ADHD in Children: Occupational Therapy, Physical Therapy, and Speech-Language Pathology

Written by: Dr. C., M.S., D.OT, OTR/L, Reviewed: May, 2026 – 14 min read

7.6%

Of children ages 3 to 12 have ADHD globally

2x

Boys are twice as likely to be diagnosed

3 Types

Inattentive, Hyperactive-Impulsive, and Combined

OT + SLP

Both play primary roles in ADHD intervention

Exercise

Evidence-based treatment for ADHD symptoms

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Key Takeaways

  • ADHD is one of the most prevalent neurodevelopmental disorders in children, affecting approximately 7.6% of children aged 3 to 12 years globally — with boys diagnosed at twice the rate of girls (Ayano et al., 2023; Popit et al., 2024)
  • ADHD affects not only attention and behavior but also motor coordination, handwriting, executive function, sensory processing, social communication, and daily living independence — creating a wide range of occupational and functional challenges (Kleeren et al., 2023; Huang et al., 2024)
  • Occupational therapy addresses the real-world functional impact of ADHD on self-care, school performance, organization, play, handwriting, and sensory regulation — and is a core component of multidisciplinary ADHD management
  • Physical activity is one of the most robustly supported nonpharmacological interventions for ADHD, with multiple systematic reviews and meta-analyses confirming significant improvements in attention, executive function, working memory, and inhibitory control (Zheng et al., 2025; Li et al., 2023; Zhu et al., 2023)
  • Speech-language pathology addresses the executive function, language processing, and social communication difficulties that frequently accompany ADHD and significantly affect learning, peer relationships, and academic participation (Senter et al., 2023)
  • Children with ADHD have significantly higher rates of motor coordination difficulties than typically developing peers, affecting handwriting, sports participation, and self-care — and motor-based interventions produce meaningful improvements in motor skill performance (Kleeren et al., 2023)
  • Sensory processing difficulties are highly prevalent in ADHD and closely associated with executive function deficits, OT-delivered sensory and regulatory interventions address these overlapping needs (Huang et al., 2024)

Important

The information on this page is educational only and is not a substitute for professional evaluation or individualized treatment. ADHD is a complex neurodevelopmental condition that requires assessment by a qualified clinician. Please consult your child’s physician, psychologist, and therapy team for guidance specific to your child’s needs.

Table of Contents

  1. What Is ADHD?
  2. Types and Presentations of ADHD
  3. How ADHD Affects Daily Function and Learning
  4. Who Provides Support for Children with ADHD?
  5. Occupational Therapy for ADHD
  6. Physical Activity and Physical Therapy in ADHD
  7. Speech-Language Pathology for ADHD
  8. Exercise and ADHD: What the Evidence Shows
  9. ADHD in the School Setting
  10. What Parents and Families Can Do
  11. A Note for Clinicians
  12. References

1. What Is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that are more frequent and severe than typically observed in children at a comparable developmental level, and that interfere significantly with functioning and development across multiple settings (Ayano et al., 2023).

ADHD is one of the most prevalent childhood neurodevelopmental disorders worldwide. A comprehensive umbrella review of global meta-analyses found that approximately 7.6% of children aged 3 to 12 years meet diagnostic criteria for ADHD, with boys diagnosed at approximately twice the rate of girls (Ayano et al., 2023). A large systematic review and meta-analysis confirmed ADHD prevalence estimates ranging from 5% to 7% of children and adolescents globally, with variability attributable to differences in diagnostic criteria, methodology, and population characteristics (Popit et al., 2024).

ADHD is not a disorder of attention alone. It reflects underlying differences in executive function, self-regulation, motor control, sensory processing, and neurological development that affect virtually every area of a child’s daily life — from getting dressed in the morning and completing schoolwork to making friends and participating in family routines (Huang et al., 2024; Kleeren et al., 2023).

