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

Abstract

Background Attention Deficit/Hyperactivity Disorder (ADHD) is a multifactorial neurodevelopmental disorder characterized by cognitive, motor, sensory, emotional, and behavioral difficulties. This disorder may lead to impairments in various executive functions, such as sustained attention, planning and organizing, and impulse control. Occupational therapy interventions offer strategies aimed at enhancing attention, executive functions, and motor skills in individuals with ADHD, while also providing guidance and support to caregivers throughout the process. Caregivers of children with ADHD play a vital supportive role and are required to manage caregiving demands through appropriate and healthy care strategies. Objective The aim of this study was investigate the effect of music-based occupational therapy activities on attention and executive functions in children diagnosed with ADHD, compared with structured occupational therapy interventions, as well as to examine changes in caregiver burden. Materials and methods A total of 39 children aged between 5 and 12 years (N = 39) participated in the study. Participants were randomly assigned into two groups: music-based occupational therapy (n = 19) and structured occupational therapy (n = 20). The music-based occupational therapy group received sessions involving harmonica and drum-based occupational therapy activities, while the structured occupational therapy group received conventional structured occupational therapy interventions. Both interventions were administered once a week for six weeks, with each session lasting 45 minutes. Children’s attention levels were assessed using the DSM-V Level-2 Inattention Scale, executive function skills were evaluated with the Behavior Rating Inventory of Executive Function–Child Version (BRIEF), and caregiver burden was measured using the Zarit Burden Interview, both at baseline and after the intervention period. Results Pre- and post-intervention assessments revealed improvements in both groups in terms of attention levels (F(1, 37) = 9.675, η2 = .207, p = .004), executive functions (F(1, 37) = 2.506, η2 = .063, p = .122), and caregiver burden (F(1, 37) = 0.002, η2 = .000, p = .967). When comparing time-group interactions, it was observed that music-based occupational therapy activities had a more beneficial effect, particularly on attention levels, in children with ADHD compared to structured occupational therapy. Conclusion Overall, music-based occupational therapy activities demonstrated positive effects on attention levels, executive functions, and caregiver burden in children with ADHD. Future studies are encouraged to incorporate a broader range of musical instruments into occupational therapy intervention plans, aligned with specific therapeutic goals. It is considered important for therapists to develop strategies that tailor the rhythm, melody, and harmony of musical instruments according to the physical, emotional, and cognitive needs of individuals.