1

Martial Arts & ADHD

Running Head: MARTIAL ARTS & ADHD

THE EFFECTIVENESS OF MARTIAL ARTS TRAINING AS THERAPY FOR

STUDENTS

WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER: AN INITIAL REVIEW OF

EXISTING LITERATURE

Kyle Kees

Western Governors University

 2

The Effectiveness of Martial Arts Training as Therapy for Students with

Attention Deficit Hyperactivity Disorder: A Review of Existing Literature

In the last 20 to 25 years, attention deficit hyperactivity disorder has

come to the forefront of both the educational and psychological

communities. As more and more students are diagnosed, professionals are

working to find new interventions that will enable these students to

experience success in the educational setting. A report published by the

United States Center for Disease Control reports that 3 to 6% of the students

in this country have been diagnosed with this disorder (Pastor & Rueben,

2008). According to the report, these numbers only reflect those children

who have ADHD alone and do not include those who have been diagnosed

with ADHD and an accompanying learning disability. With this in mind, it can

be easily assumed that number of students with the disorder is higher.

The symptoms of this disorder are what prove to be challenging for both

student and educator in the general education classroom. The three main

symptoms ADHD are inattention, hyperactivity, and impulsivity (Cheng,

2009). Students with these symptoms are greatly challenged by tasks that

are mundane and tedious. They have a need for assignments to be

“exciting” (Cheng, 2009). These students are also known to fidget, and, in

extreme cases, have problems just sitting still (Cheng, 2009). They may

also blurt out answers in class, interrupt others, and have troubles waiting

their turn (Cheng, 2009). This is just a sampling of difficulties that may be
 3
Martial Arts & ADHD

experienced with an ADHD child in a general education classroom.

With the above challenges facing educators, the problem becomes

finding and implementing therapies that can be effective in aiding ADHD

students with these symptoms, thus increasing their chance of success in the

classroom. Currently, the most prevalent therapies come from medication.

At the present time, two in particular seem to be used the most:

methylphenidate (Ritalin*) and dextroamphetamine (Adderall*) (Cheng,

2009). These therapies, though, have come under criticism as of late. Dr.

Abida Ripley cites Dr. Peter Breggin who asserts that short term usage of

these drugs “suppresses creative, spontaneous and autonomous activity in

children, making them more docile and obedient, and more willing to comply

with rote, boring tasks, such as classroom work and homework” (2003, pg.

3).

There have been some assertions made that physical exercise can help a

student with the management of the symptoms of ADHD. Studies involving

ADHD students with physical exercise have been done in an attempt to

prove this assertion. In one study, published in Medicine and Science in

Sports and Exercise, measured the amounts of spontaneous eye blinks and

the acoustic startle eye response (ASER) of children in an ADHD participant

group and a control group who were subjected to exercise (Tantillo, Kesick,

Hynd, & Dishman, 2002). Although the findings did not necessarily support

this theory, there were no reported findings of negative effects of the

 4

exercise upon the ADHD group either. This led the researchers to conclude

that more studies needed to be done. The results of another study done by

a graduate student of Miami University in Oxford, OH showed that exercise

does in fact help students with the disorder. In this study (Packard, 2007);

ten fourth grade students were divided into two groups. Each group was

composed of students with and without ADHD. One group was exposed to

20 minutes of aerobic exercise (specifically Billy Blank’s Tae Bo) and the

other group was exposed to 20 minutes of guided reading, a more sedentary

activity. After two sessions per week for a period of four weeks, the students

who participated in the exercise group showed increases in attention span

and executive function as opposed to those in the sedentary group (Packard,

2007). Despite the limitations of this last study, the results lend credibility to

the assertion of exercise being an effective intervention for ADHD students.