For Parents & Families

  • ADHD is a real neurodevelopmental condition with a strong neurological and genetic basis — it is not caused by poor parenting, too much screen time, or lack of discipline (Ayano et al., 2023)
  • ADHD looks different in every child. Some children are primarily inattentive and quiet, while others are more hyperactive and impulsive. Many children have a combination of both (Popit et al., 2024)
  • Children with ADHD are not choosing to be difficult — their brains are wired differently, and they need strategies and support rather than consequences alone
  • Early, coordinated support from OT, SLP, and other professionals alongside medical management produces the best long-term outcomes for children with ADHD

2. Types and Presentations of ADHD

ADHD is classified according to the DSM-5 into three presentations, reflecting the predominant symptom profile (Popit et al., 2024).

  • Predominantly Inattentive Presentation: Characterized by significant difficulties sustaining attention, following through on tasks, organizing activities, and avoiding distraction. Children with this presentation are often described as dreamy, forgetful, or disorganized. This presentation is more common in girls and is frequently underdiagnosed (Popit et al., 2024)
  • Predominantly Hyperactive-Impulsive Presentation: Characterized by excessive motor activity, difficulty remaining seated, talking excessively, and acting without thinking. This presentation is most noticeable in younger children and tends to be identified earlier (Ayano et al., 2023)
  • Combined Presentation: The most common presentation, in which significant symptoms of both inattention and hyperactivity-impulsivity are present. Children with combined ADHD typically experience the broadest range of functional difficulties (Ayano et al., 2023)

ADHD and Co-occurring Conditions

ADHD rarely occurs in isolation. The majority of children with ADHD have at least one co-occurring condition, including developmental coordination disorder (DCD), language disorder, anxiety, learning disabilities, autism spectrum disorder, or sensory processing difficulties. Co-occurring conditions significantly influence the child’s functional profile and should be assessed and addressed as part of a comprehensive evaluation (Kleeren et al., 2023; Huang et al., 2024).

3. How ADHD Affects Daily Function and Learning

The impact of ADHD extends far beyond the classroom. ADHD affects virtually every area of a child’s daily occupational performance, including self-care, play, social participation, school, and family routines (Kleeren et al., 2023; Huang et al., 2024).

Executive function difficulties:

  • Planning and organizing tasks, activities, and materials, affecting homeworkA young girl falls asleep on a desk surrounded by open books, illustrating study fatigue. completion, morning routines, and preparing for school (Senter et al., 2023)
  • Working memory — difficulty holding information in mind while completing tasks, following multi-step instructions, or tracking the thread of a conversation (Cheng et al., 2025)
  • Inhibitory control — difficulty stopping impulsive actions, waiting turns, and thinking before acting (Wang et al., 2023)
  • Time management — poor awareness of time passing, frequently late, underestimating how long tasks take
  • Emotional regulation — difficulty managing frustration, disappointment, and transitions between activities

Motor and sensory difficulties:

  • Motor coordination difficulties — affecting handwriting, sports, self-care tasks such as buttoning and tying shoes, and fine motor precision (Kleeren et al., 2023)
  • Handwriting difficulties — including dysgraphia, slow and effortful writing, and illegible output that does not reflect the child’s actual knowledge (Kleeren et al., 2023)
  • Sensory processing differences — including sensory seeking or sensory avoidance behaviors that affect attention, regulation, and participation in daily activities (Huang et al., 2024)

Communication and social difficulties:

  • Pragmatic language difficulties — including trouble taking conversational turns, staying on topic, reading social cues, and understanding implicit communication (Senter et al., 2023)
  • Listening comprehension — difficulty processing and retaining verbal instructions, particularly in noisy or complex classroom environments (Senter et al., 2023)
  • Peer relationships — impulsivity and social communication difficulties significantly affect the ability to make and maintain friendships (Senter et al., 2023)

