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Kurzweil S. Involving Parents in Child Mental Health Treatments: Survey of Clinician Practices and Variables in Decision Making. Am J Psychother 2023; 76:107-114. [PMID: 37114350 DOI: 10.1176/appi.psychotherapy.20220025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Child therapy outcomes research has indicated that involving parents in child mental health treatments is generally beneficial. This study aimed to explore clinicians' decisions to involve parents in treatment for childhood disorders and child-, parent-, and clinician-related variables influencing these decisions. METHODS Data on decision making and reported use of parent involvement by 40 therapists with patients ages 6-12 were obtained from a self-report survey. Most clinicians were psychologists, White, and female and worked in community-based clinics. They reported using cognitive-behavioral and family system interventions considerably more than psychodynamic therapy. RESULTS Clinician-reported use of parent involvement was significantly greater for children with oppositional defiant or conduct disorder than for those with attention-deficit hyperactivity disorder, depression, anxiety, or posttraumatic stress disorder or trauma. A child's age and diagnosis (100% of clinicians), parental level of stress (85%), and parent interest in working with the clinician (60%) were frequently reported as being important to clinicians' decisions. Ninety percent of clinicians reported that they believed working with parents was effective, whereas only 25% reported their own training to be influential in decision making. CONCLUSIONS Findings regarding use of parent involvement stratified by common childhood disorder were not surprising, given the behavioral and treatment complexities of oppositional defiant or conduct disorder. Clinicians often reported parents' stress level and interest in working with the clinician as influencing decision making, reflecting the importance of lesser researched decision variables. The relatively limited influence of training on decision making suggests the need for better parent involvement education for clinicians treating children.
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Affiliation(s)
- Sonya Kurzweil
- Department of Clinical Psychology, William James College, and Sonya Kurzweil Developmental Center, Newton, Massachusetts
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2
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Mah JW, Gill H, Doherty M. Feasibility and Efficacy of the Alert Program® for Children with Attention-Deficit/Hyperactivity Disorder. Clin Child Psychol Psychiatry 2023:13591045231162680. [PMID: 37015349 DOI: 10.1177/13591045231162680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
This study explored the feasibility and initial efficacy of a sensorimotor intervention to improve symptoms of attention-deficit/hyperactivity disorder (ADHD). Twenty-seven children (ages 8-12 years) with ADHD and their parents participated in an 8-week group intervention based on The Alert Program® for Self-Regulation (AP). Families were taught to recognize child arousal states and to use sensorimotor strategies to manage levels of alertness. Parent and teacher reports of child attention symptoms were collected at baseline, before and after intervention. Objective ratings of child problem behaviours and use of sensorimotor strategies during computerized tasks of visual and auditory attention were also coded before and after intervention. Parents and children endorsed high acceptability and satisfaction for the AP treatment. Parental ratings indicated increased knowledge and use of sensorimotor strategies, and decreased child ADHD symptoms at home from pre-AP to post-AP. However, no significant changes in child outcomes were reported by teachers. Unexpectedly, observed child problem behaviours during the visual attention task increased from pre-AP to post-AP. The AP was received positively by parents and children with improvements in regulation strategies and child attention at home, but more work needs to be done to generalize the effects to school and other peer settings.
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Affiliation(s)
| | - Harleen Gill
- 512469BC Children's Hospital Research Institute, Vancouver, CA
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3
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Hornstra R, Groenman AP, van der Oord S, Luman M, Dekkers TJ, van der Veen-Mulders L, Hoekstra PJ, van den Hoofdakker BJ. Review: Which components of behavioral parent and teacher training work for children with ADHD? - a metaregression analysis on child behavioral outcomes. Child Adolesc Ment Health 2022; 28:258-268. [PMID: 35417075 DOI: 10.1111/camh.12561] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND This metaregression analysis examined which behavioral techniques that are commonly used in behavioral parent and teacher training programs for children with attention-deficit/hyperactivity disorder (ADHD) were related to program effectiveness on children's behavioral outcomes. METHODS We included 32 randomized controlled trials (N = 2594 children) investigating behavioral parent training, teacher training, or a combination, in children with ADHD under 18 years. Outcomes were symptom counts of total ADHD, inattention, and hyperactivity-impulsivity and behavioral problems. The dosage of techniques was extracted from the intervention manuals. Metaregression was used to assess which techniques and intervention characteristics (setting, delivery method, duration, and home-school collaboration) were associated with intervention effectiveness. RESULTS Higher dosage of psycho-education for parents was associated with smaller effects on behavioral problems and, only in case of parent training, also with smaller effects on ADHD symptoms. Higher dosage of teaching parents/teachers to use negative consequences was associated with larger effects on behavioral problems. Individual training compared with group training was associated with larger effects on ADHD and hyperactivity-impulsivity symptoms. CONCLUSIONS This study provides first insights into the specific techniques that are essential in behavioral parent and teacher training programs for children with ADHD. This knowledge can eventually be used to improve and tailor interventions.
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Affiliation(s)
- Rianne Hornstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annabeth P Groenman
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Saskia van der Oord
- Clinical Psychology, KU Leuven, Leuven, Belgium.,Developmental Psychology, Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Luman
- Department of Clinical, Developmental and Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Tycho J Dekkers
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Developmental Psychology, Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Lianne van der Veen-Mulders
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Barbara J van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
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4
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Savell SM, Womack SR, Wilson MN, Lemery-Chalfant K, Shaw DS. Indirect Associations between Middle-Childhood Externalizing Behaviors and Adolescent Substance Use through Late-Childhood Exposure to Violence. J Youth Adolesc 2022; 51:628-642. [PMID: 35107744 PMCID: PMC8994499 DOI: 10.1007/s10964-022-01575-8] [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] [Received: 01/04/2022] [Accepted: 01/12/2022] [Indexed: 10/19/2022]
Abstract
Longitudinal research to understand individual risk factors in childhood associated with exposure to violence and substance use is needed to inform prevention efforts. The present study tested indirect associations between age 8.5 externalizing behaviors and age 16 substance use through age 9.5 violence victimization and witnessing. Participants were 650 racially diverse (48.6% European American, 28.1% African American, 13.3% multiracial, and 10.0% other), predominantly socioeconomically disadvantaged youth (49% female). Externalizing behaviors were associated with higher levels of violence victimization and witnessing. The indirect path from externalizing behaviors to substance use was significant through victimization but not witnessing violence. Interventions aimed at reducing early externalizing behaviors may reduce risk for violence victimization, which may, in turn, reduce risk for adolescent substance use.
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Affiliation(s)
- Shannon M Savell
- Department of Psychology, University of Virginia, Charlottesville, USA.
| | - Sean R Womack
- Department of Psychology, University of Virginia, Charlottesville, USA
| | - Melvin N Wilson
- Department of Psychology, University of Virginia, Charlottesville, USA
| | | | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
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5
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Dekkers TJ, Hornstra R, van der Oord S, Luman M, Hoekstra PJ, Groenman AP, van den Hoofdakker BJ. Meta-analysis: Which Components of Parent Training Work for Children With Attention-Deficit/Hyperactivity Disorder? J Am Acad Child Adolesc Psychiatry 2022; 61:478-494. [PMID: 34224837 DOI: 10.1016/j.jaac.2021.06.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 06/02/2021] [Accepted: 06/25/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Behavioral parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but it is unknown which of its components are most effective. This meta-regression analysis investigated which specific behavioral techniques that parents learn in parent training are associated with effects on parental outcomes. METHOD A search was performed for randomized controlled trials on parent training for children with ADHD, with positive parenting, negative parenting, parenting sense of competence, parent-child relationship quality, and parental mental health as outcome measures. After screening 23,026 publications, 29 studies contributing 138 effect sizes were included (N = 2,345). For each study, the dosage of 39 behavioral techniques was derived from intervention manuals, and meta-regression determined which techniques were related to outcomes. RESULTS Parent training had robust small- to medium-sized positive effects on all parental outcomes relative to control conditions, both for unblinded and probably blinded measures. A higher dosage of techniques focusing on the manipulation of antecedents of behavior was associated with better outcomes on parenting sense of competence and parental mental health, and a higher dosage of techniques focusing on reinforcement of desired behaviors was related to larger decreases in negative parenting. Higher dosages of psychoeducation were negatively related to parental outcomes. CONCLUSION Although techniques were not investigated in isolation, the results suggested that manipulation of antecedents of behavior and reinforcement techniques are key components of parent training for children with ADHD in relation to parental outcomes. These exploratory findings may help to strengthen and tailor parent training interventions for children with ADHD.
