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Morris S, Ling M, Sheen J, Sciberras E. Variation in latent social profiles of adolescent ADHD and related clinical features. Psychiatry Res 2021; 302:114014. [PMID: 34102374 DOI: 10.1016/j.psychres.2021.114014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 05/13/2021] [Indexed: 12/15/2022]
Abstract
Social impairment is a hallmark of Attention-deficit/hyperactivity disorder (ADHD), but the extent of variation in adolescent social strengths and weaknesses is unclear. We compared teacher-reported characteristics of social functioning in adolescents with a history of ADHD (N = 340), and without ADHD (N = 182) from the NIMH Collaborative Multisite Multimodal Treatment Study of Children with ADHD (MTA) at 72-month follow-up (13 - 15.9 years-old). Latent profile analysis of teacher-reported cooperation, assertion and self-control on the Social Skills Rating System (SSRS), was used to identify "social profiles". Their associations with clinical features were explored. Significant differences in social functioning were identified between adolescents with a history of ADHD, and without ADHD (ES = 0.54 - 0.77). Four distinct social profiles were identified in adolescents with a history of ADHD: unskilled (N = 24, 7%), low average (N = 144, 42%), average (N = 141, 41%), and skilled (N = 31, 9%). Profiles with worse social functioning (low average, unskilled) displayed more symptoms of inattention, hyperactivity/impulsivity, oppositionality, depression, global impairment, and were less liked, more rejected and ignored by peers than average and skilled. Social profile membership was not associated with sex, anxiety symptoms, or remittance / persistence of ADHD. Social functioning in adolescents with a history of ADHD is variable, and associated with worse symptomology, global functioning, and peer relationships, irrespective of persistence or remittance of ADHD. Group level summaries of social difficulties in ADHD may be inadequate given nearly half of adolescents with a history of ADHD presented with average or skilled social profiles.
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Affiliation(s)
- Sarah Morris
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Mathew Ling
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Jade Sheen
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Emma Sciberras
- School of Psychology, Deakin University, Geelong, VIC, Australia; Murdoch Childrens Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
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102
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DuPaul GJ, Evans SW, Owens JS, Cleminshaw CL, Kipperman K, Fu Q, Benson K. School-based intervention for adolescents with attention-deficit/hyperactivity disorder: Effects on academic functioning. J Sch Psychol 2021; 87:48-63. [PMID: 34303447 DOI: 10.1016/j.jsp.2021.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/24/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
Multi-component training interventions such as the Challenging Horizons Program (CHP) improve organization skills and academic functioning of middle school students with attention-deficit/hyperactivity disorder (ADHD); however, few studies have investigated treatment for high school students. We explored the extent to which CHP adapted for high school would improve proximal (e.g., organization skills, homework performance) and distal (e.g., report card grades) academic outcomes through 6-month follow-up relative to a community care (CC) condition. Participants included 186 adolescents who were randomly assigned to CHP (n = 92; 80% male; M age = 15.0; SD = 0.8) or CC (n = 94; 78% male; M age = 15.1; SD = 0.9) with CHP delivered over one school year. Parent, teacher, and self-report ratings of organization skills and academic performance, report card grades, and achievement tests were collected across multiple occasions. Intent-to-treat analyses using hierarchical linear modeling revealed significant improvements of small to medium magnitude (d range = 0.32 to 0.58) for parent-rated organization skills, homework performance, and academic functioning at 6-month follow-up. CHP effect on grades was small, but associated with a less steep decline than that found for CC. No statistically significant effects on teacher or self-report ratings were obtained. CHP appears efficacious for ameliorating organization skills and homework performance deficits exhibited by high school students with ADHD and can protect against decline in report card grades experienced by these students. CHP may require supplementation with academic skills instruction for some students and may need implementation beyond one school year to produce durable effects.
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103
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Wymbs BT, Canu WH, Sacchetti GM, Ranson LM. Adult ADHD and romantic relationships: What we know and what we can do to help. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:664-681. [PMID: 33421168 DOI: 10.1111/jmft.12475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/15/2020] [Accepted: 11/22/2020] [Indexed: 05/27/2023]
Abstract
It has been widely maintained that enduring and healthy romantic relationships are critical to quality of life in adulthood, and can buffer the impact of adversity, including psychological disorder. Unfortunately, much research points toward adults with attention-deficit hyperactivity disorder (ADHD) having short-lived and discordant romantic relationships. Despite this ample evidence, relatively little research has focused on identifying specific factors that may strengthen or explain their relational difficulties, which would have obvious relationship distress prevention and intervention implications. The current study reviews the state of the literature on romantic relationships in adults with ADHD, including differences that have been established between ADHD and non-ADHD populations as well as distal and proximal factors that appear to increase risk of relationship distress of adults with ADHD. Finally, notable gaps in the literature are identified and implications are raised with regards to prevention and intervention efforts designed to address functional impairment in adults with ADHD.
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Affiliation(s)
- Brian T Wymbs
- Department of Psychology, Ohio University, Athens, OH, USA
| | - Will H Canu
- Department of Psychology, Appalachian State University, Boone, NC, USA
| | | | - Loren M Ranson
- Department of Psychology, Appalachian State University, Boone, NC, USA
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104
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Evans SW, Allan D, Xiang J, Margherio SM, Owens JS, Langberg JM. Organization interventions as a mediator of change in grades in the Challenging Horizons Program. J Sch Psychol 2021; 87:18-27. [PMID: 34303445 DOI: 10.1016/j.jsp.2021.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 02/28/2021] [Accepted: 05/14/2021] [Indexed: 12/28/2022]
Abstract
This study evaluated whether an organization intervention was a mediator of change for grade point average (GPA) in a randomized clinical trial of a school-based treatment program for adolescents with attention deficit hyperactivity disorder (ADHD). A demographically diverse sample of 148 participants (105 males) with a diagnosis of ADHD were recruited from nine middle schools. Comprehensive diagnostic evaluations were completed and participants were randomized into one of three conditions (two active treatment conditions, one control condition) for a randomized clinical trial that lasted an entire school year. The results of the trial are reported elsewhere (Evans et al., 2016; Schultz et al., 2017); in this study we evaluated four of the criteria for determining mediation as reported by Kazdin (2007) to determine whether response to the organization intervention in this school-based treatment program mediated the relationship between dosage and GPA beyond previous GPA. The results provided evidence that response to the organization intervention mediated the relationship between intervention dosage and change in GPA.
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Affiliation(s)
- Steven W Evans
- Ohio University, Department of Psychology, Athens, OH 45701, United States.
| | - Darcey Allan
- Ohio University, Department of Psychology, Athens, OH 45701, United States.
| | - Joe Xiang
- Ohio University, Department of Psychology, Athens, OH 45701, United States.
| | | | - Julie Sarno Owens
- Ohio University, Department of Psychology, Athens, OH 45701, United States.
| | - Joshua M Langberg
- Virginia Commonwealth University, Department of Psychology, Richmond, VA 23284, United States.
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105
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Mikami AY, Owens JS, Evans SW, Hudec KL, Kassab H, Smit S, Na JJ, Khalis A. Promoting Classroom Social and Academic Functioning among Children at Risk for ADHD: The MOSAIC Program. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2021; 51:1039-1052. [PMID: 34133243 DOI: 10.1080/15374416.2021.1929250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Social and academic functioning are linked in elementary school, and both are frequently impaired in children with elevated symptoms of attention-deficit/hyperactivity disorder (ADHD). This study evaluated the Making Socially Accepting Inclusive Classrooms (MOSAIC) program, a classroom intervention to support children's social and academic functioning, especially for children at risk for ADHD. Teachers delivered MOSAIC practices to the whole class and applied some strategies more frequently to target children selected for elevated ADHD symptoms and peer impairment.Method: Participants were 34 general education teachers (grades K-5) and 558 children in their classrooms, randomized to MOSAIC or to a typical practice control group for one academic year. In the fall and spring, we assessed (a) peers' sociometric judgments of children, (b) children's self-report of supportive relationships with teachers and peers, and (c) teachers' report of children's social and academic competencies and impairments.Results: Regarding whole class effects, relative to control group children, children in MOSAIC classrooms (target and non-target children) were rated by teachers in spring as having better competencies and lower impairment, after controlling for fall functioning. There were no main effects of MOSAIC on peer sociometrics or child perceptions of supportive relationships. Target status moderated some effects such that, in spring, target children in MOSAIC perceived greater support from their teachers but received poorer sociometrics than did target children in control classrooms.Conclusions: We discuss the difficulty in changing peers' perceptions of children with ADHD symptoms, even in the presence of improvements in other aspects of social and academic functioning.