Keeping the previously mentioned studies in mind, and through this

author personally experiencing martial arts training, it can be easily asserted

that martial arts training is a viable form of exercise. In addition, the martial

arts industry has answered the call for new, alternative therapies for children

with ADHD. The industry has been publicizing the benefits for children in

general, not just those with an ADHD diagnoses (Strayhorn & Strayhorn,

2009). In that particular study, the authors write, “The marketing materials

from martial arts studios are directly aimed toward the attainment of positive

mental health outcomes” (Strayhorn & Strayhorn, 2009). This concept is

certainly not new. In a study published in Canada, 84 adult martial arts

 5
Martial Arts & ADHD

practitioners were interviewed concerning their mental health and the

possible effects of martial arts upon it (Konzak & Boudreau, 1984). The

results of the study reported “…that training in karate-do can enable an

individual to experience many changes, both physical and mental, as part of

his/her overall personal development. It can thus enable this individual to

experience a sense of personal physical and mental competence that is

consistent with recent conceptions of mental health as a sense of mind/body

harmony and well being” (Konzak & Boudreau, 1984, pg. 7). Furthermore,

the authors go on to write, “Karate-do can and does provide individuals with

a very effective form of ‘self-help’ in their search for self-knowledge,

happiness, and a fulfilling life” (Konzak & Boudreau, 1984, pg. 7). Positive

benefits of martial arts training for persons with disabilities was the result of

a study done by Richard A. Martin of the University of Wisconsin-Stout

(2002). His survey based research attracted respondents of both genders

ranging in age from 15 to 54 years of age (Martin, 2002, pg. 25). These

respondents had disabilities of the physical, cognitive, and sensory types

(Martin, 2002, pg. 26, table 1). In summarizing his results, Martin writes,

“Another important outcome of this study was the reported improvements in

functional limitations, especially in the areas of balance, strength, and

stamina. The majority of individuals in the sample identified a physical

impairment as their primary disabling condition. This may have led to the

noted improvements in areas of physical functioning” (2002, pg. 31). He

goes on to write, “Perhaps the most salient conclusions of this study relate to
 6

the perceived changes in self-perception and quality of life. A majority of

respondents reported that they felt more confident, had greater respect for

themselves, were more capable individuals, and that their overall quality of

life has been improved as a result of the martial arts”(2002, pg. 31).

To this end, it must now be determined if martial arts training can have a

positive effect on students with ADHD, a learning disability. Is this type of

training an effective therapy for students with attention deficit hyperactivity

disorder? A review of other studies will be conducted and an attempt will be

made to answer the following questions:

1. As martial arts has many sub categories, what type of martial arts

training is best

suited for students with ADHD?

2. Of the type(s) of martial arts training utilized, are any modifications or

accommodations

made for those students with ADHD during training sessions?

3. If modifications/accommodations are made, is there any progress

made by the students to the point where these are utilized less or not

at all?

4. If measurable progress is made by the students in martial arts class, is

there any correlation of progress in school?

 7
Martial Arts & ADHD

Before examining current literature, it should be noted, through my own

experience, that labeling martial arts subsystems can be a daunting task. As

the industry grows, so does the ways in which people classify martial arts

systems. What adds more confusion, especially for those who have no

exposure to the martial arts, is that a label may depend upon the person

who is doing the labeling. For the sake of the reader who may be unaware,

here are just a few examples of ways martial arts systems are labeled: hard

styles vs. soft styles; traditional styles vs. hybrid styles; traditionally based,

competitively based, and combat based (or reality based); striking vs.

grappling; philosophical vs. practical; by country of origin (e.g., Chinese,

Korean, Japanese, Okinawan, Vietnamese, Israeli, etc.). Furthermore, such

labeling methods are not limited to these. It will be imperative to determine,

in as much detail as possible, the type of martial art system utilized by those

studies which have positive or negative effects on students with ADHD.

In her research paper, Dr. Abida Ripley(2003) provides the reader with a

good overall look at some of the prior research done on this subject.

However, there is mention of only one style of martial arts training that was

utilized in any of the studies she cites and that is aikido, which could be

labeled as a traditional/philosophical style that is Japanese in origin (Ripley,

2003, pg.4). She also mention students doing forms, which would tend to

indicate that that particular study utilized a traditional or competitively

 8

based system (Ripley, 2003, pg. 8). Other than this, no detailed information

of any type of martial arts style is given.