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Affiliation(s)
- Tycho J Dekkers
- University of Groningen, the Netherlands; University of Amsterdam, the Netherlands; Levvel, Academic Center for Child- and Adolescent Psychiatry and Specialized Youthcare, Amsterdam, the Netherlands; Amsterdam University Medical Center, the Netherlands.
| | | | - Saskia van der Oord
- University of Amsterdam, the Netherlands; KU Leuven, Research Group Clinical Psychology, Belgium
| | - Marjolein Luman
- Levvel, Academic Center for Child- and Adolescent Psychiatry and Specialized Youthcare, Amsterdam, the Netherlands; Vrije Universiteit Amsterdam, the Netherlands
| | | | - Annabeth P Groenman
- University of Groningen, the Netherlands; University of Amsterdam, the Netherlands
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6
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Hornstra R, Dekkers TJ, Bosmans G, van den Hoofdakker B, van der Oord S. Attachment Representation Moderates the Effectiveness of Behavioral Parent Training Techniques for Children with ADHD: Evidence from a Randomized Controlled Microtrial. Res Child Adolesc Psychopathol 2022; 50:1151-1164. [PMID: 35362776 PMCID: PMC9525431 DOI: 10.1007/s10802-022-00921-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 11/26/2022]
Abstract
Behavioral parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but knowledge on the differential effects of behavioral techniques for specific subgroups of children is very limited. Attachment representations of children with ADHD may affect how receptive children are to changes in parenting. In this study, we investigated whether specific behavioral techniques were more or less effective for children with ADHD in relation to their attachment representations. We included parents of 74 children with ADHD (4-11 years, M = 8.15) who took part in a larger randomized controlled microtrial in which they were randomized to a two session training in antecedent-based techniques (i.e., stimulus control techniques: rules, instructions; n = 26), a two session training in consequent-based techniques (i.e., contingency management techniques: praise, rewards, ignoring; n = 25) or a waitlist control condition (n = 23). We examined whether attachment representation moderated the effectiveness of a) training versus waitlist, and b) antecedent- versus consequent-based techniques. Attachment representations were measured with a story stem task, the intervention outcome was daily parent-rated problem behaviors of the children. Attachment representation did not moderate the effects of the training compared to the waitlist. However, compared to antecedent-based techniques, consequent-based techniques were less effective for more securely and less disorganized attached children, and particularly effective for more disorganized attached children. This was the first study examining attachment as a moderator of behavioral techniques for ADHD. If replicated, the findings of this study can be used for treatment development and tailoring.
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Affiliation(s)
- Rianne Hornstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
- Accare Child Study Center, Groningen, the Netherlands.
| | - Tycho J Dekkers
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Accare Child Study Center, Groningen, the Netherlands
- Academic Center for Child and Adolescent Psychiatry, Levvel, Amsterdam, the Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center (AUMC), Amsterdam, the Netherlands
| | - Guy Bosmans
- Department of Clinical Psychology, KU Leuven, Leuven, Belgium
| | - Barbara van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Accare Child Study Center, Groningen, the Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| | - Saskia van der Oord
- Department of Clinical Psychology, KU Leuven, Leuven, Belgium
- Leuven Brain Institute, Leuven, Belgium
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7
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Hornstra R, van der Oord S, Staff AI, Hoekstra PJ, Oosterlaan J, van der Veen-Mulders L, Luman M, van den Hoofdakker BJ. Which Techniques Work in Behavioral Parent Training for Children with ADHD? A Randomized Controlled Microtrial. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2021; 50:888-903. [PMID: 34424102 DOI: 10.1080/15374416.2021.1955368] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Behavioral parent training (BPT) is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but little is known about the effects of separate techniques parents learn in BPT. METHOD In a three-armed randomized controlled microtrial including parents of 92 children (4-12 years) with ADHD, we examined the efficacy of two sessions parent training involving either stimulus control techniques (antecedent-based condition (AC)) or contingency management techniques (consequent-based condition (CC)), compared to a waitlist. Primary outcome was daily parent-rated problem behaviors, secondary outcomes were parent-rated symptoms of ADHD and oppositional defiant disorder (ODD), and mental health-care consumption. Measures were completed at baseline (T0), immediately after the training (T1), at two weeks (T2) and three months (T3) follow-up. We also explored whether child and parent characteristics moderated treatment effects. RESULTS Compared to the waitlist, in the AC, daily rated problem behaviors improved at T1 (d= .56) and T2 (d= .65); in the CC, these behaviors only improved at T2 (d= .53). Daily rated problem behaviors within both conditions remained stable between T2 and T3. In the AC compared to the other conditions, inattention symptoms decreased at T1 and T2. For both active conditions compared to waitlist, hyperactivity-impulsivity symptoms decreased only at T2 and ODD symptoms did not decrease. No moderators were identified. Mental health-care consumption after training was low and did not differ between the active conditions. CONCLUSIONS Brief training of parents in antecedent- or consequent-based techniques improves problem behaviors of children with ADHD. Antecedent-based techniques appear to be especially important to target inattention.
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Affiliation(s)
- Rianne Hornstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen
| | - Saskia van der Oord
- Clinical Psychology, KU Leuven.,Affiliated staff, Developmental Psychology, University of Amsterdam
| | - Anouck I Staff
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen
| | - 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.,Specialist in youth and family care, Levvel
| | - 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
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8
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Yuen T, Zhang H, Bonin RP. Pharmacists' knowledge, experiences and perceptions of treatments for attention-deficit/hyperactivity disorder. Can Pharm J (Ott) 2021; 154:110-119. [PMID: 33868522 DOI: 10.1177/1715163520981397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins in childhood and often persists into adulthood. ADHD increases the risk of various negative impacts, and pharmacists are well positioned to address these issues in the community. Objectives This survey study aims to first identify pharmacists' ADHD knowledge gaps and experience with ADHD management and to second assess their preferences for continuing education and their experience with sleep-related issues in ADHD. Methods A survey was sent to Part A Ontario pharmacists with active licenses who opted in to receive research-related emails (n = 6022). Descriptive statistics were used to analyze survey data, while free-form answers were pooled and evaluated for common themes and trends. Results A total of 238 complete responses were received. The average self-reported ADHD knowledge was 5.8 ± 1.96 on a 10-point scale. There was no correlation between the number of years of practice as a pharmacist, the number of working hours per week or the location of practice on pharmacists' self-reported knowledge scores. There was a significant difference in self-reported knowledge of ADHD between pharmacists who were not aware of the Canadian ADHD Resource Alliance (CADDRA) guidelines (5.1 ± 2.1) and those who refer to it for standard of care (7.1 ± 1.5). Almost all pharmacists (95%) indicated they could benefit from additional ADHD education, with a strong preference for "online continuing education modules" (81%). The majority of responders considered psychostimulant ADHD medication as the major possible contributor to sleep disturbances (47%) in ADHD, highlighting a need for further education on the inconclusive link between ADHD medication effects on sleep. Conclusion The study results raise the concern that pharmacists may require additional ADHD education but also show the lack of awareness of available resources, such as the CADDRA guidelines. Can Pharm J (Ott) 2021;154:xx-xx.
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Affiliation(s)
- Terence Yuen
- Leslie Dan Faculty of Pharmacy (Yuen, Zhang, Bonin), University of Toronto, Toronto.,Purdue Pharma (Canada) (Yuen), Pickering.,University of Toronto Centre for the Study of Pain (Bonin), Toronto, Ontario
| | - Hantao Zhang
- Leslie Dan Faculty of Pharmacy (Yuen, Zhang, Bonin), University of Toronto, Toronto.,Purdue Pharma (Canada) (Yuen), Pickering.,University of Toronto Centre for the Study of Pain (Bonin), Toronto, Ontario
| | - Robert P Bonin
- Leslie Dan Faculty of Pharmacy (Yuen, Zhang, Bonin), University of Toronto, Toronto.,Purdue Pharma (Canada) (Yuen), Pickering.,University of Toronto Centre for the Study of Pain (Bonin), Toronto, Ontario
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9
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Daley D, Tarver J, Sayal K. Efficacy of a self-help parenting intervention for parents of children with attention deficit hyperactivity disorder in adjunct to usual treatment-Small-scale randomized controlled trial. Child Care Health Dev 2021; 47:269-280. [PMID: 33159336 DOI: 10.1111/cch.12825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/20/2020] [Accepted: 10/26/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Multimodal intervention incorporating psychosocial intervention and medication is recommended for school-aged children with attention deficit hyperactivity disorder (ADHD). This randomized controlled trial (RCT) investigates the adjunctive benefit of the self-help version of the New Forest Parenting Programme (NFPP-SH) when offered in addition to treatment as usual (TAU) compared with TAU alone. METHOD Fifty-two children, receiving medication for ADHD as part of their usual care, were randomized to receive NFPP-SH + TAU or TAU alone. RESULTS When used in adjunct to TAU, NFPP-SH may have beneficial effects for parenting efficacy (F = 6.28, p = 0.02), child social performance in school and negative comments made by parents during a recorded speech sample. However, the self-help intervention did not have any additional effect on child behaviour. CONCLUSIONS This study provides further support for self-help interventions as potentially low-intensity and cost-effective alternatives to therapist-led parenting interventions. The findings require replication in larger samples before any firm conclusions about adjunctive efficacy of NFPP-SH can be drawn but underline the potential for self-help within routine treatment (ClinicalTrials.gov Identifier: NCT02174952).