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Affiliation(s)
| | | | | | | | | | - Sophie Smit
- Department of Psychology, University of British Columbia
| | | | - Adri Khalis
- Department of Psychology, University of British Columbia
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106
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Danielson ML, Bitsko RH, Holbrook JR, Charania SN, Claussen AH, McKeown RE, Cuffe SP, Owens JS, Evans SW, Kubicek L, Flory K. Community-Based Prevalence of Externalizing and Internalizing Disorders among School-Aged Children and Adolescents in Four Geographically Dispersed School Districts in the United States. Child Psychiatry Hum Dev 2021; 52:500-514. [PMID: 32734339 PMCID: PMC8016018 DOI: 10.1007/s10578-020-01027-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The Project to Learn About Youth-Mental Health (PLAY-MH; 2014-2018) is a school-based, two-stage study designed to estimate the prevalence of selected mental disorders among K-12 students in four U.S.-based sites (Colorado, Florida, Ohio, and South Carolina). In Stage 1, teachers completed validated screeners to determine student risk status for externalizing or internalizing problems or tics; the percentage of students identified as being at high risk ranged from 17.8% to 34.4%. In Stage 2, parents completed a structured diagnostic interview to determine whether their child met criteria for fourteen externalizing or internalizing disorders; weighted prevalence estimates of meeting criteria for any disorder were similar in three sites (14.8%-17.8%) and higher in Ohio (33.3%). PLAY-MH produced point-in-time estimates of mental disorders in K-12 students, which may be used to supplement estimates from other modes of mental disorder surveillance and inform mental health screening and healthcare and educational services.
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Affiliation(s)
- Melissa L. Danielson
- Division of Human Development and Disability, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE MS S106-4, Atlanta, GA 30341-3717, USA
| | - Rebecca H. Bitsko
- Division of Human Development and Disability, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE MS S106-4, Atlanta, GA 30341-3717, USA
| | - Joseph R. Holbrook
- Division of Human Development and Disability, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE MS S106-4, Atlanta, GA 30341-3717, USA
| | - Sana N. Charania
- Division of Human Development and Disability, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE MS S106-4, Atlanta, GA 30341-3717, USA,Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Angelika H. Claussen
- Division of Human Development and Disability, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE MS S106-4, Atlanta, GA 30341-3717, USA
| | - Robert E. McKeown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Steven P. Cuffe
- Department of Psychiatry, University of Florida College of Medicine–Jacksonville, Jacksonville, FL, USA
| | | | | | - Lorraine Kubicek
- Department of Pediatrics and Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kate Flory
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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107
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Zoromski AK, Epstein JN, Ciesielski HA. Unique Associations Between Specific Attention-Deficit Hyperactivity Disorder Symptoms and Related Functional Impairments. J Dev Behav Pediatr 2021; 42:343-354. [PMID: 33433140 DOI: 10.1097/dbp.0000000000000904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 11/10/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to explore the unique relationships between specific attention-deficit hyperactivity disorder (ADHD) symptoms and functional impairment in school-age children using parent and teacher ratings. METHODS Parents and teachers rated ADHD symptoms and comorbidities (internalizing and oppositional behaviors) as well as impairments (academic, relationship, and classroom behavior) for 8689 children using the Vanderbilt ADHD Diagnostic Rating Scales. Stepwise regression was used to determine which of the 18 ADHD symptom items were most associated with specific domains of impairment with relevant demographic and clinical characteristics used as covariates (e.g., sex, comorbidities, medication status, and age). RESULTS "Careless mistakes" and "avoids tasks" significantly predicted academic impairment across content areas and across parent- and teacher-rating models. ADHD symptoms accounted for limited variance in impairment in the family and peer relationship domains or in organized activities when oppositional symptoms were entered as a covariate. Regarding teacher-rated classroom behavior, the strongest predictor of impairment was "talks too much." CONCLUSION The findings indicate that the symptoms that were most predictive of impairment varied by domain of impairment.
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Affiliation(s)
- Allison K Zoromski
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Jeffery N Epstein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Heather A Ciesielski
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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108
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Dvorsky MR, Friedman LM, Spiess M, Pfiffner LJ. Patterns of Parental Adherence and the Association to Child and Parenting Outcomes Following a Multicomponent School-Home Intervention for Youth With ADHD. Behav Ther 2021; 52:745-760. [PMID: 33990247 PMCID: PMC8124088 DOI: 10.1016/j.beth.2020.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 09/16/2020] [Accepted: 09/30/2020] [Indexed: 11/30/2022]
Abstract
The goal of the present study was to evaluate the role of parent adherence in the Collaborative Life Skills (CLS) program, a multicomponent school-home intervention, for predicting child and parenting outcomes. A sample of 129 children (63% male; M age = 8.22, SD = 1.10; grades 2-5) with attention-deficit/hyperactivity disorder (ADHD) and their parents participated in CLS, which included 10 weekly behavioral parent training group sessions. Each week, parents provided information on their CLS skill use between sessions (at home) as part of the intervention. Outcome measures included parent and teacher ratings of child behavior and parenting at post-intervention and 6 months follow-up. Growth mixture models examining weekly parent skill use trajectories throughout the intervention significantly predicted parent- and teacher-reported outcomes including parent-rated child behavior, teacher-rated academic competence, and positive parenting behaviors. Fifty-two percent of parents displayed moderate skill use throughout the intervention, whereas the remaining parents had either low (20%) or high (28%) initial levels of use but demonstrated high skill utilization by the middle of the intervention. Results highlight the importance of examining individual differences in parents between session strategy use for behavioral parent training interventions targeting child and parenting outcomes.
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Affiliation(s)
- Melissa R Dvorsky
- Children's National Hospital; The George Washington University School of Medicine and Health Sciences; University of California, San Francisco.
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109
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Alperin A, Reddy LA, Glover TA, Bronstein B, Wiggs NB, Dudek CM. School-Based Interventions for Middle School Students With Disruptive Behaviors: A Systematic Review of Components and Methodology. SCHOOL PSYCHOLOGY REVIEW 2021. [DOI: 10.1080/2372966x.2021.1883996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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110
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Conroy K, Hong N, Poznanski B, Hart KC, Ginsburg GS, Fabiano GA, Comer JS. Harnessing Home-School Partnerships and School Consultation to Support Youth With Anxiety. COGNITIVE AND BEHAVIORAL PRACTICE 2021; 29:381-399. [PMID: 35812004 PMCID: PMC9267952 DOI: 10.1016/j.cbpra.2021.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Youth with anxiety often experience significant impairment in the school setting. Despite the relevance and promise of addressing anxiety in schools, traditional treatment approaches to school-based anxiety often do not adequately address generalization to the school setting, or they require removing the student from the classroom to deliver time- and staff-intensive programs. Such programs often leave teachers and caregivers feeling ill-equipped to support the student with anxiety throughout the natural course of the school day. Given the heavy demands placed on teachers and documented burnout among school professionals, providing effective school supports requires collaborative partnerships among outpatient therapists/specialists, school personnel, and caregivers. Drawing from literature on collaborative models for externalizing problems, we offer recommendations for outpatient therapists and specialists working to implement evidence-based supports in school settings and promote home-school partnerships to benefit youth with anxiety in the school setting. Our recommendations touch upon several components of such school consultation, including (a) identification of key parties involved, (b) conducting a needs assessment, (c) collaborative goal setting and development of a fear hierarchy, (d) plan development and implementation (e.g., facilitating a school-based exposure mindset, promoting home-school communication, enhancing school relationships), and (e) progress monitoring and ongoing support. We conclude with a case example to bring these recommendations to life.
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111
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Examination of developmental pathways from preschool temperament to early adolescent ADHD symptoms through initial responsiveness to reward. Dev Psychopathol 2021; 34:841-853. [PMID: 33722319 DOI: 10.1017/s0954579420002199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
To identify sources of phenotypic heterogeneity in attention-deficit/hyperactivity disorder (ADHD) accounting for diversity in developmental/ pathogenic pathways, we examined, in a large sample of youth (N = 354), (a) associations between observed temperamental emotionality at age 3, an electrocortical index (i.e., reward positivity [RewP]) of initial responsiveness to reward at age 9, and ADHD symptoms at age 12, and (b) whether the association between emotionality and ADHD symptoms is mediated by initial responsiveness to reward. Bivariate analyses indicated greater positive emotionality (PE) was associated with enhanced RewP, lower age-9ADHD and lower age-12 inattention (IA). Negative emotionality (NE) was not associated with RewP or ADHD. Mediation analyses revealed the association between PE and hyperactivity/impulsivity (H/I) was mediated by RewP; enhanced RewP was associated with greater H/I. Greater PE was associated with enhanced RewP at a trend level. These effects held accounting for age-9 ADHD, age-12 IA and age-12 oppositional defiant and conduct disorder symptoms. As such, preschool emotionality is associated with adolescent ADHD-H/I symptoms through late childhood initial responsiveness to reward. These relations indicate that individual differences in emotionality and reward responsiveness may be informative for personalizing ADHD interventions.
