SynthesisClinical psychology review2016
Is hyperactivity ubiquitous in ADHD or dependent on environmental demands? Evidence from meta-analysis.
Synthesis in Clinical psychology review, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Are Reading Interventions Effective for At-Risk Readers with ADHD? A Meta-Analysis.Journal of attention disorders · 2023Pooled it
- A Comparison of Virtual Reality Classroom Continuous Performance Tests to Traditional Continuous Performance Tests in Delineating ADHD: a Meta-Analysis.Neuropsychology review · 2019Pooled it
- Central executive training for ADHD: Impact on organizational skills at home and school. A randomized controlled trial.Neuropsychology · 2023Trial
- Comparison of Fidgeting in Adolescents with Attention-Deficit/Hyperactivity Disorder Between Before and After Stimulant Medication Intake.Journal of child and adolescent psychopharmacology · 2023Trial
- A randomized controlled trial of central executive training (CET) versus inhibitory control training (ICT) for ADHD.Journal of consulting and clinical psychology · 2020Trial
- Attention-Deficit/Hyperactivity Disorder-Related Deficits and Psychostimulant Medication Effects on Comprehension of Audiovisually Presented Educational Material in Children.Journal of child and adolescent psychopharmacology · 2018Trial
- Neurocognitive and behavioral predictors of the simple view of reading in clinically evaluated children with and without ADHD.Neuropsychology · 2026Article
- Comparing Real and Virtual Nature Exposure on Cognition, Well-Being, and Brain Activity in Adults With and Without Attention-Deficit/Hyperactivity Disorder: Protocol for a Randomized Experimental Study.JMIR research protocols · 2026Article
- Wearable Signals for Diagnosing Attention-Deficit/Hyperactivity Disorder in Adolescents: A Feasibility Study.JAACAP open · 2025Article
- Attention Deficit Hyperactivity Disorder and other neurodevelopmental traits are associated with impact on functioning among children in the general population.JCPP advances · 2025Article
- Academic Achievement in Children with ADHD: the Role of Processing Speed and Working Memory.Research on child and adolescent psychopathology · 2025Article
- Reconfiguration of Functional Brain Network Organization and Dynamics With Changing Cognitive Demands in Children With Attention-Deficit/Hyperactivity Disorder.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2025Article
- Ecological Validity of Clinic-Based Actigraphy for Assessing Hyperactivity in Clinically Evaluated Children with and without ADHD.Journal of psychopathology and behavioral assessment · 2025Article
- Hyperactive-impulsive behavior does not moderate the association between executive function and physical activity in preschoolers.Scientific reports · 2025Observational
- The utility of multiple assessments in infancy and toddlerhood to predict middle childhood ADHD symptoms: Temperamental, behavioral, and genetic contributions.Infant behavior & development · 2025Article
- A mathematical framework for modelling the dynamic nature of ADHD symptoms.Frontiers in psychiatry · 2025Article
- Is hyperactivity in children with attention deficit/hyperactivity disorder (ADHD) a functional response to demands on specific executive functions or cognitive demands in general?Neuropsychology · 2024Article
- Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder.Nature reviews. Psychology · 2024Article
- The Impact of Stimulant Medication on the Relation Between Working Memory and Activity Level in ADHD.Research on child and adolescent psychopathology · 2024Article
- Data-driven profiles of attention-deficit/hyperactivity disorder using objective and ecological measures of attention, distractibility, and hyperactivity.European child & adolescent psychiatry · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
Hyperactivity, or excess gross motor activity, is considered a core and ubiquitous characteristic of ADHD. Alternate models question this premise, and propose that hyperactive behavior reflects, to a large extent, purposeful behavior to cope with environmental demands that interact with underlying neurobiological vulnerabilities. The present review critically evaluates the ubiquity and environmental modifiability of hyperactivity in ADHD through meta-analysis of 63 studies of mechanically measured activity level in children, adolescents, and adults with ADHD relative to typically developing groups. Random effects models corrected for publication bias confirmed elevated gross motor activity in ADHD (d=0.86); surprisingly, neither participant age (child vs. adult) nor the proportion of each ADHD sample diagnosed with the inattentive subtype/presentation moderated this effect. In contrast, activity level assessed during high cognitive load conditions in general (d=1.14) and high executive functioning demands in particular (d=1.39) revealed significantly higher effect sizes than activity level during low cognitive load (d=0.36) and in-class schoolwork (d=0.50) settings. Low stimulation environments, more rigorous diagnostic practices, actigraph measurement of movement frequency and intensity, and ADHD samples that included fewer females were also associated with larger effects. Overall, the results are inconsistent with DSM-5 and ADHD models that a) describe hyperactivity as ubiquitous behavior, b) predict a developmental decline in hyperactivity, or c) differentiate subtypes/presentations according to perceived differences in hyperactive behavior. Instead, results suggest that the presence and magnitude of hyperactive behavior in ADHD may be influenced to a considerable extent by environmental factors in general, and cognitive/executive functioning demands in particular.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.