In another Damien Martin (2006) briefly touches upon our subject. His

paper also cites several studies that support martial arts training for students

with ADHD, but only mentions it in the context of “a traditional environment”

(2006, pg. 4). Other than this, no detailed information concerning type or

style is given.

Dr. Thomas W. Woodward (2009) briefly discusses our topic in a similar

fashion to Damien Martin. He cites a study that had favorable results on

children with ADHD, but the only indication as to a label had to be taken

from the reference section. The article Woodward cites is entitled, “Tai-

Kwan-Do in Relation to ADD” (2009, pg.43), so obviously the study utilized

Tai-Kwan-Do to train students with ADD. Otherwise, no style or label is used

in any other way in Dr. Woodward’s writing.

In his study done in 2002, Dr. Eric K. Cooper goes much further than the

previous authors in describing the training in which his subjects went

through. He writes, “The instructor of the tae kwon do school had been

teaching a traditional form of tae kwon do for twenty five years. This

traditional from requires adherence to the rules and regulations of the

training hall, a philosophical component of the martial arts, and respect for

the instructors, advanced students, and the art of tae kwon do” (2002, pg.

38). Cooper continues as he describes more detail of the class format in that
 9
Martial Arts & ADHD

a student had to meet certain requirements “…which included wearing the

traditional uniform, learning traditional punches and kicks, Korean

terminology, and traditional definitions” (2002, pg. 38). Based upon this

description, it is determined that the style used to train his subjects was a

traditional one, particularly traditional tae kwon do. (It needs to be noted

that since the author was particular about labeling these tae kwon do classes

as “traditional,” this could be an indicator that there are possibly tae kwon

do styles that might be labeled as “modern” or “progressive” to denote the

non-traditional influence within the system.)

Matthew K. Morand serves his readers well in a study he did in 2004. Prior

to discussion of the system utilized by his study, Morand does give the

reader some background information on martial arts in general such as the

different types of classifications and the types most studied at the time. His

study employed a hybrid system of martial arts, particularly that of a school

called Tiger Schulmann’s Karate. According to Morand, this hybrid system

blended three different styles into one discipline: karate (a striking style),

jujitsu (a grappling style), and aikido (a grappling/philosophical style) (2002,

pgs.42, 43). All three of these individual disciplines have an

Okinawan/Japanese origin. Furthermore, Morand writes to following: “The

martial arts intervention utilized a highly structured and disciplined program.

The atmosphere was one of traditionalism coupled with an effort to run a

class disciplined so that a participant was empowered to act with self-

discipline” (2002, pg. 43). From these indications, it would seem that this
 10

particular school has made a hybrid style from three more traditional

systems and has preserved traditionalism through the more rigid structuring

of their classes. We could say, with a degree of certainty, that this hybrid

style might be classified as a traditional style due to its training atmosphere,

despite the blending of three different disciplines to create a new one. It

should be noted as well that Morand’s title uses the phrase “mixed martial

arts,” which could also cause some confusion. The term “mixed martial arts”

(MMA) is also a term used for a competitive type of ring fighting that utilizes

techniques from many different types of systems, both striking and

grappling. Athletes who compete in MMA train in disciplines such as Western

boxing, Muay thai kickboxing, Greco-Roman wrestling and Brazilian jujitsu to

name just a few. While this hybrid system being taught in Morand’s study is

literally mixed martial arts and may bear some similarities to competitive

MMA, preparing students for ring fighting was most likely NOT the scope of

the classes used in the study.