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Affiliation(s)
- David Daley
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Joanne Tarver
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Kapil Sayal
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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10
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Bottema-Beutel K, Crowley S, Sandbank M, Woynaroski TG. Adverse event reporting in intervention research for young autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:322-335. [PMID: 33076682 PMCID: PMC7870528 DOI: 10.1177/1362361320965331] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT In this study, we looked at published research on interventions for young autistic children that did not involve administering medication. We were interested in determining how often studies reported on whether adverse events (i.e. physical or psychological distress to the participants) or adverse effects (i.e. adverse events that are thought to be caused by the intervention) had occurred. We found that of the 150 reports we examined, only 11 mentioned adverse events. One of these studies reported adverse events occurred, and three reported that adverse effects occurred. We also reviewed the studies to examine the reasons that were given to explain why any participants dropped out of the intervention (termed "withdrawal"), to determine if any of these reasons could be considered adverse events or adverse effects. Fifty-four studies described reasons for withdrawal, and 10 of these studies had reasons that could be categorized as an adverse event, 8 studies had reasons that could be categorized as an adverse effect, and an additional 12 studies had reasons that were too vaguely described to determine whether they were adverse events or not. We recommend that autism intervention researchers develop more systematic methods of looking for and reporting adverse events and effects, so that professionals and families can be better informed when choosing to enroll their autistic children in interventions.
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Affiliation(s)
| | - Shannon Crowley
- Boston College, Lynch School of Education and Human Development
| | | | - Tiffany G. Woynaroski
- Vanderbilt University Medical Center, Vanderbilt Brain Institute, Vanderbilt Kennedy Center
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11
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Dixson DD, Scalcucci SG. Psychosocial perceptions and executive functioning: Hope and school belonging predict students' executive functioning. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Dante D. Dixson
- Department of Counseling, Educational Psychology, and Special Education, School Psychology, College of Education Michigan State University East Lansing Michigan USA
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12
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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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13
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Fontes RM, Marinho V, Carvalho V, Rocha K, Magalhães F, Moura I, Ribeiro P, Velasques B, Cagy M, Gupta DS, Bastos VH, Teles AS, Teixeira S. Time estimation exposure modifies cognitive aspects and cortical activity of attention deficit hyperactivity disorder adults. Int J Neurosci 2020; 130:999-1014. [DOI: 10.1080/00207454.2020.1715394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Rhailana Medeiros Fontes
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Victor Marinho
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Valécia Carvalho
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Kaline Rocha
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Francisco Magalhães
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Iris Moura
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- Masters Programs in Biotechnology, Federal University of Piauí, Parnaíba, Brazil
| | - Pedro Ribeiro
- Brain Mapping and Sensory Motor Integration Laboratory, Institute of Psychiatry, Federal University of Rio De Janeiro, Rio De Janeiro, Brazil
| | - Bruna Velasques
- Brain Mapping and Sensory Motor Integration Laboratory, Institute of Psychiatry, Federal University of Rio De Janeiro, Rio De Janeiro, Brazil
| | - Mauricio Cagy
- Brain Mapping and Sensory Motor Integration Laboratory, Institute of Psychiatry, Federal University of Rio De Janeiro, Rio De Janeiro, Brazil
| | - Daya S. Gupta
- Department of Biology, Camden County College, Blackwood, NJ, USA
| | - Victor Hugo Bastos
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
- Masters Programs in Biotechnology, Federal University of Piauí, Parnaíba, Brazil
- Brain Mapping and Functionality Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Ariel Soares Teles
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- Masters Programs in Biotechnology, Federal University of Piauí, Parnaíba, Brazil
- Federal Institute of Maranhão, Maranhão, Brazil
| | - Silmar Teixeira
- Neuro-Innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
- Masters Programs in Biotechnology, Federal University of Piauí, Parnaíba, Brazil
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Grygiel P, Humenny G, Rębisz S, Bajcar E, Świtaj P. Peer Rejection and Perceived Quality of Relations With Schoolmates Among Children With ADHD. J Atten Disord 2018; 22:738-751. [PMID: 25526905 DOI: 10.1177/1087054714563791] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The main aim of the current study was to investigate the links between ADHD diagnosis and the objective and subjective dimensions of social relationships among children from primary schools. METHOD We used the data from 36 regular classrooms, consisting of 718 students, with each containing at least one child with an established clinical diagnosis of ADHD (38 children). RESULTS For children with ADHD, the level of the perceived quality of social relations was lower than that of children without such a diagnosis. After controlling for sociometric status, the impact of ADHD on perceived status proved to be statistically nonsignificant but the indirect impact of ADHD on this status through sociometric status was statistically significant. CONCLUSION Children diagnosed with ADHD are more often rejected by their peers and have a more pessimistic view of their social world. Moreover, ADHD diagnosis does not have a direct influence on the perceived quality of social relations otherwise than through sociometric status.
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Affiliation(s)
| | | | | | | | - Piotr Świtaj
- 4 Institute of Psychiatry and Neurology, Warsaw, Poland
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Chacko A, Bedard ACV, Marks D, Gopalan G, Feirsen N, Uderman J, Chimiklis A, Heber E, Cornwell M, Anderson L, Zwilling A, Ramon M. Sequenced neurocognitive and behavioral parent training for the treatment of ADHD in school-age children. Child Neuropsychol 2018; 24:427-450. [PMID: 28277151 PMCID: PMC6224162 DOI: 10.1080/09297049.2017.1282450] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The present study examines the potential of sequencing a neurocognitive intervention with behavioral parent training (BPT) to improve executive functions (EFs), psychiatric symptoms, and multiple indices of functional impairment in school-age children aged 7 to 11 years who have been diagnosed with attention-deficit/hyperactivity disorder (ADHD). Specifically, in a randomized controlled trial design, 85 children were assigned to either Cogmed Working Memory Training (CWMT) followed by an empirically supported, manualized BPT intervention, or to a placebo version of CWMT followed by the same BPT intervention. Working memory maintenance (i.e., attention control/short-term memory), working memory processing and manipulation, ADHD and oppositional defiant disorder (ODD) symptoms, impairment in parent-child dynamics, familial impairment, and overall functional compromise were evaluated as outcomes. The results suggest specific effects of the combined CWMT and BPT program on verbal and nonverbal working memory storage and nonverbal working memory processing and manipulation but no incremental benefits in regard to ADHD symptoms, ODD symptoms, and functional outcomes. The present findings do not support the hypothesis regarding the complementary and augmentative benefits of sequenced neurocognitive and BPT interventions for the treatment of ADHD. These results, the study's limitations, and future directions for research are further discussed.
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Affiliation(s)
- A Chacko
- a Department of Applied Psychology , New York University , NY , USA
| | - A-C V Bedard
- b Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education , University of Toronto , Canada
| | - D Marks
- c Department of Child and Adolescent Psychiatry , New York University School of Medicine , NY , USA
| | - G Gopalan
- d Department of Social Work , University of Maryland at Baltimore , MD , USA
| | - N Feirsen
- e Department of Psychology , City University of New York , NY , USA
| | - J Uderman
- e Department of Psychology , City University of New York , NY , USA
| | - A Chimiklis
- e Department of Psychology , City University of New York , NY , USA
| | - E Heber
- e Department of Psychology , City University of New York , NY , USA
| | - M Cornwell
- e Department of Psychology , City University of New York , NY , USA
| | - L Anderson
- e Department of Psychology , City University of New York , NY , USA
| | - A Zwilling
- e Department of Psychology , City University of New York , NY , USA
| | - M Ramon
- e Department of Psychology , City University of New York , NY , USA
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Peer Inclusion in Interventions for Children with ADHD: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7693479. [PMID: 29744363 PMCID: PMC5878915 DOI: 10.1155/2018/7693479] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/09/2018] [Indexed: 02/07/2023]
Abstract
Objective To assess the effectiveness of peer inclusion in interventions to improve the social functioning of children with ADHD. Methods We searched four electronic databases for randomized controlled trials and controlled quasi-experimental studies that investigated peer inclusion interventions alone or combined with pharmacological treatment. Data were collected from the included studies and methodologically assessed. Meta-analyses were conducted using a random-effects model. Results Seventeen studies met eligibility criteria. Studies investigated interventions consisting of peer involvement and peer proximity; no study included peer mediation. Most included studies had an unclear or high risk of bias regarding inadequate reporting of randomization, blinding, and control for confounders. Meta-analyses indicated improvements in pre-post measures of social functioning for participants in peer-inclusive treatment groups. Peer inclusion was advantageous compared to treatment as usual. The benefits of peer inclusion over other therapies or medication only could not be determined. Using parents as raters for outcome measurement significantly mediated the intervention effect. Conclusions The evidence to support or contest the efficacy of peer inclusion interventions for children with ADHD is lacking. Future studies need to reduce risks of bias, use appropriate sample sizes, and provide detailed results to investigate the efficacy of peer inclusion interventions for children with ADHD.
