Quantitative and qualitative motor performance on the Maastricht Motor test was evaluated in 401 children ages 5 to 6 years (232 males, 169 females) who were tested 18 months later for attention deficit hyperactivity disorder (ADHD) and ODD/CD, in a study at the University Hospital of Maastricht, Department of Neurology, the Netherlands. Thirty-five children were diagnosed with ADHD and 26 also had ODD/CD. Two of four qualitative motor domains (dynamic balance and diadochokinesia and manual dexterity) and the total qualitative score for motor performance at 5 to 6 years of age were predictive for the diagnosis of ADHD 1 year later, but not for ODD/CD. Both gross and fine motor performance impairments were predictive, but only qualitative test performances showed significant correlations with later diagnosis of ADHD. 
COMMENT. The significance of motor performance as an indicator of attentional problems and ADHD has been stressed by previous investigators. Denckla (1973,1974) and Denckla and colleagues (1985) used speed of motor function in repetitive tapping movements of finger, hand, and foot to assess motor performance in normal children and children with dyslexia with and without attention problems. Children with ADHD were significantly slower in motor function than controls.
Huttenlocher et al, (1990) found that “soft” neurologic signs were of predictive value for learning disabilities in preschool children, aged 3 to 5 years. A poor neurologic test score at age 5 years correlated with a lower Full-Scale IQ at age 7, and neurologic soft signs accurately identified almost all the children who needed special educational services. Soft neurologic signs and so-called “minimal brain dysfunction (MBD)” have previously been correlated with symptoms of ADHD and a beneficial response to stimulant medication (Millichap, 1974; see Attention Deficit Hyperactivity and Learning Disorders (PNB Publishers, 1999).
The present investigators evaluated both quantitative and qualitative aspects of motor performance, using the Maastricht Motor Test (MMT). The MMT includes 70 items organized in 4 domains: static balance (stork position), dynamic balance (hopping), ball skills (number of catches), and diadochokinesia and manual dexterity (speed of tapping the hand). Qualitative aspects of motor performance were predictive of ADHD in 5- to 6-year-old children.
Early motor skills and language development in at-risk dyslexic children. In a Finnish study of 88 children with familial risk for dyslexia cf 88 without risk, children with familial risk for dyslexia and slow motor development had a smaller vocabulary and spoke in shorter phrases at 18 and 24 months than other children.