A meta-analysis of the effectiveness of music interventions for children and adolescents with attention-deficit/hyperactivity disorder.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobehavioral disorder characterized by overactivity and impulsiveness beyond what is considered typical development. ADHD affects 3% to 10% of school-age children in the United States, with males being three to five times more likely to have an ADHD diagnosis compared with females (DuPaul, 2007). It is estimated that every teacher in the United States has at least one child with ADHD in his or her classroom, and four million school-age children are affected with the disorder (Dang, Warrington, Tung, Baker, & Pan, 2007). The symptoms of ADHD can affect all aspects of a child's life, especially school performance. Early recognition, assessment, diagnosis, and treatment of ADHD are important to minimize the impact of ADHD on the individual's social development, including school performance, interactions, and self-esteem. Clinicians generally find that parents of children with ADHD describe how their children prefer the use of external stimulation, such as the TV or stereo, while completing homework tasks, and parents express concern that the use of external stimulation hinders the academic performance of their children (Abikoff, Courtney, Szeibel, & Koplewicz, 1996). However, studies have found that external stimulation may have a positive impact on academic performance for children with ADHD (Abikoff et al., 1996; Chew, 2010; Greenop & Kann, 2007; Pelham et al., 2011; Pratt, Abel, & Skidmore, 1995).A landmark study by Zentall (1975) discussed the optimal stimulation theory with regard to ADHD. Using this theory, Zentall found that children with ADHD demonstrated high levels of activity when they encounter a task or situation of low arousal or stimulation. Additionally, Zentall described how certain situations require more environmental stimulation than others in order to support effective performance. However, children with ADHD have an even higher threshold for such environmental stimulation. Therefore, children with ADHD typically display hyperactive behavior when levels of stimulation are low, and this leads to low task performance (Greenop & Kann, 2007; Zentall, 1993). According to the optimal stimulation theory, the distractibility of those with ADHD is a functional attempt to control under arousal from low levels of stimulation, by seeking increased levels of stimulation (Abikoff et al., 1996). Thus, performance levels of these children will increase rather than decrease with external stimulation.Studies addressing school performance have found that children with ADHD have difficulty sustaining attention during academic tasks, and as the academic tasks continue, the performance level of children with ADHD drops (Wu, Anderson, & Castiello, 2002; Zentall, 1993). A few studies have focused on the effects of external stimulation, specifically music, and its impact on task performance for children with ADHD; however, the current research on this topic is limited. Greenop and Kann (2007) replicated previous studies of Zentall (1993). They compared children with and without ADHD on an academic task-mathematics problems- during two counterbalanced conditions of stimulation: with or without music. They believed that performance on academic tasks depended on the level of arousal created by the task as well as the quality of the distractor. Performance was measured as the number of problems correct, the number of problems attempted, and an accuracy score. The accuracy score on the mathematics problems increased significantly during the music condition for both children with ADHD and those without ADHD.Another study was conducted with boys, in elementary school, with and without ADHD to determine the effects of auditory stimulation on their arithmetic performance (Abikoff et al., 1996). The rationale was that stimulation would help children with ADHD stay on task. The participants worked on an arithmetic task during three different auditory conditions: a high stimulation condition in which music was presented, a low stimulation condition in which speech was taking place, and a no stimulation condition of silence. …