964 Journal of Physical Activity and Health, 2011, 8, 964 -970 © 2011 Human Kinetics, Inc. Barnard-Brak and Brak are with the Dept of Educational Psychology, Texas Tech University, Lubbock, TX. Davis and Sulak are with the Dept of Educational Psychology, Baylor University, Waco, TX. The Association Between Physical Education and Symptoms of Attention Deficit Hyperactivity Disorder Lucy Barnard-Brak, Tonya Davis, Tracey Sulak, and Victor Brak Objective: The purpose of the current study was to examine the association between structured physical activity, specifically physical education, and symptoms of Attention Deficit Hyperactivity Disorder (ADHD). Physical activity may be associated with lower levels of symptoms of ADHD and this rationale provided the impetus for the current study. Methods: A community-based, nationally representative sample of children from the Early Childhood Longitudinal Study, Kindergarten cohort (ECLS-K) was used. Structural equation modeling was used to examine the association of physical activity with symptoms of Attention Deficit Hyperactivity Disorder. Two random subsamples were drawn for the purposes of cross-validation of our model. Statistics reflecting model fit are reported. Results: With a standardized path coefficient value of –.23, findings from the current study indicate a significant, inverse association between physical education, as a structured form of physical activity, with the symptoms of Attention Deficit Hyperactivity Disorder in children. Conclusions: Using a community-based, nationally representative sample of children aged 5 to 7 years old from the United States, the results of the current study suggest that physical education, as a structured form of physical activity, may be considered as associated with lower levels of symptoms of ADHD across time. Keywords: physical activity, ECLS, ADHD Attention Deficit Hyperactivity Disorder (ADHD) has been reported as affecting approximately 1 in 20 school-aged children. 1 This number is equivalent to having 1 child in every classroom across the nation having ADHD. In fact, ADHD is one of the mostly com- monly diagnosed childhood psychiatric disorders. 2 The symptoms of ADHD have been typically characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity that cause significant impairment in daily functioning. 1 Needless to say, these symptoms that characterize ADHD can present challenges for children in school often translating into inappropriate behaviors such as difficulty taking turns, excessive talking, interrupting others, and excessive motor activity. The symptoms of ADHD have also been associated with poorer outcomes for children with ADHD as compared with their typically developing peers such as increased behavioral problems, 3 higher likelihood of substance abuse issues, 4 lower academic achievement, 5 and higher rates of criminal recidivism. 6 The 2 most commonly implemented treatments for addressing these difficulties and challenges experienced by children with ADHD include drug or pharmacological therapy (eg, stimulants) and behavioral interventions. 7 The use of drug treatment continues to be an issue of con- troversy in addressing the challenges faced by individuals with ADHD. This ongoing controversy has been aptly termed as the Ritalin wars. 8 In fact, several studies have demonstrated that parental perspectives of drug treatment options are not consistently favorable. Efron, Jarman, and Barker 9 indicated that many children had negative feelings toward medications while Doherty et al 10 found that approximately half of their sample of children with ADHD reported that they would stop taking medication if provided the choice. Regardless of the evidence that nonpharmacological treatments appear to be the preferred treatment option for many parents and children, medications, in the form of stimulants typically, continues to increase as a treat- ment option for ADHD. 11 Therefore, it is imperative that effective behavioral interventions are identified that are easy to implement so that parents and practitioners may have a variety of options that suit their preferred treatment choices with respect to the child such as the inclusion of exercise. The link between low motor pro- ficiency and ADHD has been well documented, but less research has investigated the effects of motor activity on the behavior related to ADHD. Exercise has been found to increase brain-derived neurotrophic factor (BDNF), which is associated with neurogenesis, or the generation of brain tissue. 12 By enhancing the ability to encode, exercise such as methods employed in dance and move- ment therapy may also contribute to improvement in measurable behaviors like concentration, hyperactivity