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112
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Lin Y, Jin H, Huang B, Zhao N, Li Z, Mao J, Chen C, Xu J, Zhang J, Shuai B. Efficacy and safety of acupuncture on childhood attention deficit hyperactivity disorder: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e23953. [PMID: 33592848 PMCID: PMC7870224 DOI: 10.1097/md.0000000000023953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/01/2020] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION The purpose of this paper is to evaluate the efficacy and safety of acupuncture in the treatment of childhood attention deficit hyperactivity disorder (ADHD). METHODS AND ANALYSIS We will electronically search PubMed, Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trial, China National Knowledge Infrastructure, China Biomedical Literature Database, China Science Journal Database, and Wan-fang Database from their inception. Also, we will manually retrieve other resources, including reference lists of identified publications, conference articles, and grey literature. The clinical randomized controlled trials or quasi-randomized controlled trials related to acupuncture treating pediatric ADHD will be included in the study. The language is limited to Chinese and English. Research selection, data extraction, and research quality assessment will be independently completed by 2 researchers. Data were synthesized by using a fixed effect model or random effect model depend on the heterogeneity test. The scores of Revised Conners' Parent Rating Scale (CPRS-R), Conners Teacher Rating Scale (CTRS-R), and Child Behavior Checklist (CBCL) will be the primary outcomes. Besides, the scores of the Conners Continuous Performance Test, Internal Restlessness Scale, and Behavior Assessment System for Children (BASC), and the possible adverse events will also be assessed as secondary outcomes. RevMan V.5.3 statistical software will be used for meta-analysis, and the level of evidence will be assessed by Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Continuous data will be expressed in the form of weighted mean difference or standardized mean difference with 95% confidence intervals (CIs), while dichotomous data will be expressed in the form of relative risk with 95% CIs. ETHICS AND DISSEMINATION The protocol of this systematic review (SR) does not require ethical approval because it does not involve humans. We will publish this article in peer-reviewed journals and presented at relevant conferences. SYSTEMATIC REVIEW REGISTRATION OSF Registries, DOI: 10.17605/OSF.IO/XVYP9 (https://osf.io/xvyp9).
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113
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Loe IM, Kakar PA, Sanders LM. Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder. JAMA Pediatr 2021; 175:191-192. [PMID: 32777021 DOI: 10.1001/jamapediatrics.2020.2218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Irene M Loe
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Pooja A Kakar
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Lee M Sanders
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
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114
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Staff AI, van den Hoofdakker BJ, van der Oord S, Hornstra R, Hoekstra PJ, Twisk JWR, Oosterlaan J, Luman M. Effectiveness of Specific Techniques in Behavioral Teacher Training for Childhood ADHD: A Randomized Controlled Microtrial. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2021; 50:763-779. [PMID: 33471581 PMCID: PMC8802898 DOI: 10.1080/15374416.2020.1846542] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: Behavioral teacher training is the most effective classroom-based intervention for children with attention-deficit/hyperactivity disorder (ADHD). However, it is currently unknown which components of this intervention add to its effectiveness and for whom these are effective. Method: In this microtrial, teachers of 90 children with impairing levels of ADHD symptoms (6–12 years) were randomly assigned to one of three conditions: a short (2 sessions), individualized intervention consisting of either (A) antecedent-based techniques (stimulus control), (B) consequent-based techniques (contingency management) or (C) waitlist. Primary outcome was the average of five daily assessments of four individualized problem behaviors, assessed pre and post intervention and three months later. Moderation analyses were conducted to generate hypotheses on child, teacher and classroom factors that may contribute to technique effectiveness. Results: Multilevel analyses showed that both antecedent- and consequent-based techniques were equally and highly effective in reducing problem behaviors compared to the control condition (Cohen’s d =.9); effects remained stable up to three months later. Child’s age and class size were moderators of technique effectiveness. For younger children, consequent-based techniques were more effective than antecedent-based techniques, whereas for older children the effect was in the opposite direction. Further, beneficial effects of antecedent-based techniques increased when the number of students per class decreased, whilst effectiveness of consequent-based techniques did not depend on class size. Conclusions: This study shows that both antecedent- and consequent-based techniques are highly effective in reducing problem behavior of children with ADHD. Interventions may be adapted to the child’s age and class size.
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Affiliation(s)
- Anouck I Staff
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam
| | - Barbara J van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen.,Department of Clinical Psychology and Experimental Psychopathology, University of Groningen
| | - Saskia van der Oord
- Faculty of Psychology and Educational Sciences, KU Leuven.,Developmental Psychology, University of Amsterdam
| | - Rianne Hornstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam
| | - Jaap Oosterlaan
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam.,Department of Pediatrics, Amsterdam Reproduction & Development, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group
| | - Marjolein Luman
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam
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115
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Perry RC, Ford TJ, O’Mahen H, Russell AE. Prioritising Targets for School-Based ADHD Interventions: A Delphi Survey. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-020-09408-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractMany studies have investigated the effectiveness of school-based ADHD interventions at modifying different social, emotional and behavioural target outcomes. However, there is a lack of evidence about which targets stakeholders perceive to be most important. This study sought to obtain consensus on which outcomes are perceived to be most important. A total of 114 people with ADHD, educational professionals, parents of children with ADHD, clinicians and researchers participated in a Delphi survey with 3 rounds. The importance of 52 intervention targets was rated on a scale from 0 to 8 (8 being extremely important). Consensus was reached if >70% of a stakeholder group rated a target as between 6–8 and <15% rated it as 0–2. Targets were dropped from subsequent rounds if more than 50% of stakeholder groups rated it as 0–5. Targets that all four stakeholder groups reached consensus on in any round were automatically included in our final outcome set. Comments were analysed using Thematic Analysis. All four stakeholder groups reached consensus on the importance of seven targets: ability to pay attention, conflict with teachers and peers, executive functioning, global functioning and quality of life, inattention symptoms, organisation skills and self-esteem. Four overarching themes were identified: Complexity of ADHD, Relationships, School Context, and What ADHD means to me. School-based ADHD interventions should target outcomes identified as most important to those who stand to benefit from such interventions. Some outcomes prioritised by our participants have not yet been targeted in school-based ADHD interventions. Implications of our findings for intervention and research design are discussed.
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Alacha HF, Lefler EK. Negative Halo Effects in Parent Ratings of ADHD, ODD, and CD. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-020-09860-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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117
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Girio-Herrera E, Egan TE, Owens JS, Evans SW, Coles EK, Holdaway AS, Mixon CS, Kassab HD. Teacher Ratings of Acceptability of a Daily Report Card Intervention Prior to and During Implementation: Relations to Implementation Integrity and Student Outcomes. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-020-09400-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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118
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Breitling-Ziegler C, Zaehle T, Wellnhofer C, Dannhauer M, Tegelbeckers J, Baumann V, Flechtner HH, Krauel K. Effects of a five-day HD-tDCS application to the right IFG depend on current intensity: A study in children and adolescents with ADHD. PROGRESS IN BRAIN RESEARCH 2021; 264:117-150. [PMID: 34167653 DOI: 10.1016/bs.pbr.2021.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Impaired executive functions in ADHD are associated with hypoactivity of the right inferior frontal gyrus (IFG). This region was targeted via repetitive applications of anodal, high-definition transcranial direct current simulation (HD-tDCS) on five consecutive days in 33 ADHD patients (10-17years) and in a healthy control group (n=13, only sham). Patients received either sham (n=13) or verum tDCS with 0.5mA (n=9) or 0.25mA (n=11) depending on individual cutaneous sensitivity. During stimulation, participants performed a combined working memory and response inhibition paradigm (n-back/nogo). At baseline, post, and a 4-month follow up, electroencephalography was recorded during this task. Moreover, interference control (flanker task) and spatial working memory (spanboard task) were assessed to explore possible transfer effects. Omission errors and reaction time variability in all tasks served as measures of attention. In the 0.25mA group increased nogo commission errors indicated a detrimental tDCS effect on response inhibition. After the 5-day stimulation, attentional improvements in the 0.5mA group were indicated by reduced omission errors and reaction time variability. Variability improvements were still evident at follow up. In all groups, nogo P3 amplitudes were reduced post-stimulation, but in the 0.5mA group this reduction was smaller than in the 0.25mA group. Results of the current study suggest distinct effects of tDCS with different current intensities demonstrating the importance of a deeper understanding on the impact of stimulation parameters and repeated tDCS applications to develop effective tDCS-based therapy approaches in ADHD.
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Affiliation(s)
- Carolin Breitling-Ziegler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany.
| | - Tino Zaehle
- Department of Neurology, Otto von Guericke University, Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), Otto von Guericke University, Magdeburg, Germany
| | - Christian Wellnhofer
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
| | - Moritz Dannhauer
- Scientific Computing and Imaging Institute, Center for Integrated Biomedical Computing, University of Utah, Salt Lake City, UT, United States
| | - Jana Tegelbeckers
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany; Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Valentin Baumann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
| | - Hans-Henning Flechtner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
| | - Kerstin Krauel
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), Otto von Guericke University, Magdeburg, Germany
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Kim YH. How can pediatricians treat neurodevelopmental disorders. Clin Exp Pediatr 2021; 64:1-2. [PMID: 32718146 PMCID: PMC7806410 DOI: 10.3345/cep.2020.00507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/17/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Young-Hoon Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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120
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Riise EN, Wergeland GJH, Njardvik U, Öst LG. Cognitive behavior therapy for externalizing disorders in children and adolescents in routine clinical care: A systematic review and meta-analysis. Clin Psychol Rev 2020; 83:101954. [PMID: 33418192 DOI: 10.1016/j.cpr.2020.101954] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/09/2020] [Accepted: 11/23/2020] [Indexed: 12/11/2022]
Abstract
Various Cognitive Behavioral Therapy (CBT) programs for externalizing disorders in children and adolescents are supported by a substantial body of empirical evidence. Most of the research evidence comes from efficacy studies conducted in university settings, but there is less knowledge about the effect of these treatments in routine clinical care. The purpose of this meta-analysis was to investigate the effectiveness of CBT in non-university settings for Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD). Embase OVID, Ovid MEDLINE and PsycINFO were systematically searched for eligible studies published up to May 2020. In total, 51 treatment effectiveness studies involving 5295 patients were included. The average within-group effect size at post-treatment was significant (g = 0.91), and there were large effect sizes for both ADHD (g = 0.80) and CD/ODD (g = 0.98). At post treatment, remission rates were 38% for ADHD and 48% for CD/ODD, and the overall attrition rate was 14%. Benchmarking against efficacy studies showed that CBT in routine clinical care yields remission rates, within-group effect sizes and attrition rates that are very similar to those found in university settings. The findings support the transportability of CBT for externalizing disorders from university settings to routine clinical care. PROSPERO registration: CRD42020147524.