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Gu Y, Xu G, Zhu Y. A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for College Students With ADHD. J Atten Disord 2018; 22:388-399. [PMID: 28038496 DOI: 10.1177/1087054716686183] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Between 2% and 8% of college students meet criteria for ADHD, with increased incidence in recent decades. There are very few clinical trials conducted on the meaningful intervention of ADHD in college. Mindfulness-based cognitive therapy (MBCT) effectively treats college students with ADHD and could be more feasibly applied in college mental health clinics. METHOD Fifty-four undergraduates with ADHD between ages 19 and 24 were randomized to receive either MBCT or wait-list (WL) during a 6-week intervention phase. ADHD symptoms, neuropsychological performance, and related outcomes were assessed at pre-treatment, post-treatment, and 3-month follow-up. RESULTS Participants receiving MBCT group showed greater treatment response rates (57%-71% vs. 23%-31%) and experience less anxiety and depression, and greater levels of mindfulness; MBCT participants show greater improvement on neuropsychological performance. CONCLUSION MBCT may be a useful intervention for college students with ADHD, improving participants' ADHD symptoms, mindfulness, and sustained attention.
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Affiliation(s)
- Yingqi Gu
- 1 East China Normal University, Shanghai, China.,2 Hainan Medical University, Haikou, China
| | | | - Yi Zhu
- 2 Hainan Medical University, Haikou, China
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18
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Enns JE, Randall JR, Smith M, Chateau D, Taylor C, Brownell M, Bolton JM, Burland E, Katz A, Katz LY, Nickel NC. A Multimodal Intervention for Children with ADHD Reduces Inequity in Health and Education Outcomes. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2017; 62:403-412. [PMID: 28146649 PMCID: PMC5455871 DOI: 10.1177/0706743717692301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate whether a multimodal intervention for children with attention-deficit hyperactivity disorder (ADHD) resulted in better long-term health and education outcomes and reduced inequity across the socioeconomic gradient. METHOD We analyzed administrative data held in the Manitoba Population Research Data Repository describing recipients of a combined pharmacological/behavioural intervention for ADHD. The study cohort included children aged 5 to 17 years who visited the Manitoba Adolescent Treatment Centre's ADHD intervention service at least 3 times (2007-2012). Controls were matched on age, sex, year of ADHD diagnosis, and income quintile. We compared rates of hospital and emergency department visits, medication use and adherence, contact with child welfare services, and whether children were in their age-appropriate grade. We used concentration curves to estimate differences in outcomes between children from high- and low-income families. RESULTS Children who received the intervention ( n = 485) had higher rates of medication use (rate ratio [RR], 1.21; 95% CI, 1.08 to 1.36) and adherence (RR, 1.42; 95% CI, 1.03 to 1.96) and were more likely to be in their age-appropriate grade (RR, 1.33; 95% CI, 1.09 to 1.63) compared with controls ( n = 1884). The intervention was also associated with reduced inequity in these outcomes across income deciles. There was no difference in the rates of hospital or emergency department visits or contacts with child welfare services. CONCLUSIONS A multimodal ADHD intervention was associated with increased medication use and adherence and higher academic achievement. It was also related to lower inequity across the socioeconomic gradient. These results suggest that multimodal approaches may provide more equitable health and education outcomes for children with ADHD.
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Affiliation(s)
- Jennifer E Enns
- 1 Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - Jason R Randall
- 1 Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - Mark Smith
- 1 Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - Dan Chateau
- 1 Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - Carole Taylor
- 1 Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - Marni Brownell
- 1 Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - James M Bolton
- 2 Department of Psychiatry, University of Manitoba, Manitoba, Canada
| | - Elaine Burland
- 1 Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - Alan Katz
- 1 Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
| | - Laurence Y Katz
- 2 Department of Psychiatry, University of Manitoba, Manitoba, Canada
| | - Nathan C Nickel
- 1 Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
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Paidipati CP, Brawner B, Eiraldi R, Deatrick JA. Parent and Family Processes Related to ADHD Management in Ethnically Diverse Youth. J Am Psychiatr Nurses Assoc 2017; 23:90-112. [PMID: 28076687 PMCID: PMC5915362 DOI: 10.1177/1078390316687023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Previous research has shown major disparities in attention deficit hyperactivity disorder (ADHD) for diverse youth across America. We do not fully understand, however, how parent and family processes are related to the identification, care-seeking approaches, treatment preferences, and engagement with care systems and services for youth with ADHD. OBJECTIVES The present study aimed to explore parent and family processes related to the management of ADHD in racially and ethnically diverse youth. DESIGN This integrative review was structured with the methodology proposed by Whittemore and Knafl. RESULTS Three major electronic databases yielded a final sample of 32 articles (24 quantitative, 6 qualitative, and 2 mixed methods). Nine themes emerged within three overarching meta-themes. CONCLUSIONS Understanding the unique perspectives of families from diverse backgrounds is essential for clinicians, researchers, and policymakers, who are dedicated to understanding racial and ethnic perspectives and developing ecologically appropriate and family-based interventions for youth with ADHD.
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Affiliation(s)
- Cynthia P. Paidipati
- Cynthia P. Paidipati, MSN, CRNP, The University of Pennsylvania, Philadelphia, PA, USA
| | - Bridgette Brawner
- Bridgette Brawner, PhD, APRN, The University of Pennsylvania, Philadelphia, PA, USA
| | - Ricardo Eiraldi
- Ricardo Eiraldi, PhD, The University of Pennsylvania, Philadelphia, PA, USA
| | - Janet A. Deatrick
- Janet A. Deatrick, PhD, RN, FAAN, The University of Pennsylvania, Philadelphia, PA, USA
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Amado L, Jarque S, Ceccato R. Differential impact of a multimodal versus pharmacological therapy on the core symptoms of attention deficit/hyperactivity disorder in childhood. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 59:93-104. [PMID: 27521718 DOI: 10.1016/j.ridd.2016.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 07/26/2016] [Accepted: 08/05/2016] [Indexed: 06/06/2023]
Abstract
UNLABELLED The aim of this study was to analyze the relative and differential efficacy of a combined versus medical treatment to reduce the symptoms of ADHD children in the school and family environment. A total of 100 subjects participated: 20 children with ADHD, their 40 parents and their 40 teachers. Half of the subjects were assigned to the drug group and half to the combined (drug plus psychosocial, psychoeducational intervention with teachers and mothers/fathers). RESULTS The group analyses indicated that both treatments were effective, without significant differences between them. Individualized clinical analyses indicated that higher percentages of improvement and normalization were obtained in the children in the combined group than in the drug only group. Our findings point to the desirability of implementing long-lasting multimodal, multicontextual interventions for ADHD in childhood.
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Affiliation(s)
- Laura Amado
- Abat Oliba-CEU University, Psychology Department, Bellesguard, 30, Barcelona Spain.
| | - Sonia Jarque
- University of Barcelona, Department of Developmental and Educational Psychology, P. Vall d'Hebron, 171, Barcelon 08035, Spain.
| | - Roberta Ceccato
- University of Valencia, Department of Developmental and Educational Psychology, Avda Blasco Ibáñez, 21, Valencia, Spain.
