השלכות של לקות וסטיבולרית אצל ילדים עם הפרעות התפתחותיות: היבטים מוטוריים, רגשיים וקוגניטיביים

Abstract

Background: Children with Attention Deficit Hyperactivity Disorder (ADHD) present a heterogeneous sensorimotor, emotional, and cognitive profile. Dysfunctions of balance control, anxiety, and spatial orientation are particularly prevalent among their non-core symptoms. All three functions are affected by vestibular input and deteriorate in patients with vestibular dysfunction.

Objective: To test vestibular function in children with ADHD and evaluate the comorbid profile of low balance performance, high anxiety level, and spatial dysfunction in children with vestibular dysfunction.

Methods: The study included children with ADHD-only (n=28), ADHD + Developmental Coordination Disorder (ADHD+DCD; n=38), and Typical Development (TD; n=19). Vestibular function was evaluated by the Dynamic Visual Acuity (DVA) test, balance by BOT-2 test, panic anxiety by the SCARED questionnaire, and spatial navigation by the Triangular Completion (TC) task.

Results: About 65% of children with ADHD had vestibular dysfunction. A subgroup of children with ADHD demonstrated balance, anxiety, and spatial dysfunctions, which correlated significantly with vestibular dysfunction. Cluster analysis revealed a co-occurrence of the three dysfunctions. This subgroup showed a lower vestibular function. Structural Equation Modeling analysis supported the hypothesis that vestibular dysfunction is a causative factor of the comorbid low balance performance, elevated panic anxiety, and spatial dysfunction.

Conclusions: A subgroup of children with ADHD demonstrated vestibular dysfunction, likely the origin of the comorbid disorder of low balance performance, elevated panic anxiety, and spatial dysfunction. This subgroup presents a V-BAS disorder: Vestibular - Balance, Anxiety, and Spatial disorder.