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Affiliation(s)
- Eili N Riise
- Department of Child and Adolescent Psychiatry, District General Hospital of Førde, Førde, Norway.
| | - Gro Janne H Wergeland
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Norway
| | - Urdur Njardvik
- Department of Psychology, University of Iceland, Reykjavik, Iceland
| | - Lars-Göran Öst
- Department of Psychology, Stockholm University, Stockholm, Sweden; Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
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121
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Monopoli WJ, Evans SW, Benson K, Allan NP, Owens JS, DuPaul GJ, Bunford N. Assessment of a conceptually informed measure of emotion dysregulation: Evidence of construct validity vis a vis impulsivity and internalizing symptoms in adolescents with ADHD. Int J Methods Psychiatr Res 2020; 29:1-14. [PMID: 32898309 PMCID: PMC7723178 DOI: 10.1002/mpr.1826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 03/06/2020] [Accepted: 03/29/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Despite advances in understanding associations among attention-deficit hyperactivity disorder (ADHD), emotion dysregulation (ED), and related outcomes, there is incongruity between ADHD-relevant conceptualizations of ED and available measures of ED. To assess the psychometric properties of a parent-report questionnaire of ED conceptualized as deficits in the ability to modulate the (a) speed/degree of emotion escalation; (b) expression intensity; and (c) speed/degree of de-escalation. METHODS Participants were 209 adolescents with ADHD (78% male; 13.5-17.8 years old [M = 15.2 SD = 0.91]). Questionnaire items were selected from parent-report scales of ED and oppositional defiant disorder and subjected to exploratory factor analysis (EFA) and validity analyses. RESULTS The EFA revealed two factors, with speed/degree of escalation combined with intensity as factor one, and speed/degree of de-escalation as factor two. Factor one scores were related to ADHD impulsivity symptoms but not to anxiety and depression symptoms and they remained predictors of impulsivity even in the presence of self-report ED, evincing convergent, discriminant, and incremental validity. Factor two scores were related to anxiety and depression but not impulsivity, evincing convergent and discriminant validity. CONCLUSION These results inform our understanding of ADHD-relevant ED in adolescence and offer avenues for future research in measurement development, as well as for understanding ED and ADHD-related impairment.
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Affiliation(s)
- W John Monopoli
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Steven W Evans
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Kari Benson
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | | | | | - George J DuPaul
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Nóra Bunford
- 'Lendület' Developmental and Translational Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
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122
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van der Oord S, Tripp G. How to Improve Behavioral Parent and Teacher Training for Children with ADHD: Integrating Empirical Research on Learning and Motivation into Treatment. Clin Child Fam Psychol Rev 2020; 23:577-604. [PMID: 32968886 PMCID: PMC7585566 DOI: 10.1007/s10567-020-00327-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2020] [Indexed: 12/17/2022]
Abstract
Attention deficit hyperactivity disorder [ADHD] is one of the most common psychiatric disorders of childhood with poor prognosis if not treated effectively. Recommended psychosocial evidence-based treatment for preschool and school-aged children is behavioral parent and teacher training [BPT]. The core elements of BPT are instrumental learning principles, i.e., reinforcement of adaptive and the ignoring or punishment of non-adaptive behaviors together with stimulus control techniques. BPT is moderately effective in reducing oppositional behavior and improving parenting practices; however, it does not reduce blinded ratings of ADHD symptoms. Also after training effects dissipate. This practitioner review proposes steps that can be taken to improve BPT outcomes for ADHD, based on purported causal processes underlying ADHD. The focus is on altered motivational processes (reward and punishment sensitivity), as they closely link to the instrumental processes used in BPT. Following a critical analysis of current behavioral treatments for ADHD, we selectively review motivational reinforcement-based theories of ADHD, including the empirical evidence for the behavioral predictions arising from these theories. This includes consideration of children's emotional reactions to expected and unexpected outcomes. Next we translate this evidence into potential ADHD-specific adjustments designed to enhance the immediate and long-term effectiveness of BPT programs in addressing the needs of children with ADHD. This includes the use of remediation strategies for proposed deficits in learning not commonly used in BPT programs and cautions regarding the use of punishment. Finally, we address how these recommendations can be effectively transferred to clinical practice.
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Affiliation(s)
- Saskia van der Oord
- Behavior, Health and Psychopathology, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium.
- Developmental Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands.
| | - Gail Tripp
- Human Developmental Neurobiology Unit, Okinawa Institute of Science and Technology Graduate University, 1919-1 Tancha, Onna, Kunigami District, Okinawa Prefecture, 904-0495, Japan.
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123
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Zheng X, Shen L, Jiang L, Shen X, Xu Y, Yu G, Wang Y. Parent and Teacher Training Increases Medication Adherence for Primary School Children With Attention-Deficit/Hyperactivity Disorder. Front Pediatr 2020; 8:486353. [PMID: 33240827 PMCID: PMC7680838 DOI: 10.3389/fped.2020.486353] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 10/05/2020] [Indexed: 12/30/2022] Open
Abstract
Objective: Attention-deficit/hyperactivity disorder (ADHD) is a common neurobiological disorder for which effective and safe medication is recommended as first-line treatment. However, many parents and teachers do not believe that ADHD is a disorder or do not accept medication treatment in China. Treatment is often short term or intermittent. Our study aimed to investigate the clinical effect of employing a 4-week, session-based training for both parents and teachers in improving medication adherence for primary school children with ADHD. Methods: From January 2018 to December 2018, a total of 5,118 primary school children were screened. Among 211 children diagnosed with ADHD, 116 were assigned to the intervention group and 95 to the control group. This study provided systematic training for parents and teachers in the intervention group. The training consisted of education about the disorder and ADHD behavioral intervention for both parents and teachers as well as classroom management techniques for just the teachers. A cluster randomized controlled trial (RCT) was conducted to investigate the effect of this training at 6 months follow-up. The study determined medication adherence using a questionnaire and scoring with a rating scale at baseline and at the 6 month follow-up endpoint. The questionnaire was self-report. Results: The study population had a relatively low rate of attention deficit hyperactivity disorder (4.1%) compared to the generally accepted prevalence. After the training, more parents and teachers believed that ADHD is a neurobiological disorder and that medication is the first line treatment. At 6 months follow-up, the Medication Adherence Report Scale (MARS) score for the intervention group was 22.8 ± 0.75 and 16.5 ± 1.63 for the control group (t = 5.217, P < 0.01). Based on parents' reports and medical records, 82 children (70.69%) were continuously taking medication for 6 months in the intervention group, while only 35 children (36.84%) were doing so in the control group. In the intervention group, the mean SNAP-IV score was 1.98 ± 0.42 at baseline but 0.99 ± 0.31 at 6-month follow-up. In the control group, the mean SNAP-IV score was 1.89 ± 0.47 at baseline but 1.37 ± 0.42 at 6-months follow-up (F = 2.67, P = 0.009). Factors influencing medication adherence for children with ADHD were parent's beliefs, teacher's beliefs, socioeconomic status, adverse effect, insurance coverage, gender, and trust of the medical system. Conclusions: Our findings indicate that comprehensive training programs improve the understanding of ADHD and medication adherence for both children's parents and teachers, providing a promising approach for improving clinical efficacy for children with ADHD.
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Affiliation(s)
- Xiaofei Zheng
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Li Shen
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Lian Jiang
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Xiao Shen
- School Affiliated With Shanghai Caoyang No. 2 High School, Shanghai, China
| | - Ying Xu
- School Affiliated With Shanghai Caoyang No. 2 High School, Shanghai, China
| | - Guangjun Yu
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yu Wang
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, China
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124
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Corona R, Dvorsky MR, Romo S, Parks AM, Bourchtein E, Smith ZR, Avila M, Langberg J. Integrating Tobacco Prevention Skills into an Evidence-Based Intervention for Adolescents with ADHD: Results from a Pilot Efficacy Randomized Controlled Trial. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1439-1453. [PMID: 32778992 PMCID: PMC7565255 DOI: 10.1007/s10802-020-00689-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at high risk for tobacco use, but tobacco use prevention strategies are not regularly incorporated into evidence-based ADHD interventions. We conducted a pilot randomized-controlled trial to determine the feasibility of integrating tobacco use prevention skills into a behavioral treatment for ADHD and to provide preliminary efficacy data comparing a combined (ADHD + tobacco) intervention (N = 40) to an ADHD only intervention (N = 23) on tobacco risk outcomes. Sixty-three adolescents (72% male; 13-17 years) with ADHD and their caregivers were randomly assigned to condition and families were masked to condition. Parent and adolescent ratings were collected at baseline, immediate post-intervention, and at 3- and 9-month follow-up assessments. The combined intervention was (1) implemented with high fidelity (94%), (2) well received by parents and adolescents as evidenced by high levels of treatment attendance (82%) and satisfaction with the intervention, and (3) associated with parent- and adolescent-reported reductions in tobacco use risk. Relative to the ADHD intervention, the combined intervention buffered against increases in tobacco risk, including reduced intentions to smoke and maladaptive social normative beliefs, and increased parental control, family cohesion, and family communication about substance use. Effect sizes at post-treatment were in the small to moderate range. Overall, this study provides preliminary support for a parent-adolescent behavioral treatment supplemented with family-based tobacco prevention strategies. This approach targets families already in treatment for ADHD, reducing barriers that occur when families attend multi-session prevention programs in addition to ADHD treatment.
