For decades, one of the recurring conclusions in ADHD research has been that children and adults with ADHD demonstrate poorer motor development or motor performance than their neurotypical peers. There are studies behind it, reviews behind it, and citations stacked upon citations behind it.
And I am mostly convinced that a substantial portion of what has been identified as ADHD motor impairment is the product of fundamentally incomplete experimental design.
I didn't arrive at that conclusion because I don't understand the research. I arrived there because I attacked it.
I am a theoretical mathematician. Before wasting time trying to prove a proposition, you attack the proposition. You search for contradictions, hidden assumptions, alternative explanations and counterexamples. You determine whether the conclusion actually follows from the premises.
Motor-command-development research became the poster child for everything that eventually made me deeply suspicious of how ADHD science constructs knowledge. The deeper I looked, the less weight the certainty carried.
I Already Knew Something Was Wrong
I have ADHD. I was a Division I soccer goalkeeper. I also pitched in baseball, played hockey and played competitive amateur golf.
So when I encountered claims about poorer motor development in ADHD, I wasn't approaching motor performance as an abstraction measured from the other side of a laboratory window. I knew what sophisticated motor performance felt like from inside it.
Goalkeeper may be the most demanding all-around athletic position in team sports. You need explosive movement, balance, proprioception and spatial awareness; hand-eye coordination, foot-eye coordination, visual tracking and anticipation; acceleration, deceleration, jumping and diving. And you need to abandon one motor command and replace it with another almost instantaneously when the play changes.
perception >> prediction >> decision >> motor command >> correction
Sometimes that entire sequence happens in a fraction of a second.
I also knew something else from years around the sport: an extraordinary percentage of the good goalkeepers I encountered had ADHD. That was anecdotal evidence, but it wasn't meaningless evidence. An observation doesn't establish prevalence, and I wasn't claiming that it did. Repeatedly encountering an apparent contradiction is exactly how hypotheses are born. When reality keeps handing you something your model doesn't adequately explain, scientific curiosity should begin—not end.
And goalkeepers weren't the only place I saw it. I saw ADHD among pitchers, hockey players and golfers. Later, when I began watching elite athletes much more deliberately, the pattern became impossible for me to ignore.
Most importantly, I had experienced something myself that made the deficit-only interpretation difficult to swallow: hyperfocus.
For me, hyperfocus is the gift of gifts associated with ADHD. When everything lines up—interest, challenge, urgency, consequence—the experience isn't one of deficient attention. Irrelevant information can disappear while the information that matters becomes extraordinarily available. Perception and movement can stop feeling like separate processes.
A goalkeeper reads a developing attack. A pitcher stares at the catcher's target. A golfer stands over a consequential shot.
Different sports. Different motor demands. Same ADHD nervous system.
That contradiction is where the mathematician in my head started asking:
What exactly did you measure?
The Tsunami of False Negatives
That's when I started reading the motor-command-development research differently.
The numbers themselves weren't necessarily wrong. The problem was what researchers believed—or subsequently allowed others to believe—the numbers represented.
There is an enormous logical difference between ADHD subjects performed worse under these experimental conditions and ADHD causes impaired motor development.
The first can be an observation. The second is a causal interpretation. Between those two statements sits an enormous collection of assumptions about what happened inside the nervous system before the researcher wrote down the score.
And when I examined the research, I kept looking for five questions.
The Five Questions That Change Everything
Were they engaged while learning the motor command?
Were they engaged while executing it?
Were they afraid of failure, judgment, or disappointing the adult administering the test?
Had they experienced trauma, and did the unfamiliar testing environment put them into a threat/safety state that affected performance?
Did they possess autistic traits below the diagnostic threshold that could be contributing to the measured motor differences?
In the research I examined, including research extending well into the 2010s, I could not find those five questions being addressed at all.
For me, that changes everything.
These aren't five interesting variables researchers could add someday to make an already good experiment slightly better. They determine what the experiment can legitimately tell us.
If you didn't assess those things, your research carries no weight with me as evidence that ADHD itself caused the measured motor impairment.
You measured something.
I'm not disputing the numbers on your spreadsheet.
I'm disputing what you claim the numbers mean.
Did the Child Ever Learn the Motor Command?
Start with engagement during acquisition.
If an ADHD child isn't sufficiently engaged while you are teaching the motor sequence, subsequent poor performance has at least two obvious explanations. The child may have difficulty learning the motor command itself, or the child may never have sufficiently engaged with the task to acquire the command properly.
