This study tested a recreational swimming program in 40 Tunisian primary-school children aged 9 to 12 with ADHD. There were 35 boys and 5 girls. Whole schools, not single children, were randomly assigned. Half the children swam and half did not.
The swimmers trained in three 90-minute sessions a week for 12 weeks. Compared with the control group, they got faster on part of a timed thinking test, the Junior Hayling test. They also scored better on a related measure of extra thinking time. Parents reported fewer social, attention, rule-breaking and aggressive problems. Reading and math marks rose, and so did aerobic fitness. These differences were unlikely to be down to chance.
Some results are less solid. Error scores on the thinking test improved within the swim group, but the paper gives no comparison with the control group. The two groups also differed slightly on that score at the start. For overall outward behavior problems, the paper's table and its text point in opposite directions. For inward problems, such as anxiety, the authors describe only a tendency to improve, and the figures do not match across tables.
The authors note that the sample was small and that boys and girls were not compared. They suggest that three 90-minute sessions a week of low-intensity swimming could support primary-school children like those studied whose ADHD hurts learning and class engagement.
The numbers Stats and what the terms mean
The statistics behind the plain-language claims above.
- Hattabi, 2022: faster thinking test time (part B latency), swim group versus control over time, F(1,38) = 19,205, p < 0.001, eta2 = 0.336.
- Hattabi, 2022: extra thinking time, swim group versus control over time, F(1,38) = 16,286 (as printed), p < 0.001, eta2 = 0.300.
- Hattabi, 2022: parent-rated social problems, F(1,38) = 153.005, p < 0.0001, ES 0.801.
- Hattabi, 2022: parent-rated attention problems, F(1,38) printed as 239,121, ES 0.863.
- Hattabi, 2022: parent-rated rule-breaking (delinquent) behavior, F(1,38) = 181.809, p < 0.0001, ES 0.827.
- Hattabi, 2022: parent-rated aggressive behavior, F(1,38) = 278.517, p < 0.0001, ES 0.880.
- Hattabi, 2022: reading marks, ES 0.368, post hoc p < 0.001.
- Hattabi, 2022: math marks, ES 0.595, post hoc p ≤ 0.001.
- Hattabi, 2022: overall pass mark, ES 0.396, post hoc p < 0.001.
- Hattabi, 2022: aerobic fitness (VO2max), F(1,38) = 102.001, p < 0.001, eta2 = 0.729.
- Hattabi, 2022: error score change within the swim group only (part B), F(1,38) = 78.114, p < 0.001, eta2 = 0.673.
- Hattabi, 2022: starting gap in part B error score, swim versus control, 22.50 ± 3.72 vs 20.35 ± 3.03, p = 0.05.
- Hattabi, 2022: overall outward behavior problems, table shows a fall, F(1,38) = 375.317, p < 0.0001, ES 0.908, while the text reports higher scores in the swim group after training, p ≤ 0.001.
- Hattabi, 2022: overall inward problems, from inconsistent source data, ES 0.324. What the terms mean:
- p How likely a difference this big would be if the program did nothing, so smaller means less likely to be chance.
- F A test figure comparing how the two groups changed over time, where bigger means a clearer group difference.
- eta2 The share of score differences linked to the program, which the paper calls minimum up to 0.04, moderate up to 0.25, strong up to 0.64 and large above 0.64.
- ES The paper's effect size, a measure of how big the difference was.
- ± The spread of scores around the group average, as printed in the paper.
Source: Hattabi S, Forte P, Kukic F, et al.. A Randomized Trial of a Swimming-Based Alternative Treatment for Children with Attention Deficit Hyperactivity Disorder. International Journal of Environmental Research and Public Health (2022). doi:10.3390/ijerph192316238