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Affiliation(s)
- Rosalie Corona
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA, 23284-2018, USA.
| | - Melissa R Dvorsky
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA, 23284-2018, USA
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Stephanie Romo
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA, 23284-2018, USA
| | - Amanda M Parks
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA, 23284-2018, USA
| | - Elizaveta Bourchtein
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA, 23284-2018, USA
| | - Zoe R Smith
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA, 23284-2018, USA
| | - Melissa Avila
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA, 23284-2018, USA
| | - Joshua Langberg
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA, 23284-2018, USA
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Barnett ML, Lau AS, Lind T, Wright B, Stadnick N, Innes-Gomberg D, Pesanti K, Brookman-Frazee L. Caregiver Attendance as a Quality Indicator in the Implementation of Multiple Evidence-Based Practices for Children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2020; 49:868-882. [PMID: 31799862 PMCID: PMC7269837 DOI: 10.1080/15374416.2019.1683851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study investigated a quality indicator for children's mental health, caregiver attendance in youth psychotherapy sessions, within a system-driven implementation of multiple evidence-based practices (EBPs) in children's community mental health services. METHOD Administrative claims from nine fiscal years were analyzed to characterize and predict caregiver attendance. Data included characteristics of therapists (n = 8,626), youth clients (n = 134,368), sessions (e.g., individual, family), and the EBP delivered. Clients were primarily Latinx (63%), male (54%) and mean age was 11; they presented with a range of mental health problems. Three-level mixed models were conducted to examine the association between therapist, youth, service, EBP characteristics and caregiver attendance. RESULTS Caregivers attended, on average, 46.0% of sessions per client for the full sample and 59.6% of sessions for clients who were clinically indicated, based on age and presenting problem, to receive caregiver-focused treatment. Following initial EBP implementation, the proportion of caregiver attendance in sessions increased over time. Caregivers attended a higher proportion of youth psychotherapy sessions when clients were younger, had an externalizing disorder, were non-Hispanic White, and were male. Further, higher proportions of caregiver attendance occurred when services were delivered in a clinic setting (compared with school and other settings), by bilingual therapists, and the EBP prescribed caregiver attendance in all sessions. CONCLUSIONS Overall, the patterns of caregiver attendance appear consistent with evidence-informed practice parameters of client presenting problem and age. Yet, several improvement targets emerged such as client racial/ethnic background and service setting. Potential reasons for these disparities are discussed.
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Affiliation(s)
- Miya L. Barnett
- University of California, Santa Barbara, Department of Counseling, Clinical, & School Psychology, Santa Barbara, CA
| | - Anna S. Lau
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA
| | - Teresa Lind
- University of California, San Diego, Department of Psychiatry; Child and Adolescent Services Research Center, San Diego, CA
| | - Blanche Wright
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA
| | - Nicole Stadnick
- University of California, San Diego, Department of Psychiatry; Child and Adolescent Services Research Center, San Diego, CA
| | | | - Keri Pesanti
- Los Angeles County Department of Mental Health, Los Angeles, CA
| | - Lauren Brookman-Frazee
- University of California, San Diego, Department of Psychiatry; Child and Adolescent Services Research Center, San Diego, CA
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126
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Friedman LM, Dvorsky MR, McBurnett K, Pfiffner LJ. Do Parents' ADHD Symptoms Affect Treatment for their Children? The Impact of Parental ADHD on Adherence to Behavioral Parent Training for Childhood ADHD. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1425-1437. [PMID: 32813210 PMCID: PMC7567125 DOI: 10.1007/s10802-020-00672-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Nearly half of all youth with Attention-Deficit Hyperactivity Disorder (ADHD) have at least one parent who also meets criteria for the disorder, and intergenerational ADHD is a significant risk factor for poor outcomes following evidence-based behavioral parent training (BPT) programs. Given that BPT is predicated on consistent parental involvement, symptoms of ADHD in parents may be a significant barrier to effective engagement with BPT treatment. In the present investigation, we examine the effect of parental ADHD symptoms on BPT treatment engagement for children with ADHD-predominantly inattentive presentation (N = 148, ages 7-11). We examine the following parent- and clinician-rated treatment engagement domains: between-session skill adherence, in-session participation, perceived skill understanding, treatment-engagement attitudes, and session attendance. Parent- and clinician-rated between-session adherence was the only treatment engagement domain related significantly to parental ADHD symptoms. This finding was robust and remained even after accounting for symptoms of parental anxiety and depression, child ADHD symptom severity, and various sociodemographic factors (parental education level, household income, employment status, and being a single parent). These findings suggest that targeting parental ADHD symptoms in the context of parenting interventions may be a promising approach for improving adherence and treatment outcomes for BPT interventions.
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Affiliation(s)
| | | | - Keith McBurnett
- Department of Psychiatry, University of California, San Francisco
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Powell V, Riglin L, Hammerton G, Eyre O, Martin J, Anney R, Thapar A, Rice F. What explains the link between childhood ADHD and adolescent depression? Investigating the role of peer relationships and academic attainment. Eur Child Adolesc Psychiatry 2020; 29:1581-1591. [PMID: 31932968 PMCID: PMC7595988 DOI: 10.1007/s00787-019-01463-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 12/16/2019] [Indexed: 01/05/2023]
Abstract
There is increasing evidence that childhood Attention-Deficit Hyperactivity Disorder (ADHD) elevates risk of later depression, but the mechanisms behind this association are unclear. We investigated the relationship between childhood ADHD symptoms and late-adolescent depressive symptoms in a population cohort, and examined whether academic attainment and peer problems mediated this association. ALSPAC (Avon Longitudinal Study of Parents and Children) is an ongoing prospective longitudinal population-based UK cohort that has collected data since September 1990. 2950 individuals with data on parent-reported ADHD symptoms in childhood (7.5 years) and self-reported depressive symptoms in late adolescence (17.5 years) were included in analyses. 2161 individuals with additional data at age 16 years on parent-reported peer problems as an indicator of peer relationships and formal examination results (General Certificate of Secondary Education; GCSE) as an indicator of academic attainment were included in mediation analyses. Childhood ADHD symptoms were associated with higher depressive symptoms (b = 0.49, SE = 0.11, p < 0.001) and an increased odds of clinically significant depressive symptoms in adolescence (OR = 1.27, 95% CI 1.15-1.41, p < 0.001). The association with depressive symptoms was mediated in part by peer problems and academic attainment which accounted for 14.68% and 20.13% of the total effect, respectively. Childhood ADHD is associated with increased risk of later depression. The relationship is mediated in part by peer relationships and academic attainment. This highlights peer relationships and academic attainment as potential targets of depression prevention and intervention in those with ADHD. Future research should investigate which aspects of peer relationships are important in conferring later risk for depression.
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Affiliation(s)
- Victoria Powell
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Lucy Riglin
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Gemma Hammerton
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Olga Eyre
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Joanna Martin
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Richard Anney
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Anita Thapar
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Frances Rice
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
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Hogue A, Bobek M, MacLean A. Core Elements of CBT for Adolescent Conduct and Substance Use Problems: Comorbidity, Clinical Techniques, and Case Examples. COGNITIVE AND BEHAVIORAL PRACTICE 2020; 27:426-441. [PMID: 34103883 PMCID: PMC8184115 DOI: 10.1016/j.cbpra.2019.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adolescent externalizing problems (AEPs), including serious conduct problems, delinquency, and substance misuse, are the most common adolescent behavioral issues in specialty care. High rates of comorbidity between conduct and substance use problems necessitate multidomain treatment strategies that can effectively address the AEP spectrum. One strategy to increase delivery of evidence-based interventions for multiproblem youth in usual care is to focus on core elements of empirically supported treatments that can be judiciously applied to clients presenting with diverse clinical profiles. This article describes six core practice elements of the cognitive-behavioral treatment (CBT) approach for AEPs: (1) Functional Analysis of Behavior Problems; (2) Prosocial Activity Sampling; (3) Cognitive Monitoring and Restructuring; (4) Emotion Regulation Training; (5) Problem-solving Training; (6) Communication Training. Integrated delivery of these core CBT elements is illustrated in two case examples, and implications for treatment planning for youth with AEPs are discussed.
