Table 5.
Recommendations for future research aimed at investigating handwriting skills in ADHD populations.
| Recommendations | Level of Importance |
|---|---|
| Eligible Population | |
| Ensure a reasonable sample size necessary to conduct the study. | High |
| Verify the diagnosis of ADHD with a formal diagnosis following DSM-5 indications and the use of gold-standard tools. | High |
| Verify the diagnosis of HD using standardized, valid and reliable tools. | High |
| Harmonize the comparator group(s) with previous studies to facilitate comparison: | |
| ADHD only; | High |
| HD only; | High |
| Typical. | High |
| Harmonize the reference group with previous studies to facilitate comparison: | |
| ADHD + HD. | High |
| Ensure children acceptability (motivation to study participation). | Low |
| Subgroup Analysis | |
| Consider demographic characteristics: | |
| Age; | High |
| Gender; | High |
| Handless; | Low |
| IQ. | High |
| Socioeconomic factors. | Low |
| Ethnicity. | Low |
| Cultural background. | Low |
| Include documentation of ADHD subtypes. | High |
| Screen for comorbid emotional or behavioral conditions (e.g., anxiety, depression, sleep disturbance). | High |
| Screen for comorbid neurodevelopmental conditions (e.g., learning and language disorders, autism spectrum disorders).s | High |
| Screen for comorbid physical conditions (e.g., tics). | Low |
| Treatment and Care | |
| Considered ADHD specific treatments. | |
| Methylphenidate. | High |
| Other medication. | Low |
| Behavioral interventions for treatment of ADHD or comorbidities. | High |
| Motor behavioral interventions (psychomotricity). | High |
| Expert Panel | |
| Harmonize measurement of key handwriting elements to facilitate pooling of and comparisons between study findings. | High |
| Use common outcome measures to facilitate pooling of and comparisons between study findings. | High |
| Supervise the experimental handwriting testing without knowing the child’s group (blind test). | Low |
| Assess the handwriting performance without knowing the child’s group (blind evaluation). | High |
| Assess the handwriting performance by an expert panel of experiment judges (two or more). | High |
| Theoretical Considerations | |
| Discuss clinical findings with more fundamental work addressing the theoretical models of handwriting applied to the specific context of ADHD. | High |