An efficacy study of a combined parent and teacher management training programme for children with ADHD Efficacy of the Incredible Years Basic parent training programme as an early intervention for children with conduct problems and ADHD. Clinical symptoms and performance on the continuous performance test in children with attention deficit hyperactivity disorder between subtypes: a natural follow-up study for 6 months Randomised social-skills training and parental training plus standard treatment versus standard treatment of children with attention deficit hyperactivity disorder - The SOSTRA trial protocol Enhancing Behavioral and Social Skill Functioning in Children Newly Diagnosed with Attention-Deficit Hyperactivity Disorder in a Pediatric Setting A randomized, controlled trial of integrated home-school behavioral treatment for ADHD, predominantly inattentive type. Combining Parent and Child Training for Young Children with ADHD Treating Parents with Attention-Deficit/Hyperactivity Disorder: The Effects of Behavioral Parent Training and Acute Stimulant Medication Treatment on Parent–Child Interactions Neurocognitive training for children with and without AD/HD Neurocognitive performance and behavioral symptoms in patients with attention-deficit/hyperactivity disorder during twenty-four months of treatment with methylphenidate. Parenting as a Mechanism of Change in Psychosocial Treatment for Youth with ADHD, Predominantly Inattentive Presentation Social Skills Training in Children With Attention Deficit Hyperactivity Disorder: A Randomized-Controlled Clinical Trial Preliminary data suggesting the efficacy of attention training for school-aged children with ADHD Parental Knowledge of Attention-Deficit Hyperactivity Disorder and Opinions of Treatment Options: Impact on Enrolment and Adherence to a 12-Month Treatment Trial Combined ω3 and ω6 Supplementation in Children With Attention-Deficit Hyperactivity Disorder (ADHD) Refractory to Methylphenidate Treatment Computerized training of working memory in children with ADHD--a randomized, controlled trial. Social-Skills and Parental Training plus Standard Treatment versus Standard Treatment for Children with ADHD – The Randomised SOSTRA Trial
Background : Several parent training programmes and behavioural teacher training programmes built on learning theory have been developed for problem prevention and treatment of attention-deficit/hyperactivity disorder ( ADHD ) and /or oppositional defiant disorder ( ODD ) during the last few decades . Group format has often been used for parent training but single-subject design s are more common in teacher training . More studies have focussed on pre-school children than on older children , and a minority have been conducted in public mental health setting s. Aim : This study aim ed to evaluate a combined parent and teacher manual-based group training programme for children with ADHD conducted by the staff at a child and adolescent psychiatric clinic in Sweden . Method : The intervention was a modified version of Barkley 's programme .  Children were r and omized to an Intervention or a Control group .  Sixty-one parents and 68 teachers answered questions about ADHD and ODD symptoms , and about behavioural problems when the study started and at a 3-month follow-up . Results : Results showed that the intervention result ed in a reduction of the number of children who met DSM-IV criteria for ADHD and /or ODD . Effects were more pronounced in the home setting than in the school setting , and were further accentuated when both parents and teachers of the same child took part in the intervention . Teachers with more problematic classroom situations benefited most from the intervention . Conclusion : The programme , “ Strategies in Everyday Life ” , has , in a regular clinical setting , demonstrated promising effects on children 's disruptive behaviour , and a clinical implication was to recommend involving both parents and teachers in the programme BACKGROUND The efficacy of the Incredible Years ( IY ) Basic parent training ( PT ) programme for a community-based sample of families with pre-school children at risk of developing both conduct problems and attention deficit hyperactivity disorder ( ADHD ) was examined . METHODS Pre-school children displaying signs of both early-onset conduct problems and ADHD were r and omly allocated to either IY PT intervention , or to a waiting list ( WL ) control group . Child symptoms were assessed before and after the intervention . RESULTS Post intervention , the intervention group was associated with significantly lower levels of parent-reported inattention and hyperactive/impulsive difficulties , even after controlling for post-intervention changes in child deviance . In addition , 52 % of those in the intervention condition , compared with 21 % in the control condition , displayed clinical ly reliable improvements post intervention , giving an absolute risk