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Affiliation(s)
- Aaron Hogue
- Center on Addiction, Robert Miranda and Jennifer C. Wolff, Brown University, Amanda Jensen-Doss, University of Miami
| | - Molly Bobek
- Center on Addiction, Robert Miranda and Jennifer C. Wolff, Brown University, Amanda Jensen-Doss, University of Miami
| | - Alexandra MacLean
- Center on Addiction, Robert Miranda and Jennifer C. Wolff, Brown University, Amanda Jensen-Doss, University of Miami
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129
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Abstract
Over the last two decades, heart centres have developed strategies to meet the neurodevelopmental needs of children with congenital heart disease. Since the publication of guidelines in 2012, cardiac neurodevelopmental follow-up programmes have become more widespread. Local neurodevelopmental programmes, however, have been developed independently in widely varying environments. We sought to characterise variation in structure and personnel in cardiac neurodevelopmental programmes. A 31-item survey was sent to all member institutions of the Cardiac Neurodevelopmental Outcome Collaborative. Multidisciplinary teams at each centre completed the survey. Responses were compiled in a descriptive fashion. Of the 29 invited centres, 23 responded to the survey (79%). Centres reported more anticipated neurodevelopment visits between birth and 5 years of age (median 5, range 2-8) than 5-18 years (median 2, range 0-10) with 53% of centres lacking any standard for routine neurodevelopment evaluations after 5 years of age. Estimated annual neurodevelopment clinic volume ranged from 85 to 428 visits with a median of 16% of visits involving children >5 years of age. Among responding centres, the Bayley Scales of Infant and Toddler Development and Wechsler Preschool and Primary Scale of Intelligence were the most routinely used tests. Neonatal clinical assessment was more common (64%) than routine neonatal brain imaging (23%) during hospitalisation. In response to clinical need and published guidelines, centres have established formal cardiac neurodevelopment follow-up programmes. Centres vary considerably in their approaches to routine screening and objective testing, with many centres currently focussing their resources on evaluating younger patients.
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130
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What Do Preschool Teachers Know About Attention-Deficit/Hyperactivity Disorder (ADHD) and Does It Impact Ratings of Child Impairment? SCHOOL MENTAL HEALTH 2020. [DOI: 10.1007/s12310-020-09395-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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131
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Psychotherapy, Atomoxetine or Both? Preliminary Evidence from a Comparative Study of Three Types of Treatment for Attention-Deficit/Hyperactivity Disorder in Children. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10157-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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132
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Abstract
The purpose of the study was to estimate the burden to families of raising a child with attention-deficit/hyperactivity disorder (ADHD). Data were drawn from a longitudinal sample recruited in western Pennsylvania. When participants were between 14 and 17 years old, parents completed a questionnaire assessing economic burden over the course of raising their children. Domains of economic burden to families included direct costs related to child's behaviors (excluding treatment expenses) and indirect costs related to caregiver strain. On average, participants with ADHD incurred a total economic burden over the course of child development that was more than five times greater compared to youths without ADHD (ADHD = $15,036 per child, Control = $2,848 per child), and this difference remained significant after controlling for intellectual functioning, oppositional defiant symptoms, or conduct problems. Parents of participants with ADHD were more likely to have changed their job responsibilities or been fired and reported lower work efficiency. The current evaluation of economic burden to individual families extends previous estimates of annual societal cost of illness (COI) of ADHD. Our rough annual estimate of COI for ADHD in children and adolescents is $124.5 billion (2017 US Dollars). Findings underscore the need for interventions to reduce the costly dysfunctional outcomes in families of children with ADHD.
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133
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Fogler JM, Normand S, O’Dea N, Mautone JA, Featherston M, Power TJ, Nissley-Tsiopinis J. Implementing Group Parent Training in Telepsychology: Lessons Learned During the COVID-19 Pandemic. J Pediatr Psychol 2020; 45:983-989. [PMID: 32940702 PMCID: PMC7543438 DOI: 10.1093/jpepsy/jsaa085] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/03/2020] [Accepted: 08/25/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE We recently transitioned from in-person delivery of a brief behavioral parent intervention to telepsychology delivery to meet families' needs during the COVID-19 pandemic. In this topical review, we describe how we used treatment fidelity as a guiding principle to orient adaptations for telepsychology, as well as preliminary findings and early lessons learned in this implementation. Methods: Using rapid-cycle quality improvement methods, we adapted a brief parent training group (Bootcamp for Attention-Deficit/Hyperactivity Disorder; BC-ADHD) to three groups of caregivers (i.e., 5-7 families) of school-aged children with ADHD (n = 20; 85% males). Families were from the following ethnic backgrounds: 75% White non-Hispanic, 15% White Hispanic, and 10% Black. Clinicians completed measures on their implementation experience. Observers completed measures on content/process fidelity and attendance. Caregivers completed measures on demographics, treatment satisfaction, and telepsychology experience. RESULTS Telepsychology BC-ADHD can be implemented with comparably high levels of content and process fidelity and treatment satisfaction to in-person groups; and it appears to be feasible and acceptable to caregivers. Caregiver and clinician qualitative feedback revealed themes of appreciating the convenience of telepsychology, while experiencing some challenges in relating to others and sharing over video. CONCLUSIONS When treatment fidelity is used as a guiding tool, telepsychology parent training groups can be delivered with high fidelity and appear to be acceptable and feasible to caregivers and clinicians. Future research using larger and more diverse samples, multimethod and multi-informant measurement approaches, and controlled designs is needed to further assess the generalizability and efficacy of telepsychology parent training groups.
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Affiliation(s)
| | | | | | | | | | - Thomas J Power
- Children’s Hospital of Philadelphia, University of Pennsylvania
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134
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Hanisch C, Eichelberger I, Richard S, Doepfner M. Effects of a modular teacher coaching program on child attention problems and disruptive behavior and on teachers’ self-efficacy and stress. SCHOOL PSYCHOLOGY INTERNATIONAL 2020. [DOI: 10.1177/0143034320958743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Symptoms of attention-deficit/hyperactivity and oppositional defiant disorder are associated with a multitude of psychosocial developmental risks, e.g. academic underachievement. Various cognitive behavioral interventions have proven to be effective in reducing problem behavior in school settings. Drawing on this previous work and on our parent-focused preventive and therapeutic programs, we developed the school-based coaching for elementary school teachers of children with attention deficits or disruptive behavior problems (SCEP). Based on functional behavior assessment, SCEP addresses teachers of children with severe externalizing behavior problems in an individualized modular manner. It consists of a one-day training course and fortnightly one-to-one or team-coaching sessions. We analyzed the effects of SCEP in a within-subject control group design ( N = 60), with student attention problems and rule-breaking behavior during class as the primary outcome measure. SCEP was found to reduce problem behavior during lessons, with small to medium effect sizes ( d = 0.42–0.6). After the intervention, teachers reported changes in their use of praise and felt more confident managing the class ( d = 0.58). The results of SCEP are discussed in light of multi-tiered preventive approaches that suggest extensive individualized interventions based on functional behavior analysis for children with severe problem behavior.
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Affiliation(s)
| | | | | | - Manfred Doepfner
- University of Cologne, Germany; University Hospital of the University of Cologne, Germany
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135
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Calub CA, Rapport MD, Alexander K. Reducing Aggression Using a Multimodal Cognitive Behavioral Treatment Approach: A Case Study of a Preschooler With Oppositional Defiant Disorder. Clin Case Stud 2020. [DOI: 10.1177/1534650120958069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Individual cognitive behavioral therapies (CBT) have been shown to be effective in decreasing disruptive behaviors in children and adolescents; however, less is known regarding their efficacy with preschoolers given the developmental limitations accompanying this age range. The current case study extends the use of individual CBT to a preschool aged girl with oppositional defiant disorder (ODD), and is the first to investigate its efficacy in combination with behaviorally-based parent training and classroom teacher consultation. A total of 18 CBT sessions with the child and her parents, in addition to school observations and on-site and phone consultations with teachers, were conducted over a 4-month period. Post-treatment and 2-month follow-up assessments demonstrated significant decreases in physical aggression and property destruction, as well as for parent and teacher reported internalizing and externalizing symptoms. Collectively, results of the case study provide preliminary evidence that a multimodal approach can be applied effectively to treat behavioral problems in preschool-age children.
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136
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Dickson KS, Chlebowski C, Haine-Schlagel R, Ganger B, Brookman-Frazee L. Impact of Therapist Training on Parent Attendance in Mental Health Services for Children with ASD. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 51:230-241. [PMID: 32816564 DOI: 10.1080/15374416.2020.1796682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The current study explored the impact of training therapists in a mental health intervention for children with autism spectrum disorder (ASD) on parent attendance in their children's therapy sessions. We also examined family, therapist, and program factors as potential moderators. METHOD Data were drawn from a cluster-randomized community effectiveness trial of "An Individualized Mental Health Intervention for ASD (AIM HI)". Participants included 168 therapists yoked with 189 children recruited from publicly-funded mental health services. Data included family (caregiver strain, parent sense of competence, race/ethnicity), therapist (background, experience), and program (service setting) characteristics, and parent session attendance. Multilevel models were used to evaluate the effectiveness of AIM HI therapist training on caregiver attendance and identify moderators of training effects on parent attendance. RESULTS Parents attended a higher percentage of sessions in the AIM HI training condition compared to the Usual Care condition. Program service setting moderated the effect of AIM HI training, with higher parent attendance in non-school (mostly outpatient) settings compared to school settings and a significantly smaller difference between the settings in the AIM HI condition. CONCLUSIONS Effective strategies to promote parent engagement, especially in service settings such as schools, are warranted. Findings support the effectiveness of AIM HI training in promoting parent attendance across multiple publicly-funded mental health service settings. The larger effect in school-based programs supports the utility of training in evidence-based interventions such as AIM HI to increase the feasibility of parent attendance in such services.