Those mechanisms can produce exactly the same endpoint:
low engagement during learning >> incomplete acquisition >> poor subsequent execution >> apparent motor-learning deficit
Unless engagement during acquisition was assessed, you haven't separated them.
Now ask the question again during execution. Perhaps the child learned the command perfectly well. Then you put that child into a sterile environment and ask them to repeat an arbitrary movement for an unfamiliar adult. Interest disappears, engagement collapses and performance deteriorates.
The score goes into the spreadsheet.
And ADHD acquires another motor deficit.
That is what I began thinking of as a tsunami of false negatives. Not necessarily false measurements, but potentially false conclusions about what those measurements represent.
Were They Afraid of Getting It Wrong?
Now look at the child rather than the spreadsheet.
Are they relaxed or tense? Are they watching the adult administering the test? Are they worried about screwing up, looking stupid or disappointing someone?
For an ADHD child experiencing intense rejection sensitivity, those aren't decorative psychological questions. Evaluative threat can change the performance state itself. Motor execution that has become automatic can deteriorate when conscious self-monitoring intrudes. Tension changes movement, fear changes attention, and flow disappears.
fear of judgment >> self-monitoring >> tension >> disrupted flow >> degraded execution
The researcher sees poorer motor performance.
You measured a difference. You haven't established what caused it.
Did Anybody Ask What Happened to the Kid?
Then there is trauma.
Much of the foundational ADHD literature was constructed before the later body of research on childhood trauma, adverse childhood experiences and their effects on cognition and executive functioning had matured.
That isn't an indictment of researchers for failing to know the future. Science is allowed to be incomplete. The problem comes when the future arrives and nobody reopens the case.
Put a trauma-exposed child into an unfamiliar room with an unfamiliar adult, give the child an unfamiliar task, tell them they are being evaluated, and then measure their performance.
unfamiliar environment >> uncertainty about safety >> vigilance >> disrupted cognitive resources >> altered performance
If you never established whether that nervous system felt safe, what exactly have you isolated?
New knowledge changes old inference. If variables discovered or better understood later could independently produce part of the outcome earlier researchers attributed to ADHD, the earlier attribution has to be revisited.
Citations don't become axioms simply because they got old.
What Else Was Inside the ADHD Bucket?
I encountered the same problem with autistic traits.
After spending substantial time observing ADHD children in classrooms, I told Dr. Joseph Llinas that my estimate was that perhaps 30–40 percent of the ADHD children I was seeing had at least one autistic trait—sometimes several—without enough traits to meet criteria for an autism diagnosis.
Dr. Llinas's response was essentially, “Yeah, that's about right.”
That wasn't a prevalence study. It was a frontline observation being informally concurred with by a highly experienced child and adolescent psychiatrist who had spent decades working with ADHD and autistic children.
But again, that's where you start looking.
A diagnostic threshold is a line human beings draw for classification. It doesn't mean the underlying traits politely disappear on the other side of that line. If autistic traits exist dimensionally within an ADHD sample, and some of those traits independently affect motor development or performance, simply excluding formally diagnosed autism doesn't solve the attribution problem.
ADHD group >> lower motor score
does not automatically establish:
ADHD >> motor impairment
The measured difference may be perfectly real. The attribution may still be wrong.
Replication Doesn't Repair the Missing Variable
This is where my mathematical training made reading some of the literature increasingly maddening.
If Study A omits a critical variable, Study B omits the same variable, Study C omits the same variable and Study D omits the same variable, replication doesn't eliminate the problem.
It replicates it.
Meta-analysis cannot magically recover variables the underlying experiments never measured. You can obtain extraordinary statistical precision around a phenomenon that remains conceptually underspecified.
Researchers thought they were studying something approximately like:
ADHD >> impaired motor-command development
But what they may actually have been measuring was closer to:
ADHD × engagement during acquisition × engagement during execution × evaluative threat × trauma/safety state × autistic-trait load × environment >> observed motor performance
Then the output gets attributed primarily to the variable printed on the diagnostic label.
On what basis?
That was where, for me, the research stopped carrying the weight people were placing upon it.
Then Explain the Athletes
There was also an enormous counterexample population standing outside the laboratory: athletes.
After my son nearly took his life, I spent the next several years using golf as one of the tools to help him learn to regulate himself. I followed the PGA Tour, watched practices, videotaped ADHD athletes and talked with people working inside elite sports.
I wasn't trying to prove that ADHD creates great athletes. I was asking a much more interesting question:
Why are so many ADHD athletes thriving here?