reduction of 31 % and a number needed to treat of 3.23 . CONCLUSIONS Findings from this study indicate that the IY PT programme is a valuable intervention for many pre-school children displaying early signs of ADHD Background The aims of this study were to determine the time course of improvements in attention deficit hyperactivity disorder ( ADHD ) clinical symptoms and neurocognitive function in a realistic clinical setting , and the differences in ADHD symptom improvement using different classifications of ADHD subtypes . Methods The Child Behavior Checklist ( CBCL ) was completed by parents of ADHD children at the initial visit . The  computerized Continuous Performance Test ( CPT ) , Swanson , Nolan , and Pelham , and Version IV Scale for ADHD ( SNAP-IV ) , and  ADHD Rating Scale ( ADHD-RS ) were performed at baseline , one month , three months , and six months later , respectively . Patient care including drug therapy was performed at the discretion of the psychiatrist . The ADHD patients were divided into DSM-IV subtypes ( Inattentive , Hyperactive-impulsive and Combined type ) , and were additionally categorized into aggressive and non-aggressive subtypes by aggression scale in CBCL for comparisons . Results There were 50 ADHD patients with a mean age of 7.84 ± 1.64 years ; 15 of them were inattentive type , 11 were hyperactive-impulsive type , and 24 were combined type . In addition , 28 of the ADHD patients were grouped into aggressive and 22 into non-aggressive subtypes . There were significant improvements in clinical symptoms of hyperactivity and inattention , and impulsivity performance in CPT during the 6-month treatment . The clinical hyperactive symptoms were significantly different between ADHD patients sub-grouping both by DSM-IV and aggression . Non-aggressive patients had significantly greater changes in distraction and impulsivity performances in CPT from baseline to month 6 than aggressive patients . Conclusions We found that ADHD symptoms , which included impulsive performances in CPT and clinical inattention and hyperactivity dimensions , had improved significantly over 6 months under pragmatic treatments . The non-aggressive ADHD patients might have a higher potential for improving in CPT performance than aggressive ones . However , it warrant further investigation whether the different classifications of ADHD patients could be valid for predicting the improvements in ADHD patients ' clinical symptoms and neurocognitive performance Background Children with attention deficit hyperactivity disorder ( ADHD ) are hyperactive and impulsive , can not maintain attention , and have difficulties with social interactions . Medical treatment may alleviate symptoms of ADHD , but seldom solves difficulties with social interactions . Social-skills training may benefit ADHD children in their social interactions . We want to examine the effects of social-skills training on difficulties related to the children 's ADHD symptoms and social interactions . Methods / Design The design is r and omised two-armed , parallel group , assessor-blinded trial . Children aged 8 - 12 years with a diagnosis of ADHD are r and omised to social-skills training and parental training plus st and ard treatment versus st and ard treatment alone . A sample size calculation estimated that at least 52 children must be included to show a 4-point difference in the primary outcome on the Conners 3rd Edition subscale for ' hyperactivity-impulsivity ' between the intervention group and the control group . The outcomes will be assessed 3 and 6 months after r and omisation . The primary outcome measure is ADHD symptoms . The secondary outcome is social skills . Tertiary outcomes include the relationship between social skills and symptoms of ADHD , the ability to form attachment , and parents ' ADHD symptoms . Discussion We hope that the results from this trial will show that the social-skills training together with medication may have a greater general effect on ADHD symptoms and social and emotional competencies than medication alone . Trial registration Clinical Trials ( NCT ) : ABSTRACT . The objective of this study was to evaluate the effectiveness of an 8-week behavioral and social skill ( BSS ) class for children newly diagnosed with attention-deficit hyperactivity disorder ( ADHD ) and their parents , initiating stimulant treatment in primary care . The subjects were 100 children , aged 5 to 12 years , recently diagnosed with ADHD and treated with stimulant medication , and their parents or guardians . Eligible families were r and omly assigned to an intervention group ( IG : n = 59 ) or control group ( CG : n = 41 ) . The BSS function of each child was assessed using DuPaul ’s ADHD Parent Rating Scale ( 18-item ) and Child Attention Profile ( 12-item ) during blinded baseline and follow-up interviews . Parent discipline practice was assessed using a five-item inventory based on Likert-scale ratings during identical periods . Computerized pharmacy records were used to track psychostimulant use over time . IG children exhibited significantly lower parent-rated ADHD symptoms , whereas IG parents reported significantly better and more consistent discipline practice s compared with CG parents across time . No significant differences were found between groups in Child Attention Profile scores across time . Psychostimulant use did not significantly differ between groups across time .  