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Affiliation(s)
- Kelsey S Dickson
- Department of Child and Family Development, San Diego State University.,Child and Adolescent Services Research Center
| | - Colby Chlebowski
- Child and Adolescent Services Research Center.,Department of Psychiatry, University of California San Diego
| | - Rachel Haine-Schlagel
- Department of Child and Family Development, San Diego State University.,Child and Adolescent Services Research Center
| | - Bill Ganger
- Child and Adolescent Services Research Center.,San Diego State University Research Foundation
| | - Lauren Brookman-Frazee
- Child and Adolescent Services Research Center.,Department of Psychiatry, University of California San Diego.,Autism Discovery Institute at Rady Children's Hospital San Diego
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137
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Hustus CL, Evans SW, Owens JS, Benson K, Hetrick AA, Kipperman K, DuPaul GJ. An Evaluation of 504 and Individualized Education Programs for High School Students With Attention Deficit Hyperactivity Disorder. SCHOOL PSYCHOLOGY REVIEW 2020. [DOI: 10.1080/2372966x.2020.1777830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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138
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Kolko DJ, Hart JA, Campo J, Sakolsky D, Rounds J, Wolraich ML, Wisniewski SR. Effects of Collaborative Care for Comorbid Attention Deficit Hyperactivity Disorder Among Children With Behavior Problems in Pediatric Primary Care. Clin Pediatr (Phila) 2020; 59:787-800. [PMID: 32503395 PMCID: PMC7444430 DOI: 10.1177/0009922820920013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This study evaluates the impact of a 6-month care management intervention for 206 children diagnosed with comorbid attention deficit hyperactivity disorder (ADHD) from a sample of 321 five- to 12-year-old children recruited for treatment of behavior problems in 8 pediatric primary care offices. Practices were cluster-randomized to Doctor Office Collaboration Care (DOCC) or Enhanced Usual Care (EUC). Chart reviews documented higher rates of service delivery, prescription of medication for ADHD, and titration in DOCC (vs EUC). Based on complex conditional models, DOCC showed greater acute improvement in individualized ADHD treatment goals and follow-up improvements in quality of life and ADHD and oppositional defiant disorder goals. Medication use had a significant effect on acute and follow-up ADHD symptom reduction and quality of life. Medication continuity was associated with some long-term gains. A collaborative care intervention for behavior problems that incorporated treatment guidelines for ADHD in primary care was more effective than psychoeducation and facilitated referral to community treatment.
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Affiliation(s)
- David J. Kolko
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - John Campo
- Ohio State University, Morgantown, WV, USA
| | - Dara Sakolsky
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Mark L. Wolraich
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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139
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Sibley MH, Morley C, Rodriguez L, Coxe SJ, Evans SW, Morsink S, Torres F. A Peer-Delivered Intervention for High School Students With Impairing ADHD Symptoms. SCHOOL PSYCHOLOGY REVIEW 2020. [DOI: 10.1080/2372966x.2020.1720803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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140
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The Transition of Youth with ADHD into the Workforce: Review and Future Directions. Clin Child Fam Psychol Rev 2020; 22:316-347. [PMID: 30725305 DOI: 10.1007/s10567-019-00274-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Previous research suggests that a majority of children with attention-deficit/hyperactivity disorder (ADHD) continue to experience increased impairment across multiple life domains into adulthood. A systematic review of the occupational impairments, and associated educational and financial difficulties, faced by individuals with childhood ADHD was conducted. Systematic searches from PsycINFO and PubMed databases and other sources (i.e., books and consultants with experts) yielded 35 relevant articles that described 19 longitudinal studies on adults with a history of ADHD or related symptoms. Multiple studies indicated that those with a history of ADHD had more educational impairment and were less likely to graduate from high school and college than their peers without a history of ADHD. Subsequently, they faced lower occupational attainment, had more job instability, and demonstrated more impaired job performance, and these outcomes were largely consistent regardless of sex, medication history, or symptom persistence. Similar results were found in clinical and representative national studies in both U.S. and abroad, although older studies tended to indicate less occupational impairment. In addition, ADHD was associated with a number of financial challenges, including lower annual income, more reliance on public aid, and increased risk for homelessness. Future research should use more varied informant sources and utilize innovative measures of occupational impairment at both a macro- and micro-level of analyses. In addition, studies of effective supports and interventions in occupational settings for individuals with ADHD are needed.
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141
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Harrison JR, Evans SW, Baran A, Khondker F, Press K, Noel D, Wasserman S, Belmonte C, Mohlmann M. Comparison of accommodations and interventions for youth with ADHD: A randomized controlled trial. J Sch Psychol 2020; 80:15-36. [DOI: 10.1016/j.jsp.2020.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/20/2020] [Accepted: 05/06/2020] [Indexed: 01/23/2023]
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142
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Does ACT-Group Training Improve Cognitive Domain in Children with Attention Deficit Hyperactivity Disorder? A Single-Arm, Open-Label Study. BEHAVIOUR CHANGE 2020. [DOI: 10.1017/bec.2020.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AbstractThis single-arm, open-label study aimed to investigate the efficacy of a cognitive-behavioural group training based on acceptance and commitment therapy (ACT) on cognition in drug-naïve children with attention deficit hyperactivity disorder (ADHD). Thirty-six children with ADHD aged 8–13 were invited to participate in the 9-month ACT training programme, which consisted of 26 weekly sessions of group therapy lasting 90 min each. Their parents also received 12 sessions of ACT-based parent training, every 2 weeks. The outcome measure for the present study was the change in the cognitive performance assessed by a battery of computerised task. The cognitive outcome of children receiving ACT-group intervention was compared to that of an external untreated control group of children with ADHD. No significant improvements were observed in any of the cognitive measures. This preliminary study suggests that the 9-month ACT-group training programme might not have positive effects on cognitive difficulties usually occurring in ADHD. Future randomised controlled trials with larger sample sizes are required to shed more light on this issue.
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143
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Malkoff AC, Grace M, Kapke TL, Gerdes AC. Family Functioning in Latinx Families of Children with ADHD: The Role of Parental Gender and Acculturation. JOURNAL OF CHILD AND FAMILY STUDIES 2020; 29:1108-1122. [PMID: 33343179 PMCID: PMC7747796 DOI: 10.1007/s10826-019-01673-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES It has been well-established that parents of children with ADHD report significantly higher levels of parenting stress and home chaos, and lower levels of parental efficacy than parents of children without ADHD. Unfortunately, most of the extant ADHD literature has focused on European American children and families, resulting in a paucity of research focusing on ethnic minority families of children with ADHD. The current study aimed to expand what is known about Latinx parents of children with ADHD by exploring contextual and cultural factors, such as parental gender and acculturation, which may account for variations in parenting experiences within this population. METHODS The present study utilized secondary data analysis to analyze ratings of parenting stress, home chaos, and parental efficacy among a sample of Latinx mothers and fathers of children with ADHD (n = 46 dyads). RESULTS Results indicated that Latinx mothers of children with ADHD reported higher levels of parenting stress than Latinx fathers of children with ADHD; however, no significant parental gender differences were found in ratings of parental efficacy or home chaos. Additionally, several significant relationships were found between parental acculturation and family functioning variables. CONCLUSIONS Latinx families of children with ADHD are an understudied and underserved population within the field of clinical psychology. The current study provides critical information on Latinx family functioning within the context of ADHD treatment, specifically pertaining to the complex interplay of parenting and acculturation variables.