At the University of North Carolina in Greensboro, Lane G. Graham

conducted a study in 2007 which also addresses the subject at hand. Early in

his study does Graham make a distinction between what he calls

“traditional” and “modern” martial arts: “In traditional martial arts, there is

stronger focus on the development of the total self perception (mind and

body) and respect for self and others. Modern martial arts focus on fighting,

physical prowess, and extreme competition” (2007, pg.6). He goes on to

write, “Traditional martial arts do not merely center on the individual, but are
 11
Martial Arts & ADHD

cognizant of helping and giving to others in the learning process” (Graham,

2007, pg. 6). In addition, Graham writes of traditional martial arts that “…

there is greater emphasis on the artistic and meditative benefits of the

practiced art. Also, there is stronger concentration in the regular training

regimen on values such as personal responsibility, perseverance, honor,

respect for self and others, wisdom, and humility” (2007, pg. 33, 34).

Whereas, in contrast, the author writes this of traditional martial arts’

counterpart: “In modern martial arts training, there is greater concentration

on the physical perspective of training. Competition between participants is

advocated and encouraged and the focus of self-development and self-

perception of competence may be denigrated to a series or combination of

acrobatically perfected motions infused with an aggressive philosophy”

(Graham, 2007, pg. 35). One can see that the definition of traditional martial

arts here is similar to that of the Morand study. As far as a particular style is

concerned, Chayon-Ryu (Korean for “The Natural Way”) was utilized by the

author for this study (Graham, 2007, pg. 39). Ironically, this style, labeled by

the author as traditional, was grafted together from five other traditional

styles making it, literally, a hybrid. According to the author, Chayon-Ryu

draws techniques from its five parent styles of Chinese Chu’an fa, Korean

Hapkido, Japanese/Okinawan Shudokan karate, Japanese Aiki/jujitsu/judo,

and Korean taekwondo (Graham, 2007, pg. 39). So it would seem that literal

hybrid styles can be labeled as traditional through the training atmosphere

and not necessarily the actual training regimen.

 12

Based upon the information gathered from these studies, traditional

martial arts with a highly structured class format seems to be what is

preferred amongst researchers seeking to use martial arts as an intervention

for children with ADHD.

Having somewhat of a minimal answer to our first question, we now turn

to the next question concerning whether or not any modifications or

accommodations were made for the ADHD students that participated in the

classes used for these studies. This question will closely relate to the third

question of whether or not progress was made to wean the students away

from the modifications/accommodations, if any were allowed to begin with.

For the sake of efficiency, it will be easy to eliminate three of these pieces

of literature. The pieces written by Dr. Thomas W. Woodward (2009), Dr.

Abida Ripley (2003), and Damien Martin (2006) offered such sparse

information to begin with, that it’s impossible to determine if any

modifications/accommodations were made for students within the studies

they cited. Further investigation would warrant finding the actual results of

these studies which were cited within these three pieces and going through

the parameters to determine if modifications or accommodations were

made. Due to the lack of information provided, this would also eliminate the

need to measure these pieces against the third question as well.

Dr. Eric K. Cooper’s (2002) piece does go into much greater detail

concerning the parameters of the study conducted. However, after going

 13
Martial Arts & ADHD

through the method, description of the participants, the description of the

classes utilized, the measures, the results, and even reading the results of

each individual participant, there was no indication of modifications or

accommodations being made for the participants or not. It should be noted

that five of the six participants were on medication at the time of the study

and were allowed to stay on the medication as long as they remained

consistent with the type of medication prescribed (Cooper, 2002, pg. 38).

Again, due to the lack of information, we can eliminate trying to answer the

third question posed earlier.

Dr. Morand’s (2004) study also went into great detail concerning the

participants used, the method of data gathering, martial arts class format,

and results of the study. Like the Cooper piece, there is not mention of any

modifications or accommodations being made for the participants during the

study. Unlike the study done by Cooper, Morand’s study specifically called

for participants who were diagnosed with ADHD and not taking any type of

medication prescribed specifically for the disorder (2002, pg. 122, Appendix

F, subsection c). In addition, as with all the last pieces of literature we’ve

looked at, since there is no indication of modifications/accommodations

being made for the participants, we are unable answer the third question

with any degree of certainty.