BSS training  was well accepted and seemed to significantly improve BSS functioning among IG children in the home setting only OBJECTIVE To evaluate the efficacy of a behavioral psychosocial treatment integrated across home and school ( Child Life and Attention Skills Program ) with attention-deficit/hyperactivity disorder ( ADHD ) predominantly inattentive type ( ADHD-I ) . METHOD Sixty-nine children ages 7 to 11 years were r and omized to the Child Life and Attention Skills Program or a control group who did not receive the intervention .  We compared groups posttreatment and at 3- to 5-month follow-up on parent and teacher ratings of inattention , sluggish cognitive tempo , and functional impairment . RESULTS Children r and omized to the Child Life and Attention Skills Program were reported to have significantly fewer inattention and sluggish cognitive tempo symptoms , and significantly improved social and organizational skills , relative to the control group . Gains were maintained at follow-up . CONCLUSIONS Behavioral psychosocial treatment , when specifically adapted for ADHD-I and coordinated among parents , teachers , and children , appears efficacious in reducing symptoms and impairment associated with The efficacy of the Incredible Years parent and child training programs is established in children diagnosed with oppositional defiant disorder but not among young children whose primary diagnosis is attention-deficit/hyperactivity disorder ( ADHD ) . We conducted a r and omized control trial evaluating the combined parent and child program interventions among 99 children diagnosed with ADHD ( ages 4–6 ) . Mother reported significant treatment effects for appropriate and harsh discipline , use of physical punishment , and monitoring , whereas fathers reported no significant parenting changes . Independent observations revealed treatment effects for mothers ' praise and coaching , mothers ' critical statements , and child total deviant behaviors . Both mothers and fathers reported treatment effects for children 's externalizing , hyperactivity , inattentive and oppositional behaviors , and emotion regulation and social competence . There were also significant treatment effects for children 's emotion vocabulary and problem-solving ability . At school teachers reported treatment effects for externalizing behaviors and peer observations indicated improvements in treated children 's social competence This multiple baseline study evaluated the efficacy of behavioral parent training ( BPT ) for 12 parents ( M age = 39.17 years ; 91 % mothers ) and their children ( ages 6–12 ; 83 % boys ) both with Attention-Deficit/Hyperactivity Disorder ( ADHD ) , and also explored the acute effect of stimulant medication for parents before and after BPT .  Parents rated their own and their children ’s symptoms and impairment and were stabilized on optimally dosed medication . Then , parents discontinued medication and were r and omly assigned to a 3 , 4 , or 5 week baseline ( BL ) , during which they provided twice-weekly ratings of their impairment , parenting , and their child ’s behavior . Following BL , parents and their children completed two laboratory tasks , once on their optimally dosed medication and once on a placebo to assess observable effects of medication on parent – child behavior , and they completed additional assessment s of family functioning . Parents then completed eight BPT sessions , during which they were unmedicated . Twice-weekly ratings of parent and child behavior were collected during BPT and additional ratings were collected upon completing BPT . Two more parent – child tasks with and without parent medication were conducted upon BPT completion to assess the observable effects of BPT and BPT plus medication . Ten ( 83.33 % ) parents completed the trial .  