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Williamson AA, Harrison RR, Reader SK, Tynan WD. Parent–Child Groups for Externalizing Disorders: Outcomes, Sociodemographic Moderators, Attendance, and Attrition in a Real-World Setting. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/23794925.2016.1227945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Affiliation(s)
- Alexander K C Leung
- Department of Paediatrics, Alberta Children's Hospital, University of Calgary, #200, 233-16th Avenue North West, Calgary, Alberta T2M 0H5, Canada.
| | - Kam Lun Hon
- Department of Paediatrics, Chinese University of Hong Kong, 6/F, Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong, China
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Wilkes-Gillan S, Bundy A, Cordier R, Lincoln M. Child outcomes of a pilot parent-delivered intervention for improving the social play skills of children with ADHD and their playmates. Dev Neurorehabil 2016; 19:238-45. [PMID: 25181635 DOI: 10.3109/17518423.2014.948639] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This pilot study examined the effectiveness of a parent-delivered intervention for improving: the social play skills of children with attention deficit hyperactivity disorder (ADHD) and their typically developing playmates and the empathy of children with ADHD. METHODS Participants were children with ADHD and their typically developing playmates (n = 9/group). The intervention was primarily parent-implemented and involved: parent-training, weekly home-modules, three clinic play-sessions, therapist-parent phone consultations and a one-month follow-up. The Test of Playfulness (ToP) was the primary outcome measure. Cohen's-d and paired sample t-test calculations were used to measure effect. RESULTS Social play outcomes of children with ADHD improved significantly from: pre- to post-test (t = 3.2; p = 0.02; d = 1.0) and post-test to follow-up intervention (t = 2.7; p = 0.02; d = 1.1). Playmate's improved significantly from pre- to post-intervention (t = 3.9; p = 0.03; d = 1.2). Children with ADHD improved significantly on 4/7 ToP empathy items (t = 2.31-3.16; p = 0.02). CONCLUSION The intervention successfully improved the social play skills of children with ADHD and their playmates.
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Affiliation(s)
- Sarah Wilkes-Gillan
- a Faculty of Health Sciences , The University of Sydney , Sydney , NSW , Australia and
| | - Anita Bundy
- a Faculty of Health Sciences , The University of Sydney , Sydney , NSW , Australia and
| | - Reinie Cordier
- a Faculty of Health Sciences , The University of Sydney , Sydney , NSW , Australia and.,b School of Occupational Therapy and Social Work, Curtin University , Perth , Western Australia , Australia
| | - Michelle Lincoln
- a Faculty of Health Sciences , The University of Sydney , Sydney , NSW , Australia and
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Impact of implementing a parental training program in the treatment of a sample of ADHD children. MIDDLE EAST CURRENT PSYCHIATRY 2016. [DOI: 10.1097/01.xme.0000475431.46273.79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Lee HS, Song CS. Effects of therapeutic climbing activities wearing a weighted vest on a child with attention deficit hyperactivity disorder: a case study. J Phys Ther Sci 2015; 27:3337-9. [PMID: 26644705 PMCID: PMC4668196 DOI: 10.1589/jpts.27.3337] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 07/13/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to evaluate the effect of therapeutic climbing
activities on the brain waves and attention of a child with attention deficit
hyperactivity disorder. [Subject and Methods] The subject of this case study was a 7 year
6-month old child diagnosed with attention deficit hyperactivity disorder. This study was
based on evidence gathered at 3 distinct stages: a pre-intervention period, 10
intervention periods (2 weeks), and one post-intervention period. The intervention
involved therapeutic climbing activities wearing a weighted vest over the course of 4
weeks. The clinical outcome measures were electroencephalography and the Star Cancellation
Test. [Results] The mean activation of alpha waves was improved by the therapeutic
intervention. During the intervention, the mean activation of alpha waves was the highest
at the F3 cortical locus and the lowest at the T4 cortical locus. The average Star
Cancellation Test scores were 43 at pre-intervention, 50 during the therapeutic
intervention, and 52 at post-intervention. The performance time of the Star Cancellation
Test was 240.1 seconds at pre-intervention, 90.2 seconds during the therapeutic
intervention, and 60.0 seconds at post-intervention. [Conclusion] The results of this
study suggest that therapeutic climbing activities performed wearing a weighted vest had
positive effects on the brain waves and the attention span of a child with attention
deficit hyperactivity disorder.
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Affiliation(s)
- Hye-Sun Lee
- Department of Occupational Therapy, Kwangju-Women's University, Republic of Korea
| | - Chiang-Soon Song
- Department of Occupational Therapy, College of Health Science, Chosun University, Republic of Korea
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Abstract
With many youth presenting to primary care settings for mental health difficulties, knowledge of the respective evidence-based psychotherapies is imperative in ensuring that these youth receive the appropriate interventions in a timely manner. Most frequently, children present with internalizing and/or externalizing disorders, which cover a broad range of common pediatric mental disorders. Treatments of these disorders generally incorporate cognitive and/or behavioral components, which are derived from theoretical underpinnings and empirical support. Although the interventions share common components, they are distinctive in nature and are further tailored toward the idiosyncratic needs of children and their families. Careful consideration of the apposite intervention and individual needs of youth are pertinent to the effective amelioration of symptomology.
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Affiliation(s)
- Monica S Wu
- Department of Pediatrics, University of South Florida, 880 6th Street South, 4th Floor North, Box 7523, St. Petersburg, FL 33701, USA; Department of Psychology, University of South Florida, 4202 East Fowler Avenue, PCD 4118G, Tampa, FL 33620-7200, USA.
| | - Rebecca J Hamblin
- Department of Pediatrics, University of South Florida, 880 6th Street South, 4th Floor North, Box 7523, St. Petersburg, FL 33701, USA; Rogers Behavioral Health - Tampa Bay, 2002 North Lois Avenue, Suite 400, Tampa, FL 33607, USA
| | - Eric A Storch
- Department of Pediatrics, University of South Florida, 880 6th Street South, 4th Floor North, Box 7523, St. Petersburg, FL 33701, USA; Department of Psychology, University of South Florida, 4202 East Fowler Avenue, PCD 4118G, Tampa, FL 33620-7200, USA; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, 3515 East Fletcher Avenue, Tampa, FL 33613, USA; Department of Health Management and Policy, University of South Florida, 13201 Bruce B. Downs Boulevard, MDC 56, Tampa, FL 33612, USA; Rogers Behavioral Health - Tampa Bay, 2002 North Lois Avenue, Suite 400, Tampa, FL 33607, USA; Mind-Body Branch, All Children's Hospital, Johns Hopkins Medicine, 880 6th Street South, 4th Floor North, Box 7523, St. Petersburg, FL 33701, USA
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Wilkes-Gillan S, Bundy A, Cordier R, Lincoln M, Hancock N. Parents’ perspectives on the appropriateness of a parent-delivered intervention for improving the social play skills of children with ADHD. Br J Occup Ther 2015. [DOI: 10.1177/0308022615573453] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction This study aimed to evaluate parents’ perspectives of the appropriateness of a parent-delivered play-based intervention, The Ultimate Guide to Making Friends. The intervention was designed to improve the social play skills of children with ADHD. Method One month post-intervention, seven parents of children with ADHD participated in individual semi-structured interviews. Interviews ranged from 40–60 minutes. Parents were asked about their perceptions of the intervention: experience, benefits, logistics that supported or hindered participation and satisfaction with the intervention for themselves and their children. Data were analysed thematically using constant comparative methods, whereby two researchers worked independently to analyse emergent themes. Findings Thematic analysis revealed a single core theme of reframing: a process whereby both parents and their children were assisted to develop new perspectives regarding their social skills and interactions. The core theme comprised three sub-themes: (1) connecting with the intervention; (2) parent and child benefits resulting from a new perspective; and (3) continued everyday use of the intervention materials and strategies. Conclusion The intervention was appropriate from parents’ perspectives. The core theme of reframing and sub-themes collectively related back to the following aspects of appropriateness: (a) a positive experience; (b) relevant and important to their/their child’s needs; (c) beneficial; (d) a socially and ecologically valid approach, fitting their everyday lives; and (e) promoting change that continued over time.
