EFFECTIVENESS OF SCHOOL-BASED ART INTERVENTIONS ON EXECUTIVE FUNCTION IN CHILDREN WITH ADHD:A SYSTEMATIC REVIEW

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with persistent executive function (EF) deficits that negatively affect children’s academic performance and behavioral regulation. Although pharmacological and behavioral interventions can reduce core ADHD symptoms, they do not consistently improve executive functioning. School-based art interventions have been suggested as complementary approaches that may support EF development. This systematic review examined the effectiveness of school-based art interventions in improving executive functioning among children aged 6–14 years diagnosed with ADHD. Following PRISMA 2020 guidelines, a comprehensive search of Pub Med, ERIC, PsycINFO, and Scopus identified studies published between January 2000 and February 2026. Eligible studies included empirical research investigating structured school-based art interventions with executive function outcomes. Thirteen studies met the inclusion criteria, including visual arts (n=4), music-based (n=3), drama/theater (n=3), and movement/creative arts (n=3) interventions. Visual arts interventions showed moderate improvements in inhibitory control and planning, while music-based interventions improved working memory. Drama and movement-based interventions demonstrated gains in self-regulation and cognitive flexibility, though results were mixed. Overall findings suggest that school-based art interventions may support executive functioning in children with ADHD; however, further large-scale and long-term studies are needed.

Keywords: ADHD, executive function, school-based art interventions, special education, systematic literature review.

Ethics and Conflict of Interest

The authors declare that ethical guidelines were followed throughout the research process. The authors also declare that there is no conflict of interest regarding this study.

REFERENCES 

Ahmed, A. (2019). Effects of music and rhythm intervention on working memory in children with ADHD [Unpublished     master’s thesis]. Cairo University.

Ahmed, S. (2019). Effects of creative arts on executive functioning in children with ADHD: A quasi-experimental study.          Journal of Child Psychology and Education, 12(3), 45–58.

Albalawi, A. S., Khayyal, A. I., Alnasser, F. A., AlSuhaymi, N. N. M., Assiri, A. A. M., & Alahmadi, R. S. S. (2026).     Effective approaches to managing behavioral problems in children with attention-deficit/hyperactivity disorder      (ADHD): A narrative review. Cureus, 18(1), e102011. https://doi.org/10.7759/cureus.102011

Alhamdan, A. A., Murphy, M. J., Pickering, H. E., & Crewther, S. G. (2023). The contribution of visual and auditory     working memory and non-verbal IQ to motor multisensory processing in elementary school children. Brain     Sciences, 13(2), 270. https://doi.org/10.3390/brainsci13020270

Alrazain, B. (2016). Developing and evaluating an arts therapies programme for children with attention deficit hyperactivity              disorder (ADHD) in primary schools in the Kingdom of Saudi Arabia (KSA) [Unpublished doctoral dissertation].         University of [Institution not specified].

Al-Salimiyah, A. H., Abu Bakar, A., Mi, M. Y., & Al-Makki, S. (2025). Impact of a visual art-based therapeutic intervention               on oral expression skills among students with learning difficulties. Ibn Khaldun Journal of Studies and Research,           5(5), 315–325.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.

American Psychiatric Association. (2022). Attention-deficit/hyperactivity disorder and related attention problems. American    Journal of Psychiatry, 179(4), 243–252. https://doi.org/10.1176/appi.ajp.2022.21101343

Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). Guilford      Press.

Biederman, J., & Faraone, S. V. (2005). Attention-deficit hyperactivity disorder. The Lancet, 366(9481), 237-248.     https://doi.org/10.1016/S0140-6736(05)66915-2

Borzabadi Farahani, Z., Rahgoi, A., Fallahi-Khoshknab, M., & Hosseinzadeh, S. (2023). The effect of art therapy (mandala     coloring) on the attention level of children with attention deficit/hyperactivity disorder. Art Therapy, 40(3), 151‑  156. https://doi.org/10.1080/07421656.2023.2184201

Cetin, Z., & Danacı, M. Ö. (2015). The effect of art education on the selective attention skills and development of     preschoolers at 4–5 years. Creative Education, 6, 2250–2255. https://doi.org/10.4236/ce.2015.614235

Chen, B. (2018). Visual arts therapy and executive functioning in Taiwanese children with ADHD [Unpublished master’s      thesis]. National Taiwan University.