Improvements in parent and child behavior were observed , and parents reported improved child behavior with BPT . Few benefits of BPT emerged through parent reports of parent functioning , with the exception of inconsistent discipline , and no medication or interaction effects emerged . These results , although preliminary , suggest that some parents with ADHD benefit from BPT . While pharmacological treatment is the most common intervention for adults with ADHD , further examination of psychosocial treatments for adults is needed There is accumulating evidence that computerised cognitive training of inhibitory control and /or working memory can lead to behavioural improvement in children with AD/HD . Using a r and omised waitlist control design , the present study examined the effects of combined working memory and inhibitory control training , with and without passive attention monitoring via EEG , for children with and without AD/HD . One hundred and twenty-eight children ( 60 children with AD/HD , 68 without AD/HD ) were r and omly allocated to one of three training conditions ( waitlist ; working memory and inhibitory control with attention monitoring ; working memory and inhibitory control without attention monitoring ) and completed with pre- and post-training assessment s of overt behaviour ( from 2 sources ) , trained and untrained cognitive task performance , and resting EEG activity . The two active training conditions completed 25 sessions of training at home over a 4- 5-week period . Results showed significant improvements in overt behaviour for children with AD/HD in both training conditions compared to the waitlist condition as rated by a parent and other adult . Post-training improvements in the areas of spatial working memory , ignoring distracting stimuli , and sustained attention were reported for children with AD/HD . Children without AD/HD showed behavioural improvements after training . The improvements for both groups were maintained over the 6-week period following training . The passive attention monitoring via EEG had a minor effect on training outcomes . Overall , the results suggest that combined WM/IC training can result in improved behavioural control for children with and without AD/HD OBJECTIVE This study investigated the trends in neurocognitive function and behavioral symptoms among patients with attention-deficit/hyperactivity disorder ( ADHD ) during 24 months of treatment with methylpheni date in a clinical setting . METHODS Study participants consisted of 181 ADHD patients with a mean age of 13.4±2.5 years ( ages ranged from 8 to 18 years ; 151 boys and 30 girls ) who were prescribed oral short-acting methylpheni date two or three times daily , with each dose ranging between 0.3 and 1.0 mg/kg . At baseline and 6 , 12 , 18 , and 24 months from baseline , neurocognitive function was assessed using the  Test of Variables of Attention ( TOVA ) on the day the patient was off medication , and behavioral symptoms were evaluated using the Swanson , Nolan , and Pelham Version IV Scale for ADHD ( SNAP-IV ) parent form , the SNAP-IV teacher form , and the ADHD-Rating Scale ( completed by a child psychiatrist ) . RESULTS Of the 181 ADHD patients at the initial visit , 103 ( 56.9 % ) completed the study . During the 24-month methylpheni date treatment , only the commission errors in TOVA significantly improved ; however , the omission errors , response time , response time variability , response sensitivity , and ADHD score did not . The behavioral symptoms of ADHD , observed by various informants , all declined substantially , and were significantly correlated with each other during the long-term follow-up . The severity of teacher ratings was lower than that of parent and psychiatrist ratings . However , the teacher-rated inattention symptoms showed the strongest correlations with TOVA performance . CONCLUSIONS Findings suggest that neurocognitive deficits in ADHD patients , except inhibition ability , might be long lasting in realistic setting s. In addition , obtaining behavior profile assessment s from multiple informants , especially from teachers , is vital for establishing a complete underst and ing of ADHD patients We investigated whether parenting and child behavior improve following psychosocial treatment for Attention-Deficit/Hyperactivity Disorder , Predominantly Inattentive Presentation ( ADHD-I ) and whether parenting improvements mediate child outcomes . We analyzed data from a r and omized clinical trial investigating the efficacy of a multicomponent psychosocial intervention ( Child Life and Attention Skills , CLAS , n = 74 ) in comparison to Parent-Focused Treatment ( PFT , n = 74 ) and treatment as usual ( TAU , n = 51 ) for youth with ADHD-I ( average child age = 8.6 years , range 7–11 years , 58 % boys ) . Child and parent/family functioning were assessed prior to treatment , immediately following treatment , and at follow-up into the subsequent school year using parent and teacher reports of inattention , organization , social skills , academic competency ( teachers only ) , parenting daily hassles , and positive and negative parenting behaviors ( parents only ) . Both treatment groups improved on negative parenting and home impairment , but only CLAS families also improved on positive parenting as well as academic impairment . Improvements in positive and negative parenting mediated treatment effects on child impairment independent of improvements in child inattention , implicating parenting as an important mechanism of change in psychosocial treatment