The study conducted by Lane G. Graham (2007) did not give many

indications of modifications/accommodations. The study only utilized 10

 14

elementary school students, three of which did not complete the study

(Graham, 2007, pg. 61). There were no other students present during the

training sessions, so the small group setting could be considered by some to

be a modification or accommodation, although there is no indication by the

researcher that that was the original intent of the small sample size. In

addition, the paper does show evidence of more individualized attention for

students having difficulties with learning the material, but again, this may or

may not be considered a modification/accommodation on the part of the

study (Graham, 2007, pg. 67). Above and beyond this, Graham writes, “If at

any point the program became too arduous or if the students had

trepidations about continuing, there was opportunity for one-on-one

discussions with students and parents” (2007, pg. 68). But again, would this

be considered a modification? What’s also interesting is that there were

three instructors present during every training session, which brings the

student-to-teacher ratio to a little over 3 if one includes all ten participants

present in the beginning of the study (Graham, 2007, pg. 140). This would

seem to be an accommodating strategy on the part of the researcher in

anticipation of any classroom management issues, although, again, the

study gives no indication of this.

At this point, attention must be turned to the last question in regards to

this review, and that is the existence of any data that correlates progress in

the general education classroom by the participants who show progress in

the martial arts arena.

 15
Martial Arts & ADHD

As before, the papers written by Dr. Abida Ripley (2003) and Dr. Thomas

Woodward (2009) contain such little information about the studies they cite,

there are no indications made as to whether participants within these studies

made any progress within the martial arts setting itself let alone progress in

the general education classroom. Therefore, in regards to these papers, it’s

impossible to answer the last question posed by this review.

Dr. Eric K. Cooper’s study displayed much different results. According to

his results, there was a direct correlation between the martial arts training

and the behaviors exhibited in the general education classroom. His study

tracked behaviors both at home and at school of six participants. The

behaviors that were targeted were inattention, impulsivity, hyperactivity,

and aggression (Cooper, 2002). The interesting part of this study is that

most parents noted overall positive changes in their children in regards to

these four behaviors (Cooper, 2002, pg. 13, Table 1). Teachers, however,

recorded that, overall, behaviors for most of the participants didn’t change

for the better or worse (Cooper, 2002, pg. 13, Table 2). The data collected

by teachers in this study can be confirmed by the Strayhorn & Strayhorn

(2009) study which found no evidence to support the martial arts’ industries

claims of improved self confidence, self control and concentration. It should

be noted however, the latter study had no data on the number of children

with this disorder that was part of their sampling.

Morand’s study done in 2004 does contain data that was collected on the
 16

participants in the general education classroom. In fact, Morand directly

hypothesized that martial arts training for students with ADHD would have

the following effects: (1) increased percentage of completed homework, (2)

increased frequency of following classroom rules, (3) decreased number of

inappropriate call outs, (4) decreased number of times a participant

inappropriately leaves their seat, (5) improved academic performance, (6)

decreased amount of redirection to task, and (7) improved classroom

preparation (2004, pgs. 32-34). The results of this study showed that five of

seven hypotheses were supported by Morand’s research (2004). Hypothesis

number three was only partially supported as the results of another group of

students exposed to an exercise program showed better results in this area

(Morand, 2004, pg.81). Hypothesis number six, however was not supported

at all by Morand’s research and the group of students exposed to martial arts

didn’t perform as well compared to that of the group exposed to exercise

(Morand, 2004, pg. 85-86). So, as with Cooper’s study (2006), Morand’s

study suggests that there is an overall direct correlation between behavior

during martial arts training and the general education classroom.

These last two studies are starkly contrasted by Graham’s study (2007).

Graham’s study made no reference at all concerning behaviors in the

general education classroom. Despite the positive findings of Graham’s

study, it is impossible at this point to examine this study based upon the last

question asked in the beginning.