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Affiliation(s)
- Sarah Wilkes-Gillan
- PhD candidate, Faculty of Health Science, University of Sydney, NSW, Australia; Lecturer, School of Allied Health, Australian Catholic University, NSW, Australia
| | - Anita Bundy
- Professor, Faculty of Health Sciences, University of Sydney, NSW, Australia
| | - Reinie Cordier
- Associate Professor, School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia
| | - Michelle Lincoln
- Professor, Deputy Dean, Faculty of Health Sciences, The University of Sydney, NSW, Australia
| | - Nicola Hancock
- Lecturer, Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, NSW, Australia
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Vidal R, Castells J, Richarte V, Palomar G, García M, Nicolau R, Lazaro L, Casas M, Ramos-Quiroga JA. Group therapy for adolescents with attention-deficit/hyperactivity disorder: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry 2015; 54:275-82. [PMID: 25791144 DOI: 10.1016/j.jaac.2014.12.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 12/15/2014] [Accepted: 01/21/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To determine the efficacy of group cognitive-behavioral therapy (CBT) on adolescents with attention-deficit/hyperactivity disorder (ADHD) who were in pharmacological treatment but still had persistent symptoms. METHOD We conducted a multicenter, randomized, rater-blinded, controlled trial between April 2012 and May 2014 in a cohort of 119 adolescents (15-21 years of age). Participants were randomly assigned to 12 manualized group CBT sessions (n = 45) or a waiting list control group (n = 44). Primary outcomes were assessed by a blinded evaluator (ADHD Rating Scale [ADHD-RS], Clinical Global Impression Scale for Severity [CGI-S], Global Assessment of Functioning [GAF]) before and after treatment, as well as by self-report and parent informant ratings. RESULTS Of the initial 119 participants enrolled, 89 completed treatment. A mixed-effects model analysis revealed that participants who were assigned to the group CBT sessions experienced significantly reduced ADHD symptoms compared to the control group (ADHD-RS Adolescent: -7.46, 95% CI = -9.56 to -5.36, p < .001, d = 7.5; ADHD-RS Parents: -9.11, 95% CI = -11.48 to -6.75, p < .001, d = 8.38; CGI-S Self-Report: -0.68, 95% CI = -0.98 to -0.39, p < .001, d = 3.75; CGI-S Clinician: -0.79, 95% CI = -0.95 to -0.62, p < .001; d = 7.71). Functional impairment decreased significantly in the CBT group according to parents (Weiss Functional Impairment Scale -4.02, 95% CI = -7.76 to -0.29, p < .05, d = 2.29) and according to the blinded evaluator (GAF: -7.58, 95% CI = -9.1 to -6.05, p < .001, d = 7.51). CONCLUSION Group CBT associated with pharmacological treatment is an efficacious intervention for reducing ADHD symptoms and functional impairment in adolescents. Clinical trial registration information-CBT Group for Adolescents With ADHD: a Randomized Controlled Trial; http://clinicaltrials.gov/; NCT02172183.
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Affiliation(s)
- Raquel Vidal
- Hospital Universitari Vall d'Hebron, ADHD (Attention-Deficit/Hyperactivity Disorder) Program, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain, and Universitat Autònoma de Barcelona
| | | | - Vanesa Richarte
- Hospital Universitari Vall d'Hebron, ADHD Program, Barcelona, Spain
| | - Gloria Palomar
- Hospital Universitari Vall d'Hebron, ADHD Program, Barcelona, Spain
| | | | | | - Luisa Lazaro
- Hospital Clinic of Barcelona, (CIBERSAM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and with the University of Barcelona
| | - Miguel Casas
- Hospital Universitari Vall d'Hebron, ADHD (Attention-Deficit/Hyperactivity Disorder) Program, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain, and Universitat Autònoma de Barcelona
| | - Josep Antoni Ramos-Quiroga
- Hospital Universitari Vall d'Hebron, ADHD (Attention-Deficit/Hyperactivity Disorder) Program, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain, and Universitat Autònoma de Barcelona.
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Goodman DW, Lasser RA, Babcock T, Pucci ML, Solanto MV. Managing ADHD across the Lifespan in the Primary Care Setting. Postgrad Med 2015; 123:14-26. [DOI: 10.3810/pgm.2011.09.2456] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Intervention with students with ADHD: Analysis of the effects of a multi-component and multi-contextualized program on academic and socio-emotional adjustment. ACTA ACUST UNITED AC 2015. [DOI: 10.1108/s0735-004x(2009)0000022010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Mazor-Karsenty T, Parush S, Bonneh Y, Shalev L. Comparing the executive attention of adult females with ADHD to that of females with sensory modulation disorder (SMD) under aversive and non-aversive auditory conditions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 37:17-30. [PMID: 25460216 DOI: 10.1016/j.ridd.2014.10.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 10/23/2014] [Accepted: 10/24/2014] [Indexed: 06/04/2023]
Abstract
Certain behavioral expressions of sensory modulation disorder (SMD) such as distractibility, hyperactivity, and impulsivity are often similar to those of attention deficit/hyperactivity disorder (ADHD) in pediatric and adult populations. There is also a high comorbidity rate between these two diagnoses and absence of research regarding the objective neuropsychological differentiation between them. In the present study we employed a factorial design which enabled us to: (a) systematically examine the effects of SMD and ADHD on executive attention in a sample of adult females using a Stroop-like task, and (b) measure the effect of aversive conditions (sounds) on executive attention. The experimental measures used were the Stroop-like Location-Direction Task (SLDT) to assess executive attention and the battery of aversiveness to sounds (BAS), a standardized measure of aversive sounds that was developed for this study and enabled individual customization of aversive auditory sounds. Results revealed, as expected, a specific core deficit in executive attention for the ADHD factor. In addition to that, the present study provides an important, pioneering finding of SMD impairment in a unique combination of a cognitively demanding task with aversive sounds, providing preliminary objective evidence differentiating SMD from ADHD.
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Affiliation(s)
- Tal Mazor-Karsenty
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Israel.
| | - Shula Parush
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Israel.
| | - Yoram Bonneh
- Department of Human Biology, University of Haifa, Israel.
| | - Lilach Shalev
- School of Education and School of Neuroscience, Tel-Aviv University, Israel.
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Chacko A, Kofler M, Jarrett M. Improving outcomes for youth with ADHD: a conceptual framework for combined neurocognitive and skill-based treatment approaches. Clin Child Fam Psychol Rev 2014; 17:368-84. [PMID: 25120200 PMCID: PMC4335705 DOI: 10.1007/s10567-014-0171-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and chronic mental health condition that often results in substantial impairments throughout life. Although evidence-based pharmacological and psychosocial treatments exist for ADHD, effects of these treatments are acute, do not typically generalize into non-treated settings, rarely sustain over time, and insufficiently affect key areas of functional impairment (i.e., family, social, and academic functioning) and executive functioning. The limitations of current evidence-based treatments may be due to the inability of these treatments to address underlying neurocognitive deficits that are related to the symptoms of ADHD and associated areas of functional impairment. Although efforts have been made to directly target the underlying neurocognitive deficits of ADHD, extant neurocognitive interventions have shown limited efficacy, possibly due to misspecification of training targets and inadequate potency. We argue herein that despite these limitations, next-generation neurocognitive training programs that more precisely and potently target neurocognitive deficits may lead to optimal outcomes when used in combination with specific skill-based psychosocial treatments for ADHD. We discuss the rationale for such a combined treatment approach, prominent examples of this combined treatment approach for other mental health disorders, and potential combined treatment approaches for pediatric ADHD. Finally, we conclude with directions for future research necessary to develop a combined neurocognitive + skill-based treatment for youth with ADHD.
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Affiliation(s)
- Anil Chacko
- Department of Applied Psychology, New York University, New York, NY, USA,
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Review of clinical guidelines for children and adolescents with attention deficit hyperactivity disorder and their application to an Irish context. Ir J Psychol Med 2014; 32:283-293. [DOI: 10.1017/ipm.2014.63] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background:Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with international prevalence rates estimated to be 5%. It is currently the most common disorder treated in Child and Adolescent Mental Health Services in Ireland. There have been a number of guidelines worldwide produced to aid clinicians in the diagnosis and treatment of ADHD; however, there are no guidelines available specifically for the Irish population and healthcare system.Objectives:The aim of this paper is to review the available clinical guidelines for the diagnosis and management of ADHD in children adolescents across North America, Canada, Europe and the United Kingdom and to apply these to an Irish context.Methods:A number of international guidelines were reviewed. A proposed pathway for the assessment and treatment of children and adolescents with ADHD has been devised with the recommendation that a formalised consensus guideline should be implemented.Conclusion:This review paper has highlighted that there is consensus between the guidelines for the diagnosis of ADHD with a thorough clinical history remaining the gold standard. They further agree on the importance of identifying co-morbid disorders. When it comes to the treatment, the guidelines are less unified. This current paper has devised a proposed care pathway for ADHD in Ireland to ensure high quality cost effective care within its healthcare system.
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Wilkes-Gillan S, Bundy A, Cordier R, Lincoln M. Evaluation of a Pilot Parent-Delivered Play-Based Intervention for Children With Attention Deficit Hyperactivity Disorder. Am J Occup Ther 2014; 68:700-9. [DOI: 10.5014/ajot.2014.012450] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. This study evaluated a parent-delivered intervention aiming to address the social difficulties of children with attention deficit hyperactivity disorder (ADHD). The intervention was evaluated from three perspectives: effectiveness, feasibility, and appropriateness.