Professional golf became an especially rich place to look because individualized performance psychology had been embedded in the sport long before many other American sports caught up. During spring training in the 2010s, I also talked with people around the Philadelphia Phillies while baseball was still developing much of the performance infrastructure that is far more commonplace today.
And I kept encountering a completely different way of thinking about human performance.
The People Studying the Other Half of the Curve
Academic ADHD psychology and psychiatry have historically concentrated enormous intellectual energy on pathology.
That work matters. When somebody is drowning, you need to understand why they're drowning and how to get them out of the water. Sports psychology has to understand that too. A golfer loses confidence. A pitcher can't execute a movement he has performed thousands of times. Anxiety hijacks automatic execution. An athlete becomes trapped inside his own head.
The performance psychologist has to get that person out of the hole.
But then the job continues.
They have to take that same human being to the moon.
That means moving not merely from dysfunctional to adequate or impaired to average, but from good to exceptional and elite to world-class.
collapse >> recovery >> development >> optimization >> exceptional performance
That requires understanding both sides of the performance curve.
After spending years around those environments, I became convinced that some sports psychologists understood vastly more about ADHD development and performance than many academic psychologists and psychiatrists whose work defined ADHD for everyone else.
Not because sports psychologists necessarily understood ADHD pathology better. The difference was that academics overwhelmingly studied pathology while the performance people had to understand pathology and exceptional performance.
Pathology is only half a nervous system.
That distinction changed the way I looked at the entire field.
The Caddy Hiding in Plain Sight
Golf made the missing architecture impossible for me to ignore.
Professional golf is an individual sport surrounded by individualized human support. A golfer may have a swing coach, putting coach, mental coach, physical trainer and other specialists.
And then there is the caddy.
I have explored this much more deeply elsewhere, so I won't reproduce that argument here. But once I recognized the caddy functionally—as an external scaffold providing feedback, regulation, strategic narrowing, memory, accountability and body doubling—I started seeing metaphorical caddies everywhere ADHD people seemed to thrive.
That produced another question the laboratory model rarely seemed interested in asking:
What happens when you change the architecture surrounding the ADHD nervous system?
Sports had been asking versions of that question for decades.
Get Out of Your Own Building
The Philadelphia Eagles provide a useful example of the intellectual attitude I found largely missing from ADHD academia.
When Chip Kelly gained personnel control and Howie Roseman entered his wilderness period, Roseman spent that year learning from leaders across professional sports, including the English Premier League. He later described himself as substantially better personally and professionally because of that experience.
The principle is more important than the football history.
If somebody else is solving a human-performance problem better than you are, go look. Don't merely read more papers produced inside your own intellectual silo. Go to soccer, baseball, golf, dance and music. Look at what coaches, trainers, performance psychologists and development specialists have discovered after millions of repetitions with actual human beings.
Then bring the useful knowledge home.
ADHD science needed its own wilderness years.
Instead, too often, it stared harder at the lab bench.
Then Came the Flying Monkeys
This realization was happening while I was sharing my observations and arguments online, and I got skewered.
Dr. Russell Barkley had enormous influence over the pathology-centered conception of ADHD that dominated much of the public and professional conversation. Challenge one of the accepted deficit narratives online and some of his defenders could descend with citations as though the existence of published research terminated the argument.
I came to call them Barkley's flying monkeys.
The message was essentially: The research says you're wrong.
But by then I had stopped being intimidated by the phrase the research. Show me the proposition. Show me the assumptions. Show me the variables.
Then show me where you tried to break your own conclusion.
I wasn't rejecting science. I was doing what my mathematical training had taught me to do: attack the proposition before accepting the proof.
And motor-command development kept failing that attack.
Pathology Became the Searchlight
This is where I began seeing the systemic problem.
If a scientific culture studies ADHD primarily through impairment, it can become extraordinarily sophisticated at describing ADHD impairment while remaining remarkably ignorant about ADHD performance.
Point the searchlight toward pathology and you will find pathology. Recruit from clinics and you will find clinical impairment. Construct low-engagement laboratory tasks and you may discover poor ADHD performance under low-engagement laboratory conditions.
Then build theories from those findings.
Replicate them.
Cite them.
Call the resulting description ADHD.
That is where the problem becomes systemic. The conditions under which an ADHD nervous system performs poorly begin to be confused with the limits of the ADHD nervous system itself.
Meanwhile, professional sports are studying the other end of the distribution. Coaches and performance psychologists manipulate engagement, feedback, emotional state, environment, relationships, repetition, urgency and scaffolding precisely because performance changes when those variables change.