For Parents & Families

  • If your child’s handwriting is significantly behind peers, seems effortful, or causes distress, ask for an OT evaluation. Handwriting difficulties in ADHD are extremely common and highly responsive to occupational therapy (Kleeren et al., 2023)
  • Morning routines, homework time, and transitions are typically the hardest parts of the day for children with ADHD. OT can help you build practical routines and visual supports that make these times calmer and more successful
  • If your child frequently seems “not to listen,” has difficulty following classroom instructions, or struggles to find words in conversation, an SLP evaluation may identify language processing or social communication differences that can be effectively addressed (Senter et al., 2023)
  • Sensory seeking behaviors — such as constant movement, touching everything, or difficulty settling — are common in ADHD and can be addressed with OT sensory strategies (Huang et al., 2024)

4. Who Provides Support for Children with ADHD?

ADHD is best managed through a coordinated, multidisciplinary approach that combines medical management with therapeutic and educational support tailored to the child’s individual profile.

  • Occupational therapy (OT): Executive function strategies, sensory regulation, fine motor skills, handwriting, self-care, daily routine building, and school participation (Kleeren et al., 2023; Huang et al., 2024)
  • Speech-language pathology (SLP): Language processing, social communication, pragmatic language, listening comprehension, and executive function strategies for communication (Senter et al., 2023)
  • Physical therapy (PT): Gross motor skills, coordination, body awareness, and structured physical activity programs for children with motor difficulties alongside ADHD (Kleeren et al., 2023)
  • Pediatrician or child psychiatrist: Medical diagnosis, medication management, monitoring of treatment response, and coordination of care
  • Psychologist: Formal ADHD assessment, cognitive behavioral therapy, parent training programs, and emotional regulation support
  • Educational team: Classroom accommodations, individualized education programs (IEPs) or 504 plans, and academic support strategies
  • Parents and caregivers: Consistent implementation of strategies across home and school environments — parent involvement is one of the strongest predictors of outcomes in ADHD intervention

For Clinicians

  • ADHD rarely presents without co-occurring difficulties. Motor coordination problems, language disorders, sensory processing differences, and anxiety are highly prevalent in ADHD populations and significantly influence functional outcomes (Kleeren et al., 2023; Huang et al., 2024). Comprehensive assessment should include OT and SLP evaluation alongside medical and psychological assessment.
  • Physical activity is supported by multiple Level 1 meta-analyses as a nonpharmacological intervention that significantly improves core ADHD symptoms including attention, working memory, and inhibitory control. Physical activity should be recommended as a standard component of ADHD management, not an optional lifestyle suggestion (Zheng et al., 2025; Zhu et al., 2023).

5. Occupational Therapy for ADHD

Occupational therapy addresses the impact of ADHD on a child’s ability to participate meaningfully in the activities and roles that define their daily life, at home, at school, and in the community. OT is one of the most broadly relevant therapeutic disciplines for children with ADHD, given the pervasive impact of executive function, motor, and sensory difficulties on occupational performance (Kleeren et al., 2023; Huang et al., 2024).

Key areas of OT intervention for children with ADHD include:

  • Executive function strategies: OT teaches practical strategies for planning, organizing, prioritizing, and managing time, including visual schedules, checklists, timers, workspace organization systems, and task breakdown techniques that reduce the executive demands of daily routines (Senter et al., 2023)
  • Handwriting and fine motor skills: Handwriting difficulties are among the most common reasons for OT referral in ADHD. OT assesses and addresses pencil grip, letter formation, sizing, spacing, speed, and written output through targeted fine motor programs and, where appropriate, keyboarding as an alternative (Kleeren et al., 2023)
  • Sensory regulation: OT evaluates sensory processing differences and develops individualized sensory diets, structured programs of sensory input that help the child maintain an optimal level of alertness and regulation for learning and participation. This may include movement breaks, fidget tools, seating modifications, and environmental adjustments (Huang et al., 2024)
  • Self-care and daily routines: OT helps children develop independence in dressing, grooming, and personal organization through habit training, visual supports, and environmental modifications that reduce the executive demands of morning and evening routines
  • Attention and task completion: OT develops individualized strategies to support sustained attention during schoolwork and homework, including work station organization, distraction reduction, and structured break schedules
  • Social participation and play: OT supports participation in peer play, group activities, and school social contexts by building the motor, organizational, and regulatory skills that underpin successful social engagement
  • Motor coordination: A systematic review and meta-analysis confirmed that motor-based interventions produce significant improvements in motor skill performance in children with ADHD, addressing the coordination difficulties that affect sports, physical education, and self-care tasks including cutting, tying shoes, and buttoning (Kleeren et al., 2023)
  • Parent and teacher coaching: OT provides practical strategies for parents and teachers to support executive function, sensory regulation, and task completion in home and classroom environments