for ADHD-I. Further , whereas parent-focused training produces improvements in negative parenting and impairment at home for children with ADHD-I , a multicomponent approach ( incorporating child skills training and teacher consultation ) more consistently produces improvements at school and in positive parenting , which may contribute to improvements in social skills into the next school year Evaluated efficacy of social skills training ( SST ) on children with 2 subtypes of attention deficit hyperactivity disorder ( ADHD ) . Participants were 120 children ( 30 girls , 90 boys ) , ages 8 to 12 with ADHD-Inattentive type ( ADHD-I ; n = 59 ) or Combined type ( ADHD-C ; n = 61 ) . The children were r and omly assigned within diagnosis subtype to the treatment condition ( 8 weeks of SST ) or the no-intervention control condition . SST led to greater improvements in both parent- and child-perceived assertion skills in the children with ADHD , yet did not affect the other domains of social competence . Diagnostically heterogeneous groups led to greater improvements on parent-report of their child 's cooperation and assertion abilities as well as children 's report of their own empathy skills . Diagnostically homogeneous groups led to greater decreases in externalizing behaviors at posttreatment but not at follow-up . Children with comorbid oppositional defiant disorder ( ODD ) did not benefit as much from the intervention . Children with ADHD-I improved in assertion skills more than children with ADHD-C , yet the 2 diagnostic entities did not differ in improvement levels across all other social skills A pilot r and omized clinical trial was conducted to examine the initial efficacy of Pay Attention ! , an intervention training sustained , selective , alternating , and divided attention , in children diagnosed with Attention-Deficit/Hyperactivity Disorder ( ADHD ) . After a diagnostic and baseline evaluation , school-aged children with ADHD were r and omized to receive 16 bi-weekly sessions of Pay Attention ! ( n=54 ) or to a waitlist control group ( n=51 ) . Participants completed an outcome evaluation approximately 12 weeks after their baseline evaluation . Results showed significant treatment effects for parent and clinician ratings of ADHD symptoms , child self-report of ability to focus , and parent ratings of executive functioning . Child performance on neuropsychological tests showed significant treatment-related improvement on strategic planning efficiency , but no treatment effects were observed on other neuropsychological outcomes . Treatment effects were also not observed for teacher ratings of ADHD . These data add to a growing body of literature supporting effects of cognitive training on attention and behavior , however , additional research is warranted Objective : This study examines the relationship between parents ' knowledge of attention-deficit hyperactivity disorder ( ADHD ) and opinions of treatment and their impact on enrolment in and adherence to both pharmacological and nonpharmacological interventions for children with ADHD . Method : Participants in the study were the parents of 81 children who reached diagnostic criteria for ADHD and who were referred to a treatment study of ADHD involving stimulant medication and parent groups . The mothers completed a modified version of the ADHD Knowledge and Opinion Scale  ( AKOS ) prior to receiving diagnostic feedback and prior to the families ' decisions to participate in a 12-month r and omized trial ( medication [ methylpheni date or placebo ] and parent groups [ training or support ] ) . Treatment enrolment and adherence were monitored over the 12-month trial , and families who remained in the study at 12 months completed another modified AKOS . Results : A higher level of knowledge of ADHD was found to be related to more favourable opinions of parent groups but not of medication . Moreover , parents who were more knowledgeable about ADHD were more likely to enrol in both pharmacological and nonpharmacological treatments . Adherence to pharmacological and nonpharmacological treatments was not predicted by parental knowledge of ADHD or opinions of the treatment . Conclusion :  Parents ' knowledge of ADHD and opinions of treatments play a significant role in enrolment in treatments for their children with ADHD . Providing information to parents regarding ADHD prior to offering treatment modalities could have a favourable impact on treatment enrolment and hence treatment adherence Children ( 6 - 12 years ) with attention-deficit hyperactivity disorder ( ADHD ) being treated with methylpheni date and st and ard behavior therapy for more than 6 months , whose parents reported no improvement in behavior and academic learning , were r and omly assigned to receive supplementation with a combined ω3 and ω6 preparation or a placebo . Outcome was measured at 3 and 6 months after treatment using a self- assessment checklist