). Two thousand and fifty-seven children (1095 boys, 962 girls) ages 9–12 years were recruited from 18 elementary schools in Taiwan. The Movement Assessment Battery for Children was used to assess motor coordination ability. International cut-off points for body mass index were used to classify participants into the following groups: normal-weight, overweight or obese. Compared with TD children, children in the DCD-BP group were more than twice as likely to be obese (OR = 2.28; 95% CI = 1.41–3.68). DCD-BP children were also more likely to be obese compared to DCD-NBP children (OR = 1.79; 95% CI = 1.02–3.16). Boys in the DCD-BP group were more likely to be obese when compared to DCD-BP girls (OR = 3.12; 95% CI = 1.28–7.57). Similarly, DCD-NBP boys were more likely to be obese when compared to DCD-NBP girls (OR = 2.67; 95% CI = 1.21–5.89). Children with both DCD and BP were significantly more likely to be obese when compared to TD and DCD-NBP children. From an intervention perspective, the inclusion of regular physical activity, including activities that encourage development of both balance and energy expenditure, may be required to prevent obesity in this population.     

Language comprehension of children with Asperger's disorder and children with autistic disorder

This study investigated language comprehension of Mandarin-speaking children with Asperger's disorder (AspD) (n = 88) and children with autistic disorder (AD) (n = 136) and compared their language comprehension to that of children with typical development (TD) (n = 832). The Mandarin Token Test was used in this study. This study found that (a) when IQ was not controlled, children with AspD showed higher language comprehension than did children with AD. But, when IQ was controlled, there was no significant difference between the two groups; (b) children with AspD did not differ from children with TD in language comprehension; (c) gender difference was found in the AspD group at the middle childhood age level (10–12 years).     

Association of dopamine gene variants,emotion dysregulation and ADHD in autism spectrum disorder

The aim of the present study was to evaluate the association of dopaminergic gene variants with emotion dysregulation (EMD) and attention-deficit/hyperactivity disorder (ADHD) symptoms in children with autism spectrum disorder (ASD). Three dopamine transporter gene (SLC6A3/DAT1) polymorphisms (intron8 5/6 VNTR, 3′-UTR 9/10 VNTR, rs27072 in the 3′-UTR) and one dopamine D2 receptor gene (DRD2) variant (rs2283265) were selected for genotyping based on à priori evidence of regulatory activity or, in the case of DAT1 9/10 VNTR, commonly reported associations with ADHD. A sample of 110 children with ASD was assessed with a rigorously validated DSM-IV-referenced rating scale. Global EMD severity (parents’ ratings) was associated with DAT1 intron8 (ηp² = .063) and rs2283265 (ηp² = .044). Findings for DAT1 intron8 were also significant for two EMD subscales, generalized anxiety (ηp² = .065) and depression (ηp² = .059), and for DRD2 rs2283265, depression (ηp² = .053). DRD2 rs2283265 was associated with teachers’ global ratings of ADHD (ηp² = .052). DAT1 intron8 was associated with parent-rated hyperactivity (ηp² = .045) and both DAT1 9/10 VNTR (ηp² = .105) and DRD2 rs2283265 (ηp² = .069) were associated with teacher-rated inattention. These findings suggest that dopaminergic gene polymorphisms may modulate EMD and ADHD symptoms in children with ASD but require replication with larger independent samples.     

Impact of tactile function on upper limb motor function in children with Developmental Coordination Disorder

This study investigated the presence of, and relationship between tactile dysfunction and upper limb motor function in children with Developmental Coordination Disorder (DCD) compared to typical developing (TD) children. Participants were 36 children aged 6–12 years. Presence of DCD (n = 20) or TD (n = 16) was confirmed using the Movement Assessment Battery for Children, second edition. All children participated in a comprehensive assessment of tactile registration (Semmes Weinstein Monofilaments); tactile spatial perception (Single Point Localisation (SPL) and two-point discrimination (2PD)); haptic perception (Stereognosis); speed of simple everyday manual tasks (Jebsen–Taylor Test of Hand Function (JTTHF)); and handwriting speed and accuracy (Evaluation Tool of Children's Handwriting (ETCH)). Compared to TD children, children with DCD demonstrated poorer localisation of touch in the non-dominant hand (p = 0.04), slower speed of alphabet writing (p < 0.05) and less legible handwriting (p < 0.01), but no difference in speed of simple everyday manual tasks (JTTHF: p > 0.05). Regression analysis showed that spatial tactile perception (SPL) predicted handwriting legibility (ETCH: r = 0.11) and speed of functional tasks (JTTHF: r = 0.33). These results suggest that tactile function, specifically single point localisation, should be a primary tactile assessment employed to determine reasons for upper limb motor difficulties experienced by children with DCD.     