For Parents & Families

  • OT for ADHD is not just about handwriting. It addresses everything from morning routines and homework organization to sensory regulation, self-care independence, and social participation
  • A visual schedule from your OT can transform a chaotic morning routine into a predictable, manageable sequence — reducing conflict and building independence at the same time
  • Sensory strategies from OT — such as movement breaks before homework, a wobble cushion at the desk, or a fidget tool — can make a significant difference to your child’s ability to focus and regulate (Huang et al., 2024)
  • Motor coordination difficulties in ADHD are highly responsive to intervention. A motor-based OT program can improve your child’s confidence in handwriting, sports, and physical activities (Kleeren et al., 2023)

For Clinicians

  • A 2023 systematic review and meta-analysis of motor-based interventions for children with ADHD confirmed that structured motor programs produce significant improvements in motor skill performance — with effect sizes comparable to those seen in typically developing children receiving motor intervention (Kleeren et al., 2023). OT referral for motor and coordination difficulties should be standard in ADHD management.
  • Sensory processing differences and executive function deficits are closely associated in children with ADHD, with atypical sensory processing independently predicting executive function outcomes (Huang et al., 2024). OT assessment of sensory processing should be part of the comprehensive ADHD evaluation, particularly when self-regulation difficulties are prominent.
  • Handwriting difficulties in ADHD frequently go unaddressed in clinical settings, despite significant impact on academic performance and self-esteem. Routine referral to OT for handwriting assessment in school-age children with ADHD is warranted (Kleeren et al., 2023).

6. Physical Activity and Physical Therapy in ADHD

Physical activity is among the most evidence-supported nonpharmacological interventions for ADHD, with consistent evidence across multiple high-quality systematic reviews and meta-analyses demonstrating significant improvements in core ADHD symptoms, executive function, and motor performance (Zheng et al., 2025; Li et al., 2023; Zhu et al., 2023; Wang et al., 2023; Cheng et al., 2025).

Physical therapy is directly relevant for children with ADHD who have co-occurring motor coordination difficulties, a group that represents a significant proportion of the ADHD population. A 2023 systematic review and meta-analysis confirmed that motor-based interventions significantly improve motor skill performance in children with ADHD, with both task-oriented and process-oriented approaches producing meaningful gains (Kleeren et al., 2023).

Key areas of PT and physical activity intervention in ADHD include:

  • Gross motor skill development: PT addresses the running, jumping, catching, throwing, and balance difficulties that affect physical education participation, sports, and playground activities in children with ADHD and co-occurring DCD (Kleeren et al., 2023)
  • Structured aerobic exercise programs: Aerobic exercise produces the strongest improvements in ADHD symptoms and executive function. A 2025 systematic review and meta-analysis confirmed significant improvements in ADHD symptoms, social impairment, and dropout rates from physical activity interventions (Zheng et al., 2025)
  • Motor coordination intervention: Task-oriented approaches including neuromotor task training and Cognitive Orientation to daily Occupational Performance (CO-OP) address the motor difficulties that affect participation across all daily activities (Kleeren et al., 2023)Four diverse children practicing yoga indoors, promoting fun and exercise in a learning environment.
  • Body awareness and proprioception: PT addresses the body awareness and spatial orientation difficulties that contribute to clumsiness, falls, and difficulty with sports in children with ADHD
  • Coordination and balance training: Targeting the balance and bilateral coordination difficulties that affect physical education and self-care activities including bike riding and stair navigation