One group studies when the nervous system fails. The other studies when it becomes extraordinary.
You need both to understand the nervous system.
Hawkins Meets Dodson
This is where Jeff Hawkins's criticism of institutional scientific funding collided, for me, with Dr. William Dodson's frustration with the way ADHD academia ignored frontline knowledge.
Consensus has enormous value in science, but it can also become a gate. Funding committees naturally reward questions recognizable within existing paradigms. Researchers build careers inside established literatures. Novel propositions must survive reviewers trained within the frameworks those propositions may be challenging.
Eventually, an intellectual silo can become self-reinforcing.
Meanwhile, frontline practitioners are running informal experiments every day. Teachers, coaches, psychiatrists, social workers, mentors, sports psychologists and parents observe thousands upon thousands of interactions, failures, adaptations, interventions and successes.
They are sensor networks.
Science should be harvesting their anomalies. Instead, anecdotal evidence too often becomes a phrase used to terminate curiosity.
That's backwards.
Anecdote isn't where science ends. It's often where science starts.
Get Off the Lab Bench
The answer isn't to abandon laboratory research. It's to stop confusing experimental control with complete understanding.
Use the laboratory, then walk outside. Find the goalkeeper, the golfer, the dancer and the musician. Find the construction worker and the chef. Find the ADHD child who performs terribly in one environment and extraordinarily in another.
Then ask why.
Instead of designing another experiment merely demonstrating that ADHD subjects perform worse under Condition A, put the same ADHD subjects into Conditions A, B, C and D. Manipulate engagement, meaningfulness and evaluation threat. Measure autistic traits dimensionally. Characterize trauma exposure and safety state. Compare isolated performance with scaffolded performance.
Study the same nervous system when it struggles, when it functions normally and when it becomes exceptional.
Now we're doing something interesting.
Epistemic Status & Testable Predictions
My claim is not that every published finding of poorer motor performance in ADHD is false. Nor am I claiming that ADHD can never coexist with genuine motor-development difficulties. The literature does document group-level motor differences, but it also contains substantial heterogeneity and unresolved questions about what is inherent to ADHD and what may be mediated by other factors such as developmental coordination disorder. A 2017 review explicitly described the inherent-versus-mediated question as unresolved, while a 2019 systematic review found early motor-development findings sufficiently heterogeneous that no firm conclusion could be drawn. (PubMed)
My claim is narrower and, I think, much more damaging to the certainty surrounding the literature:
I am mostly convinced that a substantial amount of what has been identified as intrinsic ADHD motor impairment is instead the product of incomplete experimental design, misattribution and context-dependent performance being mistaken for underlying capacity.
The five-question problem is central to that hypothesis. In the motor research I examined, including research extending well into the 2010s, I could not find those five questions being addressed at all.
That generates straightforward, falsifiable predictions:
- If engagement during acquisition matters, ADHD participants should demonstrate substantially different motor learning when the same underlying task is presented under high-engagement versus low-engagement conditions.
- If engagement during execution matters independently of acquisition, subjects who successfully acquire the same motor command should show different execution performance when engagement is subsequently manipulated.
- If evaluative threat matters, performance should change when the identical motor task is performed under judgment-heavy versus psychologically safer conditions, with the largest effects predicted among ADHD participants with greater rejection sensitivity.
- If trauma and safety state matter, trauma history and state measures should explain part of the variance currently attributed simply to ADHD status.
- If subthreshold autistic traits matter, dimensional measurement of those traits should explain some portion of the motor-performance variance currently assigned to the ADHD group as a whole.
- If my larger argument about context-dependent ADHD performance is correct, within-person variation should become particularly revealing:
same ADHD nervous system >> different engagement >> different environment >> different scaffolding >> different performance
That experiment can fail.
Good.
Try to make it fail.
That's what science is supposed to do.
The Poster Child
Motor-command-development research became the poster child for everything I came to believe was wrong with ADHD research because I could attack the proposition from almost every direction and encounter another unanswered question.
My own athletic experience contradicted the simplistic interpretation. The ADHD athletes I encountered demanded explanation. Hyperfocus demanded explanation. Elite sports performance demanded explanation.
The five missing questions demanded explanation.
And the pathology-heavy architecture of the field helped explain why those questions weren't being pursued with anything resembling the intensity with which deficits were studied.