 17
Martial Arts & ADHD

Based upon the studies that have been examined, it is quite apparent

that the amount of research done in this area is quite minute. To conclude,

one reoccurring theme that was indicated in all of these studies was the

need for more research to be done in order to obtain more concrete

evidence, and, due to the lack of information found here, this would suggest

these authors are correct in that assertion.

 18

REFERENCES

Cheng, Michael, MD, FRCP(C). (2009) ADHD and ADD: Guide for Families. Retrieved
December 15, 2009 from www.drcheng.ca/page1/assets/adhd-for_families.doc

Cooper, Eric K. (2008) Martial Arts Training for Children with Attention-Deficit/Hyperactivity
Disorder. Proteus, 25(2), 37-42. Retrieved January 11, 2010, from PsychFIRST database.

Graham, Lane G., PhD. (2007) Traditional Martial Arts and Children with ADHD: Self-
Perceptions of Competence. Retrieved January 11, 2010 from the Graduate School at the
University of North Carolina at Greensboro. Web site: http://libres.uncg.edu/edocs/etd/
1270/umi-uncg-1270.pdf.

Konzak, Burt, PhD., & Boudreau, Francoise, PhD. (1984) Martial Arts training and Mental
Health: An Exercise in Self Help. Canada’s Mental Health, December, 2-8. Retrieved
January 12, 2010 from the ArticleFirst database

Martin, Damien. (2006) The Psychological Benefits of Traditional Martial Arts Training:
What Most Instructors Know But Can’t Articulate. Retrieved January 13, 2010 from
www.kidzkarate./com/documents//2Benefits_of_Martial_Arts.pdf.

Martin, Richard A. (2002) The Physical and Psychological Benefits of Martial Arts Training for
Individuals with Disabilities. Retrieved January 13, 2010 from www.uwstout.edu/lib/thesis/
2002/2002martin.pdf.

Morand, Matthew K. (2004) The Effects of Mixed Martial Arts Training on Behavior of Male
Children with Attention Deficit Hyperactivity Disorder. Retrieved December 5, 2010 from
 19
Martial Arts & ADHD

www.milehighkarate.com/.../MA%20&%20%20ADHD_Full%20study.pdf

Packard, Stacie S. (2007) Effects of Vigorous Bouts of Physical Activity in Elementary

Students with and without a Diagnosis of Attention Deficit Disorder: An Examination
of How Physical Activity Influences the Attention and Concentration of Students in the
School Environment. Retrieved January 21, 2010 from http://etd.ohiolink.edu/send-pdf.
cgi/Packard%20Stacie%20S.pdf?acc_num=miami:1182358294

Pastor, Patricia N., PhD. & Rueben, Cynthia A., MA. (2008) Diagnosed Attention Deficit and
Hyperactivity Disorder and Learning Disability: United States 2004-2006. National Center
Health Statistics. Vital Health Stat 10(23). United States Center for Disease Control.
Retrieved January 7, 2010, from www.cdc.gov/nchs/data/series/sr_10/Sr10_237pdf

Ripley, Dr. Abida. (2003) An Awesome Alternative to Drugs: Martial Arts Practice as
Treatment for Children with ADHD. Retrieved December 5, 2010 from
www.milehighkarate.com/pdf/ma_add.pdf

Strayhorn, Joseph M. & Strayhorn, Jillian C. (2009) Martial Arts as a Mental Health
Intervention for Children? Evidence from the ECLS-K. Child and Adolescent Psychiatry
And Mental Health, 3:32. Retrieved January 11, 2010, from MEDLINE database.

Tantillo, Mary, Kesick, Christina M., Hynd, George W., & Dishman, Rod K. (2002)
The Effects of Exercise on Children with Attention-Deficit Hyperactivity Disorder.
Medicine and Science in Sports and Exercise, 34(2), 203-212. Retrieved January 10, 2010
from WinstonSelect Plus database.

Woodward, Thomas W., MD. (2009) A Review of the Effects of Martial Arts Practice on
Health. Wisconsin Medical Journal, 108(1), 40-43. Retrieved January 11, 2010 from
MEDLINE database
20