For Parents & Families

  • Exercise is one of the best things you can do for a child with ADHD. Even 20 to 30 minutes of aerobic activity before school or homework can significantly improve attention and impulse control for the hours that follow (Zheng et al., 2025)
  • Structured activities such as martial arts, swimming, gymnastics, and dance are particularly beneficial because they combine physical activity with attention, sequencing, and self-regulation demands
  • If your child is noticeably clumsier than peers, avoids physical activities, or struggles with sports and physical education, ask for a motor coordination assessment from OT or PT (Kleeren et al., 2023)
  • Recess and physical education are not luxuries for children with ADHD — they are therapeutic. Regular movement breaks throughout the school day support attention and self-regulation in the classroom (Li et al., 2023)

For Clinicians

  • A 2023 network meta-analysis found that mind-body exercise had the largest effect on executive function in children with ADHD, followed by open-skill exercise and aerobic exercise. Exercise type should be matched to the child’s preferences and adherence capacity (Zhu et al., 2023).
  • A 2023 systematic review and meta-analysis of RCTs confirmed that physical activity significantly improves attention in school-age children with ADHD, supporting its use as a structured daily intervention alongside other treatments (Li et al., 2023).
  • Physical activity significantly improves inhibitory control in children with ADHD — a 2023 systematic review and meta-analysis confirmed significant effect sizes for inhibitory function improvement from physical activity interventions (Wang et al., 2023).

7. Speech-Language Pathology for ADHD

Speech-language pathology plays a critical and frequently underrecognized role in ADHD management. The executive function deficits that define ADHD have profound implications for language processing, social communication, and academic language, all of which fall within the SLP scope of practice (Senter et al., 2023).

A 2023 systematic review of SLP interventions for children with executive function deficits confirmed that school-based SLPs are well positioned to address the language and communication consequences of executive dysfunction, with multiple evidence-supported intervention approaches available for children with co-occurring developmental language disorder and executive function difficulties (Senter et al., 2023).

Key areas of SLP intervention for children with ADHD include:

  • Executive function and language: SLP addresses the intersection of executive function and language — including narrative organization, verbal problem-solving, following complex instructions, and using language to regulate behavior and plan actions (Senter et al., 2023
  • Pragmatic language and social communication: Many children with ADHD have significant difficulties with pragmatic language, including conversational turn-taking, topic maintenance, understanding implied meaning, and adapting communication to different social contexts. SLP provides targeted social communication intervention (Senter et al., 2023)
  • Listening comprehension: Difficulty processing and retaining verbal information in complex listening environments is a major barrier to learning for children with ADHD. SLP addresses auditory processing and comprehension strategies that improve classroom performance (Senter et al., 2023)
  • Working memory and language: Working memory deficits in ADHD directly affect the ability to hold and manipulate verbal information, affecting reading comprehension, writing, and following multi-step directions. SLP develops compensatory strategies and environmental modifications to support working memory in communication contexts (Cheng et al., 2025)
  • Reading and written language: Language processing difficulties in ADHD frequently manifest as reading comprehension problems and written expression difficulties that do not reflect the child’s intellectual ability. SLP addresses the language foundations of literacy (Senter et al., 2023)
  • Self-regulation through language: SLP teaches children to use inner speech and verbal mediation strategies to self-regulate behavior, manage transitions, and approach tasks systematically (Senter et al., 2023)
  • Fluency and voice: Some children with ADHD experience increased disfluencies under conditions of high cognitive demand. SLP assesses and addresses fluency difficulties when present

For Parents & Families

  • If your child struggles to follow classroom instructions, loses track of conversations, has difficulty with reading comprehension, or finds social interactions confusing, an SLP evaluation can identify whether language processing or pragmatic language difficulties are contributing (Senter et al., 2023)
  • Social communication difficulties in ADHD are not just behavioral — they reflect genuine language-based challenges in reading social cues and managing conversation. SLP intervention can significantly improve social communication skills and peer relationships (Senter et al., 2023)
  • Many children with ADHD are very bright but struggle enormously with written expression. SLP can help identify the language-based barriers to writing and develop effective strategies and accommodations
  • SLP and OT work well together for children with ADHD, OT addresses the organizational and motor aspects of schoolwork while SLP addresses the language and communication aspects. Ask about combined or coordinated OT and SLP services