METHOD. This one-group pretest–posttest study included 5 children with ADHD and their parents, who had previously participated in a therapist-delivered play-based intervention. The 7-wk parent-delivered intervention involved home modules (including a DVD, manual, and play dates with a typically developing playmate) and three therapist-led clinic-based play sessions. The Test of Playfulness was used as a pre- and postintervention and follow-up measure. Parents were interviewed 1 mo following the intervention, and data were analyzed for recurring themes.
RESULTS. Children’s social play outcomes improved significantly from pretest to 1-mo follow-up (Z = 2.02, p = .04, d = 1.0). Three themes emerged: the clinic play environment as a sanctuary, parental barriers to intervention delivery, and tools for repeating learned lessons.
CONCLUSION. The parent-delivered intervention demonstrated preliminary evidence for feasibility and effectiveness. Further research is warranted regarding appropriateness.
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Affiliation(s)
- Sarah Wilkes-Gillan
- Sarah Wilkes-Gillan, BAppSc(OT)Hons, is PhD Candidate, University of Sydney, 75 East Street, Lidcombe, New South Wales 2141, Australia;
| | - Anita Bundy
- Anita Bundy, ScD, is Professor and Chair of Occupational Therapy, University of Sydney, Sydney, New South Wales, Australia
| | - Reinie Cordier
- Reinie Cordier, PhD, is Associate Professor, School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, and Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Michelle Lincoln
- Michelle Lincoln, PhD, is Professor and Deputy Dean, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
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Maeir A, Fisher O, Bar-Ilan RT, Boas N, Berger I, Landau YE. Effectiveness of Cognitive–Functional (Cog–Fun) Occupational Therapy Intervention for Young Children With Attention Deficit Hyperactivity Disorder: A Controlled Study. Am J Occup Ther 2014; 68:260-7. [DOI: 10.5014/ajot.2014.011700] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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McCann DC, Thompson M, Daley D, Barton J, Laver-Bradbury C, Hutchings J, Coghill D, Stanton L, Maishman T, Dixon L, Caddy J, Chorozoglou M, Raftery J, Sonuga-Barke E. Study protocol for a randomized controlled trial comparing the efficacy of a specialist and a generic parenting programme for the treatment of preschool ADHD. Trials 2014; 15:142. [PMID: 24767423 PMCID: PMC4020350 DOI: 10.1186/1745-6215-15-142] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 04/10/2014] [Indexed: 01/09/2023] Open
Abstract
Background The New Forest Parenting Programme (NFPP) is a home-delivered, evidence-based parenting programme to target symptoms of attention-deficit/hyperactivity disorder (ADHD) in preschool children. It has been adapted for use with ‘hard-to-reach’ or ‘difficult-to-treat’ children. This trial will compare the adapted-NFPP with a generic parenting group-based programme, Incredible Years (IY), which has been recommended for children with preschool-type ADHD symptoms. Methods/design This multicentre randomized controlled trial comprises three arms: adapted-NFPP, IY and treatment as usual (TAU). A sample of 329 parents of preschool-aged children with a research diagnosis of ADHD enriched for hard-to-reach and potentially treatment-resistant children will be allocated to the arms in the ratio 3:3:1. Participants in the adapted-NFPP and IY arms receive an induction visit followed by 12 weekly parenting sessions of 1½ hours (adapted-NFPP) or 2½ hours (IY) over 2.5 years. Adapted-NFPP will be delivered as a one-to-one home-based intervention; IY, as a group-based intervention. TAU participants are offered a parenting programme at the end of the study. The primary objective is to test whether the adapted-NFPP produces beneficial effects in terms of core ADHD symptoms. Secondary objectives include examination of the treatment impact on secondary outcomes, a study of cost-effectiveness and examination of the mediating role of treatment-induced changes in parenting behaviour and neuropsychological function. The primary outcome is change in ADHD symptoms, as measured by the parent-completed version of the SNAP-IV questionnaire, adjusted for pretreatment SNAP-IV score. Secondary outcome measures are: a validated index of behaviour during child’s solo play; teacher-reported SNAP-IV (ADHD scale); teacher and parent SNAP-IV (ODD) Scale; Eyberg Child Behaviour Inventory - Oppositional Defiant Disorder scale; Revised Client Service Receipt Inventory - Health Economics Costs measure and EuroQol (EQ5D) health-related quality-of-life measure. Follow-up measures will be collected 6 months after treatment for participants allocated to adapted-NFPP and IY. Discussion This trial will provide evidence as to whether the adapted-NFPP is more effective and cost-effective than the recommended treatment and TAU. It will also provide information about mediating factors (improved parenting and neuropsychological function) and moderating factors (parent and child genetic factors) in any increased benefit. Trial registration Current Controlled Trials, ISRCTN39288126.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Edmund Sonuga-Barke
- Developmental Brain and Behaviour Lab, Psychology, University of Southampton, Southampton SO17 1BJ, UK.
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Wilkes-Gillan S, Bundy A, Cordier R, Lincoln M. Eighteen-month follow-up of a play-based intervention to improve the social play skills of children with attention deficit hyperactivity disorder. Aust Occup Ther J 2014; 61:299-307. [DOI: 10.1111/1440-1630.12124] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah Wilkes-Gillan
- Discipline of Occupational Therapy; Faculty of Health Sciences; The University of Sydney; Sydney New South Wales
| | - Anita Bundy
- Discipline of Occupational Therapy; Faculty of Health Sciences; The University of Sydney; Sydney New South Wales
| | - Reinie Cordier
- Discipline of Occupational Therapy; Faculty of Health Sciences; The University of Sydney; Sydney New South Wales
- School of Occupational Therapy and Social Work; Faculty of Health Sciences; Curtin University; Perth Western Australia Australia
| | - Michelle Lincoln
- Discipline of Occupational Therapy; Faculty of Health Sciences; The University of Sydney; Sydney New South Wales
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38
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Feldman HM, Reiff MI. Clinical practice. Attention deficit-hyperactivity disorder in children and adolescents. N Engl J Med 2014; 370:838-46. [PMID: 24571756 DOI: 10.1056/nejmcp1307215] [Citation(s) in RCA: 154] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Heidi M Feldman
- From the Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (H.M.F.); and the Department of Pediatrics, University of Minnesota, Minneapolis (M.I.R.)
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Dias TGC, Kieling C, Graeff-Martins AS, Moriyama TS, Rohde LA, Polanczyk GV. Developments and challenges in the diagnosis and treatment of ADHD. BRAZILIAN JOURNAL OF PSYCHIATRY 2014; 35 Suppl 1:S40-50. [PMID: 24142127 DOI: 10.1590/1516-4446-2013-s103] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder, often associated with other psychiatric comorbidities, functional impairments, and poor long-term outcomes. The objective of this selected review is to describe current advances and challenges in the diagnosis and treatment of ADHD. The disorder is associated with neurobiological underpinnings and is highly heterogeneous in various aspects, such as symptom profiles, cognitive impairments, and neurobiological and genetic features. The efficacy and safety of short-term pharmacological treatments across the life cycle is well studied, but further research investigating long-term treatment, impact of treatment in preschoolers, and non-pharmacological interventions is needed. Future research is also needed to better characterize the neurodevelopmental pathways of the disorder, linking clinical and neurobiological information, less investigated populations, and new interventions.
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Affiliation(s)
- Taciana G Costa Dias
- Universidade de São Paulo, Department of Psychiatry, School of Medicine, São PauloSP, Brazil
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40
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Sonuga-Barke EJS, Koerting J, Smith E, McCann DC, Thompson M. Early detection and intervention for attention-deficit/hyperactivity disorder. Expert Rev Neurother 2014; 11:557-63. [DOI: 10.1586/ern.11.39] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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41
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Kaiser NM, Hoza B, Hurt EA. Multimodal treatment for childhood attention-deficit/hyperactivity disorder. Expert Rev Neurother 2014; 8:1573-83. [DOI: 10.1586/14737175.8.10.1573] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pritchard AE, Koriakin T, Jacobson LA, Mahone EM. Incremental validity of neuropsychological assessment in the identification and treatment of youth with ADHD. Clin Neuropsychol 2013; 28:26-48. [PMID: 24345262 DOI: 10.1080/13854046.2013.863978] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Comprehensive neuropsychological assessments for youth with ADHD allow for thorough consideration of co-occurring disorders and provide targeted recommendations for treating ADHD and comorbid conditions. This study offers a preliminary evaluation of the added value (compared to routine care) associated with neuropsychological assessment in the identification and treatment of ADHD in youth ages 3-17 years. First we describe a novel measure developed to evaluate broad-based outcomes for youth with ADHD following neuropsychological assessment. Next we compare parent ratings of child symptoms and quality of life between two groups of youth with ADHD: those who have recently received neuropsychological assessments (NP+), and those who have not (NP-). Participants were surveyed again 5 months after baseline to assess changes in symptoms, quality of life, and service utilization. While both groups experienced significant improvements in behavioral/emotional symptoms, the NP+ group had greater initiation of parent behavior management training and special education services and greater initiation of medication management over the follow-up period, compared with the NP- group. Satisfaction with neuropsychological assessment was high overall but slightly decreased over the course of the follow-up period. The findings offer preliminary support for the incremental efficacy of neuropsychological evaluation in the diagnosis and management of ADHD.