That doesn't mean every motor-development study was fraudulent, and it doesn't mean every number was wrong. It means something more fundamental:
The numbers coming out of the experiment may be perfectly real. The thing the researchers say those numbers represent may not be.
That's the hubris of the lab bench.
Limited observation becomes inference. Inference becomes citation. Citation becomes consensus.
Consensus becomes truth.
Then somebody standing outside the silo points toward an enormous contradiction and gets told that the contradiction can't exist because the literature says otherwise.
No. That's precisely when science is supposed to become interesting.
Dr. Dodson has repeatedly warned against assuming that today's understanding represents the end of knowledge. Jeff Hawkins has described institutional structures that can make genuinely disruptive ideas difficult to fund. Thomas Kuhn described how paradigms organize what scientists can see—and what they have difficulty seeing.
Motor-command development gave me my own window into that problem. I went into the literature because something didn't make sense. I attacked the proposition.
And I came away mostly convinced that a substantial portion of what had been characterized as intrinsic ADHD motor impairment could instead represent a tsunami of false negatives and misattributions generated by experiments that never adequately established what they were measuring.
That conclusion changed much more than what I thought about motor development.
Because once you see how the poster child was constructed, one question becomes impossible to avoid:
What else did they get wrong?
References
ADHD & Motor Performance
Kaiser, M.-L., Schoemaker, M. M., Albaret, J.-M., & Geuze, R. H. (2015). What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? Systematic review of the literature. Research in Developmental Disabilities, 36, 338–357. DOI: 10.1016/j.ridd.2014.09.023.
Goulardins, J. B., Marques, J. C. B., & De Oliveira, J. A. (2017). Attention deficit hyperactivity disorder and motor impairment. Perceptual and Motor Skills, 124(2), 425–440. DOI: 10.1177/0031512517690607.
Havmoeller, S. R., Thomsen, P. H., & Lemcke, S. (2019). The early motor development in children diagnosed with ADHD: A systematic review. Attention Deficit and Hyperactivity Disorders, 11(3), 233–240. DOI: 10.1007/s12402-018-0280-y.
Van Damme, T., Simons, J., Sabbe, B., & Van West, D. (2015). Motor abilities of children and adolescents with a psychiatric condition: A systematic literature review. World Journal of Psychiatry, 5(3), 315–329. DOI: 10.5498/wjp.v5.i3.315.
Faraone, S. V., et al. (2021). The World Federation of ADHD international consensus statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789–818.
ADHD, Autistic Traits & Motor Phenotype
Mulligan, A., et al. (2009). Autism symptoms in attention-deficit/hyperactivity disorder: A familial trait which correlates with conduct, oppositional defiant, language and motor disorders. Journal of Autism and Developmental Disorders, 39, 197–209.
Reiersen, A. M., Constantino, J. N., Volk, H. E., & Todd, R. D. (2007). Autistic traits in a population-based ADHD twin sample. Journal of Child Psychology and Psychiatry, 48(5), 464–472.
Trauma, Cognition & Executive Function
Op den Kelder, R., Van den Akker, A. L., Geurts, H. M., Lindauer, R. J. L., & Overbeek, G. (2018). Executive functions in trauma-exposed youth: A meta-analysis. European Journal of Psychotraumatology, 9(1).
ADHD, Hyperfocus & Performance
Archer, D. (2015). The ADHD Advantage: What You Thought Was a Diagnosis May Be Your Greatest Strength. Avery / Penguin Random House.
Csikszentmihalyi, M. (1990). Flow: The Psychology of Optimal Experience. Harper & Row.
Scientific Paradigms, Funding & Institutional Silos
Hawkins, J. (2021). A Thousand Brains: A New Theory of Intelligence. Basic Books.
Hawkins, J., & Blakeslee, S. (2004). On Intelligence. Times Books / Henry Holt and Co.
Kuhn, T. S. (1962). The Structure of Scientific Revolutions. University of Chicago Press.
Clinical Models & Frontline ADHD Observation
Dodson, W. (2016). Recognizing and Managing the Emotional Intensity of ADHD.
Dodson, W. (2018). Secrets of the ADHD Brain: How Your Interest-Based Nervous System Works.
Epistemic Note
The personal observations in this article—including observations involving athletes, goalkeepers, golf environments and subthreshold autistic traits—are presented as frontline observations and hypothesis-generating evidence, not as population prevalence estimates. The article's central claims about engagement, evaluative threat, trauma, autistic traits and environmental scaffolding are intended as falsifiable mechanistic hypotheses where direct experimental evidence remains incomplete.