For Clinicians

  • A 2023 systematic review confirmed that school-based SLPs have a well-defined role in addressing executive function deficits in children, including those with co-occurring language disorder and ADHD. SLP referral thresholds for ADHD should be low, particularly when language processing, social communication, or academic language difficulties are present (Senter et al., 2023).
  • Less than half of children with ADHD and co-occurring language difficulties access SLP services, despite significant need. Routine SLP screening as part of the ADHD diagnostic workup is warranted (Senter et al., 2023).
  • Working memory deficits in ADHD are among the most functionally impactful executive function difficulties, significantly affecting reading, writing, and following instructions. Physical activity interventions significantly improve working memory in children with ADHD, reinforcing the value of structured exercise as a component of comprehensive ADHD management (Cheng et al., 2025).

8. Exercise and ADHD: What the Evidence Shows

Exercise is one of the most consistently and robustly supported nonpharmacological interventions for ADHD, with multiple high-quality systematic reviews and meta-analyses confirming significant improvements in attention, executive function, working memory, inhibitory control, and overall ADHD symptom severity (Zheng et al., 2025; Li et al., 2023; Zhu et al., 2023; Wang et al., 2023; Cheng et al., 2025).

A 2025 systematic review and meta-analysis confirmed that physical activity significantly reduces ADHD symptom severity, social impairment, and treatment dropout rates in children with ADHD (Zheng et al., 2025). A 2023 network meta-analysis of multiple exercise modalities found that mind-body exercise (yoga, tai chi, martial arts) had the largest effect on executive function, followed by open-skill sports and aerobic exercise (Zhu et al., 2023).

Evidence-supported exercise approaches for ADHD:

  • Aerobic exercise: Running, swimming, cycling, and other aerobic activities consistently reduce ADHD symptoms and improve attention. Even single bouts of aerobic exercise produce immediate improvements in attention and inhibitory control (Li et al., 2023)
  • Mind-body exercise: Yoga, tai chi, and martial arts combine physical activity with attention, sequencing, and self-regulation demands that directly target executive function difficulties. Network meta-analysis identifies this category as having the largest effects on executive function in children with ADHD (Zhu et al., 2023)
  • Open-skill sports: Sports requiring rapid decision-making and adaptation to changing environments — such as basketball, soccer, and tennis, produce particularly strong executive function benefits (Zhu et al., 2023)
  • Structured exercise programs: Regular, structured physical activity programs produce larger and more sustained benefits than unstructured free play, both frequency and duration of exercise matter (Zheng et al., 2025)
  • Movement breaks: Short bouts of physical activity interspersed throughout the school day improve attention and on-task behavior for children with ADHD in the classroom (Li et al., 2023)

For Clinicians

  • Exercise should be prescribed as a standard component of ADHD management, not an optional lifestyle recommendation. Multiple meta-analyses confirm significant effects on attention, working memory, inhibitory control, and overall symptom severity (Zheng et al., 2025; Zhu et al., 2023).
  • A 2023 systematic review and meta-analysis of RCTs confirmed significant improvements in attention from physical activity in school-age children with ADHD (Li et al., 2023). Advocating for physical education, recess, and structured daily exercise for children with ADHD is evidence-based clinical practice.
  • A 2025 meta-analysis confirmed physical activity significantly improves working memory in children with ADHD (Cheng et al., 2025). A 2023 meta-analysis confirmed significant improvements in inhibitory function (Wang et al., 2023). Prescribe exercise type based on child preference and adherence — mind-body activities and open-skill sports show the largest executive function effects (Zhu et al., 2023).

