Effects of music-based occupational therapy activities on attention executive functions in children with attention deficit and hyperactivity disorder.

TL;DR

Music-integrated occupational therapy activities produced greater improvements in attention in children with ADHD compared to structured occupational therapy alone over a 6-week period . Both interventions improved attention, but the effect sizes were modest and the study was small.

What the Study Found

Researchers compared two occupational therapy approaches in 39 children with ADHD aged 5 to 12 years. One group received music-based occupational therapy using harmonica and drum activities (19 children), while the other received standard structured occupational therapy (20 children). Both groups attended one 45-minute session per week for six weeks, with assessments done before and after the intervention period.

The results showed that both groups improved significantly on attention measures, as assessed by the DSM-V Level-2 Inattention Scale (F(1, 37) = 9.675, p = .004). The key finding was that when comparing the two groups directly, music-based occupational therapy demonstrated a more substantial benefit for attention than standard structured occupational therapy. However, the improvement in executive function skills, measured using the Behavior Rating Inventory of Executive Function (BRIEF), did not reach statistical significance between groups (p = .122). This suggests that while both approaches helped with executive functions, the difference between them was not conclusive.

Caregiver burden, a key measurement since caregivers of children with ADHD often experience significant stress, showed no meaningful change in either group (p = .967). Both groups maintained similar levels of caregiver burden at baseline and post-intervention. This finding indicates that the six-week intervention window may have been insufficient to produce detectable shifts in how much burden caregivers perceived, or that improvements in child attention alone do not automatically translate to reduced caregiver stress within this timeframe.

The effect size for the primary attention outcome was moderate (eta squared = .207), meaning music-based therapy accounted for roughly 20 percent of the variance in attention improvement. The study design included random assignment to groups, which strengthens causal inference, though the modest sample size and short intervention period limit generalizability.

What This Means for You

If your child has ADHD and is considering occupational therapy, this research suggests that integrating musical elements like drums or harmonica may enhance attention-focused gains compared to conventional approaches. The practical implication is that occupational therapists might consider incorporating instruments that require rhythmic coordination and sustained focus alongside traditional structured activities.

That said, this single small study should not be the sole basis for choosing an intervention. The improvements occurred in both groups, indicating that standard occupational therapy still produced benefits. The failure to show improvements in caregiver burden also suggests that addressing child attention alone may not fully address family-level stress, which might require parallel caregiver support strategies.

The brief duration (six weeks) means this was a proof-of-concept study. Longer interventions, larger samples, and comparison with untreated controls would provide clearer evidence about whether these gains persist and whether music-based approaches justify the additional training and resources required.

Study Details

Sources

PubMed: https://pubmed.ncbi.nlm.nih.gov/42149817/