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Affiliation(s)
- Alison E Pritchard
- a Department of Neuropsychology , Kennedy Krieger Institute , Baltimore , MD , USA
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Adult attention deficit hyperactivity disorder and violence in the population of England: does comorbidity matter? PLoS One 2013; 8:e75575. [PMID: 24086575 PMCID: PMC3782445 DOI: 10.1371/journal.pone.0075575] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 08/14/2013] [Indexed: 11/19/2022] Open
Abstract
Background It is unclear whether the association between Attention Deficit/Hyperactivity Disorder (ADHD) and violence is explained by ADHD symptoms or co-existing psychopathology. We investigated associations of ADHD and its symptom domains of hyperactivity and inattention, among individuals reporting violence in the UK population. Methods We report data from the Adult Psychiatric Morbidity Survey (2007), a representative sample of the household population of England. A randomly selected sample of 7,369 completed the Adult Self-Report Scale for ADHD and the self-reported violence module, including repetition, injury, minor violence, victims and location of incidents. All models were weighted to account for non-response and carefully adjusted for demography and clinical predictors of violence: antisocial personality, substance misuse and anxiety disorders. Results ADHD was moderately associated with violence after adjustments (OR 1.75, p = .01). Hyperactivity, but not inattention was associated with several indicators of violence in the domestic context (OR 1.16, p = .03). Mild and moderate ADHD symptoms were significantly associated with violence repetition, but not severe ADHD where the association was explained by co-existing disorders. Stratified analyses further indicated that most violence reports are associated with co-occurring psychopathology. Conclusions The direct effect of ADHD on violence is only moderate at the population level, driven by hyperactivity, and involving intimate partners and close persons. Because violence associated with severe ADHD is explained by co-existing psychopathology, interventions should primarily target co-existing disorders.
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Miranda A, Presentación MJ, Siegenthaler R, Jara P. Effects of a psychosocial intervention on the executive functioning in children with ADHD. JOURNAL OF LEARNING DISABILITIES 2013; 46:363-376. [PMID: 22064952 DOI: 10.1177/0022219411427349] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The purpose of this study was to analyze the effects of an intensive psychosocial intervention on the executive functioning (EF) in children with ADHD. The treatment was carried out in a coordinated manner over a period of 10 weeks with 27 children with ADHD aged 7 to 10, their parents, and their teachers. A battery of neuropsychological tasks was applied to evaluate attention, interference control, verbal and visuospatial working memory, planning ability, and flexibility. The comparative analysis of the treated group of ADHD children and an untreated ADHD group showed significant differences that were especially important in visuospatial memory and planning in favor of the treated children, even when the scores in the pretreatment phase were included as covariables. Likewise, improvements were observed in the parents' and teachers' behavioral ratings of hyperactivity or impulsivity and inattention. The conclusion was drawn that psychosocial interventions with children with ADHD can have a positive effect on some executive functions.
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Affiliation(s)
- Ana Miranda
- Departamento de Psicología Evolutiva y de la Educación, University of Valencia, Valencia, Spain.
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Lee PC, Niew WI, Yang HJ, Chen VCH, Lin KC. A meta-analysis of behavioral parent training for children with attention deficit hyperactivity disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:2040-2049. [PMID: 22750360 DOI: 10.1016/j.ridd.2012.05.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 05/15/2012] [Indexed: 06/01/2023]
Abstract
This meta-analysis examined the effect of behavioral parent training on child and parental outcomes for children with attention deficit hyperactivity disorder. Meta-analytic procedures were used to estimate the effect of behavioral parent training on children with attention deficit hyperactivity disorder. Variables moderating the intervention effect were examined. Forty studies were included and generated an overall moderate effect size at post-treatment and a small effect size at follow-up. The majority of outcome categories were associated with a moderate effect size at post-treatment that decreased to a small effect size at follow-up. Parenting competence was the only outcome that had a large effect, which decreased to moderate at follow-up. The strength of the effect differed between questionnaire and observation measures. Behavioral parent training is an effective intervention for children with attention deficit hyperactivity disorder. Sustainability of the effects over time is a problem that awaits further scrutiny. Recommendations for further research and clinical practices are provided.
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Affiliation(s)
- Pei-chin Lee
- School of Occupational Therapy, Chung Shan Medical University No. 110, Sec. 1, Jiang-Gou N. Road, Taichung, Taiwan.
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Abstract
This review examines the long-standing finding that ADHD is a common sequela of pediatric traumatic brain injury (PTBI) in light of the current conceptualization of ADHD as a dimensional, neuropsychologically heterogeneous disorder. The review contends that this conceptualization established the basis for concluding that frequently occurring symptoms caused by PTBI, such as slow processing speed, emotional dysregulation and disinhibition, are indicative of ADHD. Consequently, it concludes that ADHD following PTBI is even more common than the 30% rate the current literature suggests. It provides recommendations for the assessment and treatment of ADHD associated with PTBI.
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Affiliation(s)
- Robert Eme
- American School of Professional Psychology, Argosy University, Schaumburg Campus, 999 Plaza Drive, Suite 111, Schaumburg, IL 60173, USA.
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Abstract
OBJECTIVE This study examined the relationship of ADHD symptoms to different aspects of close friendship quality as rated by both adolescents (target adolescent and a close friend) within a friendship dyad. METHOD Participants were 41 same-sex friendship dyads who completed questionnaires about their friendship. Separate symptom dimensions of ADHD (inattention and hyperactivity-impulsivity) were examined. Teacher and parent ratings of social functioning were also used. RESULTS Symptoms of inattention, hyperactivity-impulsivity, and overall ADHD were positively related to target-reported friendship quality, and symptoms of inattention and total ADHD were positively associated with friend-reported friendship quality. Potential explanations for these surprising findings were explored. CONCLUSION Results suggest that the close friendships of adolescents with symptoms of ADHD may be distinct from the peer rejection commonly faced by this population and that adolescents with symptoms of ADHD may have at least one close, positive friendship. Treatment implications and future research directions are discussed.
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Affiliation(s)
- Kerrie Glass
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA.
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López Seco F, Masana Marín A, Martí Serrano S, Acosta García S, Gaviria Gómez A. Curso del trastorno por déficit de atención y/o hiperactividad en una muestra ambulatoria. An Pediatr (Barc) 2012; 76:250-5. [DOI: 10.1016/j.anpedi.2011.09.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Revised: 09/07/2011] [Accepted: 09/09/2011] [Indexed: 10/15/2022] Open
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Verma R, Balhara YPS, Mathur S. Management of attention-deficit hyperactivity disorder. J Pediatr Neurosci 2011; 6:13-8. [PMID: 21977081 PMCID: PMC3173906 DOI: 10.4103/1817-1745.84400] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD/ADD) is a neurobehavioral disorder of childhood onset characterized by severe, developmentally inappropriate motor hyperactivity, inattention, and impulsiveness that result in impairment in more than one setting. It affects the home, school, and community life of 39% of school-going children worldwide. There is increasing recognition that ADHD symptoms and clinically defined disorder can persist into adult life and are associated with later drug and alcohol misuse and social and work difficulties. Added to that is the extreme variability of the disorder over time, within the same individual, between individuals, and across different circumstances. Treatment with stimulants and nonstimulants has proven effective in different subgroups, with the effectiveness of specific agents most likely related to the primary neurotransmitter involved. However, stimulants with a short duration of action have been problematic for some patients. Parent training and cognitive behavioral therapies represent the most widely adjunct psychosocial interventions to pharmacotherapy.
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Affiliation(s)
- Rohit Verma
- Department of Psychiatry and De-addiction, PGIMER and Dr RML Hospital, New Delhi, India
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50
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Canu WH, Bearman SK. Community-Clinic-Based Parent Intervention Addressing Noncompliance in Children With Attention-Deficit/Hyperactivity Disorder. COGNITIVE AND BEHAVIORAL PRACTICE 2011. [DOI: 10.1016/j.cbpra.2010.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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