9. ADHD in the School Setting

School is often the most challenging environment for children with ADHD, given the sustained attention, organizational, behavioral, and social demands of the academic day. However, with appropriate accommodations, support, and therapy, children with ADHD can and do thrive academically and socially (Senter et al., 2023).

Common school supports for children with ADHD include:

  • Individualized Education Program (IEP) or 504 Plan: Formal documentation of the child’s needs and the accommodations and supports the school must provide — including extended time, preferential seating, reduced written output, and access to technology
  • OT in schools: School-based OT addresses the fine motor, handwriting, organizational, and sensory needs that affect academic participation and performance (Kleeren et al., 2023)
  • SLP in schools: School-based SLP addresses language processing, pragmatic communication, written expression, and executive function strategies for academic language demands (Senter et al., 2023)
  • Environmental modifications: Seating near the teacher, away from distractions, reduced visual clutter in the workspace, and access to movement opportunities throughout the day
  • Assistive technology: Text-to-speech, speech-to-text, audiobooks, and digital organization tools can significantly reduce the executive demands of schoolwork for children with ADHD
  • Structured routines: Consistent, predictable classroom routines with visual supports significantly reduce the daily executive demands faced by children with ADHD

For Parents & Families

  • You have the right to request an evaluation for an IEP or 504 Plan at your child’s school at any time. A diagnosis of ADHD does not automatically qualify a child for school services, the school must determine that the ADHD is adversely affecting educational performance
  • OT and SLP services can often be provided within the school setting as part of an IEP, ask your child’s educational team about school-based therapy services
  • Share your child’s OT and SLP strategies with the teacher. The strategies that work at home and in the clinic are the same strategies that work in the classroom, consistency across environments produces the best outcomes
  • Regular physical activity during the school day is not a reward for children with ADHD, it is a therapeutic necessity. Advocate for recess and physical education as non-negotiable parts of your child’s school day (Li et al., 2023)

10. What Parents and Families Can Do

  • Get a comprehensive evaluation early. Early identification and intervention produces significantly better long-term outcomes. If you have concerns about your child’s attention, motor skills, language, or behavior, request a comprehensive evaluation from your pediatrician and ask for OT and SLP referrals (Ayano et al., 2023)
  • Build consistent daily routines. Predictable, structured routines with visual supports at home significantly reduce the daily executive function demands on children with ADHD. Work with your OT to develop routines that work for your family
  • Make exercise a daily priority. Even 20 to 30 minutes of aerobic activity before school or homework produces meaningful improvements in attention and impulse control (Zheng et al., 2025). Choose activities your child enjoys and can sustain consistently
  • Work with the school. Request an IEP or 504 Plan evaluation if ADHD is affecting your child’s academic performance. Ensure OT and SLP services are included where appropriate
  • Learn about your child’s specific profile. ADHD presents differently in every child. Understanding your child’s particular strengths and challenges allows you to advocate more effectively for the right support
  • Take care of yourself. Parenting a child with ADHD is demanding. Connecting with other ADHD parents, support groups, and parent training programs significantly reduces parenting stress and improves outcomes for both parent and child

When to Request OT or SLP Referral

  • At or shortly after ADHD diagnosis — early OT and SLP assessment identifies co-occurring difficulties and establishes intervention priorities
  • When handwriting is significantly behind peers, causes distress, or affects academic output — OT evaluation (Kleeren et al., 2023)
  • When morning routines, homework, or self-care are consistently overwhelming — OT for executive function strategies and routine building
  • When sensory behaviors — seeking or avoidance, are significantly affecting attention, regulation, or participation, OT for sensory assessment and intervention (Huang et al., 2024)
  • When the child struggles to follow classroom instructions, loses track of conversations, or has difficulty with reading comprehension — SLP evaluation (Senter et al., 2023)
  • When peer relationships are affected by social communication difficulties — SLP for pragmatic language assessment and intervention (Senter et al., 2023)
  • When motor coordination is significantly below peers, OT or PT for motor assessment and intervention (Kleeren et al., 2023)
  • When written expression is significantly below the child’s verbal ability, SLP for language-based writing assessment (Senter et al., 2023)
  • When the child is about to start school or transition to a new school, OT and SLP can support a successful transition

