The Frontier Psychiatrists is a newsletter and media empire, writ tiny. My most popular one-day article of all time was New Year’s Day, this year, in which I reviewed the data on “Walking” for depression, in the same manner in which I review medicines. Spoiler Alert: It’s a remarkably potent intervention (effect size: > 0.8).
I have written about medical-ish devices for ADHD before (like a satire piece about the Eames Chair and my advocacy for Timer Cubes). I have also written go-to articles about ADHD in adults like this one.
Today, I review the data on Fidgeting as assisted by spinners in youth with ADHD. Kids love ‘em. However, do they help?
What is fidgeting? Even the dictionary definition is stigmatizing and misses the point:
fidg·et
/ˈfijət/
verb
gerund or present participle: fidgeting
make small movements, especially of the hands and feet, through nervousness or impatience.
"the audience had begun to fidget on their chairs"
What about just having to move, you know? Cause that is what your brain is screaming to do in almost all moments of horrible—excruciating—repose? Welcome to our world, dictionary behavior police. I’m not nervous, and I am impatient, but it’s a second-order phenomenon, thank you.
I was a bit surprised when I got the inspiration to crank this article out, to see the following data present itself in the scientific literature. Did you know that—beyond the fact that ADHD kiddos and adults move more—the fidgeting helps them stay “on task?1” I did not!
The evidence that is available is based on contentions that body movements during learning activities can improve a student’s ability to concentrate (Rapport et al., 2009). In groups of boys aged 8–12 years, both students with ADHD and without ADHD moved more when completing tasks that purported to measure working memory (Rapport et al., 2009) and behavioral inhibition (Alderson et al., 2012).
In the most popular study design with young people that one could imagine, they were provided with assistive technology. This technology was in the form of a fidget spinner.
The initial release of wildly popular fidgit spinners was met with opprobrium by pediatrics journals:
Due to a recent surge in popularity, fidget spinners and other self-regulatory occupational therapy toys have yet to be subjected to rigorous scientific research. Thus, their alleged benefits remain scientifically unfounded. Paediatricians should be aware of potential choking hazards with this new fad, and inform parents that peer-reviewed studies do not support the beneficial claims.2
There is nothing like informing parents about peer reviewed literature to really move the needle on a health belief, of course3.
In fairness, as of 2018, early studies were negative as it relates to the efficiency of spinners…I will of course start with methods:
Method: Using an A-B-A-B design, 60 children (Mage = 4.86 years, 83% Hispanic) diagnosed with ADHD participated in the study. Following a baseline period, four random children from each classroom were given fidget spinners across three separate days (n = 48). Children wore accelerometers and were videotaped for 5-min during class in which attentional data were coded.
This is strong internal control design! The kids serve as their own controls! However, in this trial, we learn…well, first, kids LOVE spinners!
Upon given the chance, children used the fidget spinner at a high frequency during the first intervention observation (M = 2.49 out of 3, SD = .89) as well as during the second intervention observation (M = 2.53 out of 3, SD = .79). In fact, only two children never used the fidget spinner during the observations. The majority of children used the fidget spinner during almost the entire observation (71% during first intervention observation and 69% during second intervention observation). Use of fidget spinner was not related to DBD symptom severity.4
So here is where the data gets interesting! In a shorter study design, or with less careful rating, one would conclude spinners are helpful…as our 2018 small sample study did, above.
The effect on where the kid is physically is observed early but wears off…
When evaluating if the kids are paying attention (not just “not wandering around”) The impact of spinners is dramatically (and statistically) negative!
The spinner is probably what they are paying attention to! But in this cohort of very ADHD youngsters, they do not pay attention to school stuff at higher rates when given spinners which is a durable effect.
This pernicious effect in young kids persists in older and less impaired kiddos:
While a small number of previous research studies indicate that fidget spinners reduce on-task behavior, no research to date has evaluated their effect on student performance. The current study evaluated 3rd grade students to determine whether their performance on 5-min math curriculum–based measures (CBM) changed depending on whether they had access to a fidget spinner. Results indicated that student performance was lower when they were allowed to use fidget spinners than when the fidget spinner was removed. The current study suggests that fidget spinners may cause a deficit in student performance5
They not only don’t help—they appear to help at first (less gross motor movement, aka spending time in the general area of the task). This effect wears off rapidly. The impairing of effects of spinners persist, and even in older and less sick kids, lead to less engaging school task impairment.
The kids pay attention to the spinners. Because, of course.
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Aspiranti KB, Hulac DM. Using Fidget Spinners to Improve On-Task Classroom Behavior for Students With ADHD. Behav Anal Pract. 2021 Jun 2;15(2):454-465. doi: 10.1007/s40617-021-00588-2. PMID: 35692528; PMCID: PMC9120292.
Schecter, Rachel A.a; Shah, Jayb; Fruitman, Katec; Milanaik, Ruth Lynnc. Fidget spinners: Purported benefits, adverse effects and accepted alternatives. Current Opinion in Pediatrics 29(5):p 616-618, October 2017. | DOI: 10.1097/MOP.0000000000000523
Schaefer, E. S. (1991). Goals for parent and future-parent education: Research on parental beliefs and behavior. The Elementary School Journal, 91(3), 239-247.
Graziano, P. A., Garcia, A. M., & Landis, T. D. (2020). To fidget or not to fidget, that is the question: A systematic classroom evaluation of fidget spinners among young children with ADHD. Journal of attention disorders, 24(1), 163-171.
Hulac, D. M., Aspiranti, K., Kriescher, S., Briesch, A. M., & Athanasiou, M. (2021). A multisite study of the effect of fidget spinners on academic performance. Contemporary School Psychology, 25, 582-588.
Two things— I briefly taught at a school where things like this were all the rage with kids who had ADHD. Also— i will always regret not buying the Steve Bannon fidget spinner when it was available.