completed by the parents . Statistically significant improvement was found in the treatment group compared with the placebo group ( P < .01 ) in the following measures : restlessness , aggressiveness , completing work , and academic performance . Statistically significant improvement was not found at 3 months of treatment between groups but was evident at 6 months of treatment ( P < .05 ) with inattention , impulsiveness , and cooperation with parents and teachers . Distractibility failed to show improvement . Effect sizes ranged from 0.3 to 1.1 at 3 months and 0.2 to 1.4 at 6 months for individual symptom variables OBJECTIVE Deficits in executive functioning , including working memory ( WM ) deficits , have been suggested to be important in attention-deficit/hyperactivity disorder ( ADHD ) . During 2002 to 2003 , the authors conducted a multicenter , r and omized , controlled , double-blind trial to investigate the effect of improving WM by computerized , systematic practice of WM tasks . METHOD Included in the trial were 53 children with ADHD ( 9 girls ; 15 of 53 inattentive subtype ) , aged 7 to 12 years , without stimulant medication . The compliance criterion ( > 20 days of training ) was met by 44 subjects , 42 of whom were also evaluated at follow-up 3 months later . Participants were r and omly assigned to use either the treatment computer program for training WM or a comparison program . The main outcome measure was the span-board task , a visuospatial WM task that was not part of the training program . RESULTS For the span-board task , there was a significant treatment effect both post-intervention and at follow-up . In addition , there were significant effects for secondary outcome tasks measuring verbal WM , response inhibition , and complex reasoning . Parent ratings showed significant reduction in symptoms of inattention and hyperactivity/impulsivity , both post-intervention and at follow-up . CONCLUSIONS This study shows that WM can be improved by training in children with ADHD . This training also improved response inhibition and reasoning and result ed in a reduction of the parent-rated inattentive symptoms of ADHD Objective To investigate the effects of social-skills training and parental training programme for children with attention deficit hyperactivity disorder ( ADHD ) .  Methods We conducted a r and omized two-armed , parallel group , assessor-blinded superiority trial consisting of social-skills training plus parental training and st and ard treatment versus st and ard treatment alone . A sample size calculation showed at least 52 children should be included for the trial with follow up three and six months after r and omization . The primary outcome measure was ADHD symptoms and secondary outcomes were social skills and emotional competences . Results 56 children ( 39 boys , 17 girls , mean age 10.4 years , SD 1.31 ) with ADHD were r and omized , 28 to the experimental group and 27 to the control group . Mixed-model analyses with repeated measures showed that the time course ( y = a + bt + ct2 ) of ADHD symptoms ( p = 0.40 ) , social skills ( p = 0.80 ) , and emotional competences ( p = 0.14 ) were not significantly influenced by the intervention . Conclusions Social skills training plus parental training did not show any significant benefit for children with attention deficit hyperactivity disorder when compared with st and ard treatment . More and larger r and omized trials are needed . Trial Registration Clinical Trials.gov
In this latter study , outcomes were better for girls and for children on medication .
Positive results on an inventory of child behaviour problems were reported for one small study ( n = 24 ) with the caveat that results were only positive when parent training was delivered to individuals and not groups .
Results for this outcome from a small study ( n = 24 ) suggested a long-term benefit for mothers who received the intervention at an individual level ; in contrast , fathers benefited from short-term group treatment .
Parent training may have a positive effect on the behaviour of children with ADHD .
It may also reduce parental stress and enhance parental confidence .
BACKGROUND Attention Deficit Hyperactivity Disorder ( ADHD ) is a neurodevelopmental disorder characterised by high levels of inattention , hyperactivity and impulsivity that are present before the age of seven years , seen in a range of situations , inconsistent with the child 's developmental level and causing social or academic impairment .
Parent training programmes are psychosocial interventions aim ed at training parents in techniques to enable them to manage their children 's challenging behaviour .
OBJECTIVES To determine whether parent training interventions are effective in reducing ADHD symptoms and associated problems in children aged between five and eigtheen years with a diagnosis of ADHD , compared to controls with no parent training intervention .