Chen, L. (2018). Visual arts interventions and cognitive control in school-aged children with ADHD. International Journal       of Art Therapy, 23(2), 85–97. https://doi.org/10.1080/17454832.2018.1491460

Contreras-Osorio, F., Guzmán-Guzmán, I. P., Cerda-Vega, E., Chirosa-Ríos, L., Ramírez-Campillo, R., & Campos-Jara, C.        (2022). Effects of the type of sports practice on the executive functions of schoolchildren. International Journal of            Environmental Research and Public Health, 19(7), 3886. https://doi.org/10.3390/ijerph19073886

Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135–168. https://doi.org/10.1146/annurev-              psych-113011-143750

DuPaul, G. J., & Stoner, G. (2014). ADHD in the schools: Assessment and intervention strategies (3rd ed.). Guilford Press.

Evans, S. W., Owens, J. S., & Bunford, N. (2014). Evidence-based psychosocial treatments for children and adolescents with            ADHD. Journal of Clinical Child & Adolescent Psychology, 43(4), 527–551.     https://doi.org/10.1080/15374416.2013.850700

Garcia, C. (2015). Integrated arts intervention and executive functions in Mexican schoolchildren with ADHD [Unpublished             master’s thesis]. National Autonomous University of Mexico.

Hassan, A., & Ali, M. (2024). Music-based intervention effects on working memory in children with ADHD in the UAE     [Unpublished research report]. United Arab Emirates University.

Ibrahim, D. (2021). Drama approaches to self-regulation in UK children with ADHD [Unpublished doctoral dissertation].              University of Oxford.

Johnson, E. (2025). Drama-based classroom strategies and self-regulation outcomes in ADHD [Unpublished master’s thesis]. University of California, Los Angeles.

Johnson, K. A. (2025). The creative classroom: A phenomenological study of engagement in students with ADHD [Unpublished doctoral dissertation]. University of Nebraska at Kearney.

Kasuya-Ueba, Y., Zhao, S., & Toichi, M. (2020). The effect of music intervention on attention in children: Experimental             evidence. Frontiers in Neuroscience, 14, 757. https://doi.org/10.3389/fnins.2020.00757

Kim, H., & Park, J. (2021). Music-based interventions for enhancing working memory in Korean children with ADHD     [Unpublished master’s thesis]. Seoul National University.

Lee, S. (2014). Art therapy: Planning and self-regulation outcomes in children with ADHD [Unpublished master’s thesis].        Korea University.

Lopez, J. (2020). Visual arts intervention effects on inhibitory control in children with ADHD [Unpublished master’s thesis].        Harvard University.

Ludyga, S., Hanke, M., Leuenberger, R., Bruggisser, F., Pühse, U., Gerber, M., Lemola, S., Capone-Mori, A., Keutler, C.,               Brotzmann, M., & Weber, P. (2023). Martial arts and cognitive control in children with attention-deficit         hyperactivity disorder and children born very preterm: A combined analysis of two randomized controlled trials.         Medicine & Science in Sports & Exercise, 55(5), 777–786. https://doi.org/10.1249/MSS.0000000000003110

Martin, K. (2022). Movement/creative arts intervention and cognitive flexibility in ADHD [Unpublished master’s thesis].        University of Toronto.

Novak, L., & Brown, P. (2016). Drama interventions and self-regulation gains in children with ADHD [Unpublished master’s thesis]. University of Sydney.

Pelham, W. E., & Fabiano, G. A. (2008). Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder.     Journal of Clinical Child & Adolescent Psychology, 37(1), 184–214. https://doi.org/10.1080/15374410701818681

Rodriguez, M., & Smith, T. (2017). Creative movement for cognitive flexibility in ADHD: Pre-post outcomes [Unpublished             master’s thesis]. University of Barcelona.

Shin, H. J., Lee, H. J., Kang, D., Kim, J. I., & Jeong, E. (2023). Rhythm-based assessment and training for children with            attention deficit hyperactivity disorder (ADHD): A feasibility study protocol. Frontiers in Human Neuroscience,            17, 1190736. https://doi.org/10.3389/fnhum.2023.1190736

Silva, R. (2023). Visual arts and impulse control improvements in Brazilian children with ADHD [Unpublished master’s      thesis]. University of São Paulo.

Willcutt, E. G., Doyle, A. E., Nigg, J. T., Faraone, S. V., & Pennington, B. F. (2005). Validity of the executive function     theory of attention-deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57(11), 1336–         1346. https://doi.org/10.1016/j.biopsych.2005.02.006

Wong, T.-Y., Chang, Y.-T., Wang, M.-Y., & Chang, Y.-H. (2023). The effectiveness of child-centered play therapy for              executive functions in children with attention-deficit/hyperactivity disorder. Clinical Child Psychology and          Psychiatry, 28(3), 877–894. https://doi.org/10.1177/13591045221128399