11. A Note for Clinicians

ADHD is one of the most prevalent neurodevelopmental disorders in clinical practice, yet OT and SLP services remain significantly underutilized in ADHD management despite strong evidence for their effectiveness. Motor coordination difficulties affect a large proportion of children with ADHD and are highly responsive to motor-based OT intervention (Kleeren et al., 2023). Sensory processing differences are closely associated with executive function deficits in ADHD and warrant OT assessment and intervention (Huang et al., 2024). Language processing and social communication difficulties affect the majority of children with ADHD and significantly impact academic and social outcomes, yet fewer than half of affected children access SLP services (Senter et al., 2023).

Physical activity has Level 1 evidence across multiple meta-analyses for improving core ADHD symptoms, attention, working memory, inhibitory control, and overall symptom severity (Zheng et al., 2025; Li et al., 2023; Zhu et al., 2023; Wang et al., 2023; Cheng et al., 2025). Physical activity should be prescribed as a standard component of ADHD management alongside pharmacological and behavioral approaches.

Routine referral to OT and SLP as part of the ADHD diagnostic and management pathway, rather than waiting for significant functional failure — is the approach most likely to produce optimal outcomes for children with ADHD and their families.

Related Pages on TherapyTopics

  • Autism Spectrum Disorder — Another neurodevelopmental condition with significant OT and SLP overlap, frequently co-occurring with ADHD
  • Sensory Processing — Sensory processing difficulties are highly prevalent in ADHD and closely related to executive function and regulation challenges
  • Speech and Language Delays in Children — Language difficulties frequently co-occur with ADHD and require SLP assessment and intervention
  • Cerebral Palsy — Another condition where OT, PT, and SLP address motor, communication, and participation needs across the lifespan
  • Traumatic Brain Injury — Acquired executive function and attention difficulties with overlapping OT and SLP rehabilitation approaches

12. References

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  2. Cheng, G., Song, C., & Hong, X. (2025). The impact of physical activity on working memory in children with ADHD: A meta-analysis. Frontiers in Psychiatry, 16, 1578614. https://doi.org/10.3389/fpsyt.2025.1578614
  3. Huang, Z., Wang, F., Xue, L., Zhu, H., & Zou, X. (2024). Relationships between sensory processing and executive functions in children with combined ASD and ADHD compared to typically developing and single disorder groups. Brain Sciences, 14(6), 566. https://doi.org/10.3390/brainsci14060566
  4. Kleeren, L., Hallemans, A., Hoskens, J., Klingels, K., Smits-Engelsman, B., & Verbecque, E. (2023). A critical view on motor-based interventions to improve motor skill performance in children with ADHD: A systematic review and meta-analysis. Journal of Attention Disorders, 27(6), 571–590. https://doi.org/10.1177/10870547221146244
  5. Li, D., Li, L., Zang, W., Wang, D., Miao, C., Li, C., Zhou, L., & Yan, J. (2023). Effect of physical activity on attention in school-age children with ADHD: A systematic review and meta-analysis of randomized controlled trials. Frontiers in Physiology, 14, 1189443. https://doi.org/10.3389/fphys.2023.1189443
  6. Popit, S., Serod, K., Locatelli, I., & Stuhec, M. (2024). Prevalence of attention-deficit hyperactivity disorder (ADHD): Systematic review and meta-analysis. European Psychiatry, 67(1), e68. https://doi.org/10.1192/j.eurpsy.2024.1786
  7. Senter, R., Chow, J. C., & Willis, E. C. (2023). Speech-language pathology interventions for children with executive function deficits: A systematic literature review. Language, Speech, and Hearing Services in Schools, 54(1), 336–354. https://doi.org/10.1044/2022_LSHSS-22-00013
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