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Affiliation(s)
- Anne C Malkoff
- Psychology Department, Marquette University, Milwaukee, WI, USA
| | - Margaret Grace
- Psychology Department, Marquette University, Milwaukee, WI, USA
| | - Theresa L Kapke
- Psychology Department, Marquette University, Milwaukee, WI, USA
| | - Alyson C Gerdes
- Psychology Department, Marquette University, Milwaukee, WI, USA
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144
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Babinski DE, Mazzant JR, Merrill BM, Waschbusch DA, Sibley MH, Gnagy EM, Molina BSG, Pelham WE. Lifetime caregiver strain among mothers of adolescents and young adults with attention-deficit/hyperactivity disorder. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:342-352. [PMID: 31750692 PMCID: PMC7102920 DOI: 10.1037/fam0000609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The lifetime maternal caregiver strain (CS) associated with raising a child with attention-deficit/hyperactivity disorder (ADHD) into adolescence and young adulthood was examined in the Pittsburgh ADHD Longitudinal Study (PALS), a longitudinal study of individuals diagnosed with ADHD in childhood and recontacted in adolescence and young adulthood for yearly follow-up. Mothers of adolescents/young adults with (n = 364, 89.6% male; Mage = 19.79) and without childhood ADHD (n = 240, 88.8% male; Mage = 18.97) rated their lifetime maternal CS at Wave 3. Adolescent/young adult (AYA) ADHD and ODD severity measured at Wave 1, AYA delinquency measured at Wave 2, and school disciplinary actions combined from Waves 1 and 2 were explored as mediators of the association between childhood ADHD and lifetime maternal CS at Wave 3 using path analysis. AYA gender and age, parental marital status, maternal depression and ADHD, and highest parental education were included as covariates. Greater lifetime CS was reported among mothers of adolescents/young adults with versus without childhood ADHD. In the mediation model, direct effects of childhood ADHD on AYA ADHD and ODD severity, delinquency, and school discipline problems emerged, and direct effects of AYA ODD severity, delinquency, and school discipline problems on lifetime CS emerged. AYA ODD, delinquency, and school discipline mediated the association between childhood ADHD and lifetime maternal CS. These findings extend research on childhood ADHD to identify AYA sequelae contributing to maternal CS. Future research on the transaction between AYA functional impairment and maternal CS across the transition from adolescence into adulthood is needed to clarify opportunities for intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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145
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Ciesielski HA, Loren REA, Tamm L. Behavioral Parent Training for ADHD Reduces Situational Severity of Child Noncompliance and Related Parental Stress. J Atten Disord 2020; 24:758-767. [PMID: 31046533 DOI: 10.1177/1087054719843181] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Parents are more likely to seek treatment when a child's behaviors cause impairment and increase parental burden. Thus, it is important to document the effectiveness of behavioral parent training (BPT) on the pervasiveness and severity of children's behavior and related parental distress. Method: Data were obtained from 304 parents of school-aged children with attention-deficit hyperactivity disorder (ADHD) attending BPT groups in an outpatient setting. Results: After BPT, parents reported fewer and less severe problematic situations related to child noncompliance, particularly for chores, homework, mealtimes, and peer interactions. Parents also reported significantly reduced stress related to parenting a child with ADHD. Improvements in Nonfamilial Transactions and Task Performance were associated with reductions in degree of parental stress. Conclusion: BPT offered in a real-world clinical setting has meaningful impacts on the child behaviors that lead parents to seek treatment and reduces stress related to parenting a child with ADHD.
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Affiliation(s)
- Heather A Ciesielski
- Cincinnati Children's Hospital Medical Center, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, OH, USA
| | - Richard E A Loren
- Cincinnati Children's Hospital Medical Center, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, OH, USA
| | - Leanne Tamm
- Cincinnati Children's Hospital Medical Center, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, OH, USA
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146
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Hogue A, Horan Fisher J, Dauber S, Bobek M, Porter N, Henderson CE, Evans SW. Randomized Trial of Academic Training and Medication Decision-Making for Adolescents with ADHD in Usual Care. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 50:874-887. [PMID: 32078394 DOI: 10.1080/15374416.2020.1716362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objective: This study tested two family-based interventions designed for delivery in usual care: Changing Academic Support in the Home for Adolescents with ADHD (CASH-AA), containing motivational interventions, homework management and schoolwork organization training, and family-school partnership building; and Medication Integration Protocol (MIP), containing ADHD psychoeducation, medication decision-making, and integrated medication management.Method: This study used a cluster randomized design to test CASH-AA + MIP versus CASH-AA Only for adolescents with ADHD in five sites. Therapists (N = 49) were site clinicians randomized to condition. Clients (N = 145) included 72% males; 42% White Non-Hispanic, 37% Hispanic American, 15% African American, and 6% more than one race; average age was 14.8 years. Fidelity data confirmed protocol adherence and between-condition differentiation.Results: One-year improvements were observed across conditions in several outcomes. Overall, CASH-AA + MIP produced greater declines in adolescent-report inattentive symptoms and delinquent acts. Similarly, among non-substance users, CASH-AA + MIP clients attended more treatment sessions. In contrast, among substance users, CASH-AA Only clients showed greater declines in caregiver-report hyperactive symptoms and externalizing.Conclusions: This study provides initial experimental support for family-based ADHD medication decision-making when coupled with academic training in usual care. The treatment protocols, CASH-AA and MIP, showed positive effects in addressing not only ADHD symptoms but also common co-occurring problems, and youth with substance use problems benefitted along with non-using peers.
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147
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Shrestha M, Lautenschleger J, Soares N. Non-pharmacologic management of attention-deficit/hyperactivity disorder in children and adolescents: a review. Transl Pediatr 2020; 9:S114-S124. [PMID: 32206589 PMCID: PMC7082245 DOI: 10.21037/tp.2019.10.01] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a very common neurobehavioral disorder that affects children and adolescents with impact that persists beyond adolescence into adulthood. Medication and non-pharmacological treatments are evidence-based interventions for ADHD in various age groups, and this article will elaborate on the psychosocial, physical and integrative medicine interventions that have been studied in ADHD.
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Affiliation(s)
- Mahesh Shrestha
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | | | - Neelkamal Soares
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
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148
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Nicolia AC, Fabiano GA, Gordon CT. An investigation of predictors of attendance for fathers in behavioral parent training programs for children with ADHD. CHILDREN AND YOUTH SERVICES REVIEW 2020; 109:104690. [PMID: 32863500 PMCID: PMC7454040 DOI: 10.1016/j.childyouth.2019.104690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Behavioral parent training programs are evidence-based treatment for children with attention-deficit/hyperactivity disorder (ADHD), yet attendance in such programs is variable. Relative to mothers of children with ADHD, far less is known about fathers and what predicts their attendance in treatment. The current study aimed to explore predictors of father (N = 171) attendance using data from four studies that tested the efficacy of behavioral parent training programs aimed specifically at fathers. A hierarchical regression was performed to test four potential predictors of attendance, including father race/ethnicity, father education level, child medication status, and father ratings of the child's oppositional defiant disorder symptoms. Father education level was determined to be a significant predictor of attendance, whereas father race/ethnicity, child medication status, and father ratings of the child's ODD behavior were not. The results suggest that future parent training interventions may need to be adapted to improve attendance from fathers of lower education levels.
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Affiliation(s)
- Andrea C. Nicolia
- Corresponding author at: University at Buffalo, State University of New York, Department of Counseling, School, and Educational Psychology, 409 Baldy Hall, Buffalo, NY 14260, United States. (A.C. Nicolia)
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149
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Abstract
Many authors have contributed to the description of attention deficit/hyperactivity disorder (ADHD) for the two last centuries. In this chapter, we review the current diagnostic criteria, epidemiology, and history of ADHD. The different phenotypes (predominantly inattentive, predominantly hyperactive/impulsive, or combined) and diagnostic process are detailed. The DSM-5 includes the three phenotypes that begin before age 12, are present in at least two settings, and cannot be explained by another condition. Theoretical underpinnings and biological and environmental etiologies reported in the latest literature are discussed. There are many comorbidities associated with ADHD, which are associated with an increase in the negative impact on everyday life. Treatment decisions involve a complex interaction between child's age, symptom severity levels, comorbidities, functional impairments, and parents' preferences. Medication (psychostimulant and nonstimulant) and psychosocial (mainly behavioral parent training) treatments as well as school-based interventions are described.
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Affiliation(s)
- Kevin M Antshel
- Department of Psychology, Syracuse University, Syracuse, NY, United States.
| | - Russell Barkley
- Department of Psychiatry, Virginia Commonwealth University Medical Center, Richmond, VA, United States
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150
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Chronic Care for Attention-Deficit/Hyperactivity Disorder: Clinical Management from Childhood Through Adolescence. J Dev Behav Pediatr 2020; 41 Suppl 2S:S99-S104. [PMID: 31996572 PMCID: PMC9295618 DOI: 10.1097/dbp.0000000000000772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Impairments generally persist when children diagnosed with attention-deficit/hyperactivity disorder (ADHD) mature into adolescence. To examine changes in ADHD care during the transition from childhood to adolescence, we conducted a retrospective, longitudinal cohort study of patients diagnosed with ADHD before the age of 10 years to assess changes from preadolescence through adolescence in (1) frequency by which primary care providers offer ADHD care to patients, (2) range of concerns assessed during patient encounters, and (3) treatments implemented or recommended. METHODS We identified patients from 3 practices included in a large primary care network who (1) were born between 1996 and 1997, (2) were diagnosed with ADHD before the age of 10 years, and (3) received primary care continuously from age 9 through late adolescence. Clinical care was compared among patients in preadolescence (age 9-11), early adolescence (age 12-14), and late adolescence (age 15-18). RESULTS Children diagnosed with ADHD before the age of 10 years were less likely to have a documented visit for ADHD during late adolescence (41% of patients) compared with preadolescence (63%, p < 0.001). Evidence of monitoring for depression, suicide, and substance abuse increased from preadolescence to adolescence (p < 0.001) and occurred in about 90% of adolescent patients. However, monitoring for risky sexual activity occurred in only about 50% of adolescents. Discussions of medication diversion and driver readiness were essentially not documented. CONCLUSION The findings raise concerns about how primary care providers manage adolescents with a history of ADHD. Improving monitoring of risky sexual behavior and driver readiness and providing patient education about medication diversion are needed.
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