Inattention and hyperactivity in association with autism spectrum disorders in the CHARGE study

BackgroundAttention deficits in young children with autism spectrum disorder (ASD) are not well understood. This study sought to determine: 1) the prevalence of ADHD symptoms in young children with ASD, typical development (TD), and developmental delay (DD) and 2) the association between ADHD symptoms and cognitive and behavioral functioning in children with ASD.MethodADHD symptoms, defined according to Aberrant Behavior Checklist (ABC) hyperactivity subscale scores, were compared across children aged 2–5 from a large case-control study with ASD (n = 548), TD (n = 423), and DD (n = 180). Inattention and hyperactivity items within this subscale were also explored. Within the ASD group, linear and logistic regression were used to examine how ADHD symptoms were associated with cognition as assessed by the Mullen Scales of Early Learning and adaptive functioning as assessed by the Vineland Adaptive Behavior Scales.ResultsMean hyperactivity subscale scores were lowest in children with TD (mean = 3.19), higher in children with DD (12.3), and highest in children with ASD (18.2; between-group p < 0.001). Among children with ASD, significant associations were observed with higher ADHD symptoms and poorer adaptive and cognitive functioning (adjusted beta for hyperactivity score in association with: Vineland composite = −5.63, p = 0.0005; Mullen visual reception scale = −2.94, p = 0.02; for the highest vs. lowest quartile of hyperactivity score, odds of lowest quintile of these scores was approximately doubled). Exploratory analyses highlighted associations with inattention-related items specifically.ConclusionThese results suggest ADHD symptoms may play a key role in the functioning of young children with ASD.     

Catechol-O-methyltransferase Val158Met polymorphism and hyperactivity symptoms in Egyptian children with autism spectrum disorder

Catechol-O-methyltransferase (COMT) plays an important role in the catabolism of brain dopamine and norepinephrine, which have been implicated in the pathogenesis of Autism spectrum disorder (ASD) as well as in other neuropsychatric disorders. We aimed to investigate the association of COMT Val158Met gene polymorphism with ASD and to examine the influence of such genotypes on hyperactivity symptoms in ASD patients. Eighty ASD patients (mean age 9 ± 1.9 years) and 100 control children (mean age 8.9 ± 1.9 years) were examined. COMT Val58Met polymorphism was genotyped using Tetra-primer ARMS-PCR method. The clinical diagnosis of ASD and ADHD were confirmed according to the DSM-IV criteria for research. We found no significant difference in genotypes or alleles’ frequencies of COMT Val158Met polymorphism between ASD patients and control group. There was a significant association between COMT (Val/Val) genotype and both increasing CARS (p = 0.001) and hyperactivity scores (p = 0.006). Regarding Conner's Score, the DSM-IV hyperactive impulsive were significantly higher in Val/Val genotype than both Met/Val and Met/Met genotypes (p = 0.03). Our data suggested an association between COMT Val58Met polymorphism and hyperactivity symptoms in Egyptian children with ASD.     

Stress in mothers of children with autism: Trait mindfulness as a protective factor

Mindfulness-based interventions may reduce parents’ stress and improve parent–child relationships. Given the chronic nature of autism spectrum disorder (ASD) and its influence on parents’ stress, interventions to promote mindfulness may be especially helpful for parents of children with ASD. Prior to undertaking intervention development, it is first necessary to establish the relationship between mindfulness and stress, as other factors like child behavioral difficulties may overshadow the mother's regulation strategies. In a sample of mothers of children with ASD (n = 67) and a comparison sample of mothers without ASD (n = 87), mindfulness was significantly associated with the level of maternal stress above and beyond child behavior problems (non-ASD: β = −.232; F(1, 64) = 15.749, p < .000; ASD: β = −.206; F(1, 84) = 15.576, p < .000). Results suggest that interventions to promote mindfulness may be helpful in reducing parenting stress among mothers of children with ASD, as well as mothers of typically developing children. Due to the chronic nature of ASD, such interventions may be particularly applicable.     

Evaluating physical activity using accelerometry in children at risk of developmental coordination disorder in the presence of attention deficit hyperactivity disorder

Physical activity (PA) is compromised in children and adolescents with developmental coordination disorder (DCD). Approximately half of all children with DCD suffer from attention-deficit hyperactive disorder (ADHD); a cohort often considered more physically active than typically developing youth. Accelerometry is an effective method of assessing physical activity patterns; although estimates of PA in children with DCD using this quantifiable method have not been attempted. We hypothesize that children with co-morbid DCD/ADHD will be more physically active than children with DCD and healthy peers. Therefore, the purpose of this study was to contrast physical activity (step count and activity energy expenditure using accelerometry [AEE]) between children with DCD, co-morbid DCD and ADHD (DCD/ADHD), and healthy controls. A sample of 110 children with DCD (N = 32), DCD/ADHD (N = 30) and controls (N = 48) age 12-13 years agreed to participate. Co-morbid DCD/ADHD was present in nearly half of the children with DCD (48.4%). Analysis of covariance demonstrated a positive interaction for females step count (F[1,92] = 4.92, p = 0.009). A significant group difference for step count (F[1,92] = 4.43, p = .04) was identified in females. Post hoc comparison tests identified significantly lower step count between males with DCD and controls (p = .004) and males with DCD/ADHD and controls (p = 0.003). Conversely, females with DCD/ADHD had significantly more step counts than their controls (p = .01). Hyperactivity in females with DCD/ADHD appears to contribute to more physical activity, whereas DCD may contribute to decreased activity in males with DCD and DCD/ADHD. Hyperactivity expressed among girls with DCD/ADHD appears to override the hypoactive behavior associated with females with DCD. Conversely, the expression of hyperactivity among boys with DCD/ADHD does not translate as hypothesized. The contrasting expression of physical activity (i.e., step count and AEE) evaluated using accelerometry in boys and girls with DCD, co-morbid DCD/ADHD and healthy peers are intriguing and constitute further investigation in a larger investigation.