The efficacy of group parent training was assessed in improving compliance and time on task in preschoolers with attention-deficit disorder with hyperactivity. Positive effects were obtained on measures of child compliance, but not on measures of attention. Parental compliance-management skills and overall style of interaction were also positively affected. The use of parent training for early intervention with ADDH children is discussed.
"Parent training has been shown to be the most effective approach to the prevention and treatment of disruptive behaviour [29-32] and it represents one of the most well-validated therapeutic techniques . The effectiveness of parent training has been established in small groups [34,35], large groups [36,37], and home-based coach-supported distance formats . "
[Show abstract][Hide abstract] ABSTRACT: Oppositional Defiant Disorder (ODD) is characterized by angry and noncompliant behaviour. It is the most common disruptive behaviour disorder (DBD), with prevalence estimates of 6-9% for preschoolers and is closely linked to several long-term difficulties, including disorders of conduct, mood, anxiety, impulse-control, and substance abuse. ODD in children is related to parental depression, family dysfunction, and impairments in parental work performance. Children displaying early DBDs exhibit more symptoms of greater severity, more frequent offences, and commit more serious crimes later in life. The goal of the Strongest FamiliesTM Finland Canada (SFFC) Smart Website intervention research program is to develop and evaluate an affordable, accessible, effective secondary prevention parent training program for disruptive behaviour in preschoolers to prevent the negative sequelae of ODD. Strongest Families is an 11-session program with two booster sessions that focuses on teaching skills to: strengthen parent--child relationships; reinforce positive behaviour; reduce conflict; manage daily transitions; plan for potentially problematic situations; promote emotional regulation and pro-social behaviour and decrease antisocial behaviour.Methods/design: This protocol paper describes an ongoing population-based randomized controlled trial (RCT) of high-risk 4 year-olds attending well-child clinics in Turku, Finland and environs to examine the effectiveness of the Strongest Families Smart Website intervention compared to an Education Control condition. Randomization consists of a 1:1 ratio for intervention versus the education group, stratified by the child's sex. The participants randomized to the intervention group receive access to the Strongest Families Smart Website and weekly telephone coaching sessions. The participants randomized to the Education Control condition receive access to a static website with parenting tips. Children are followed using parental and daycare teacher measures at 6 and 12 months after randomization.
The Strongest Families Smart Website intervention is hypothesized to improve parenting skills, reduce child disruptive behaviour, reduce parental distress and improve family functioning. These results will likely inform subsequent investigations, public policy, and early treatment of childhood disruptive behaviour problems.Trial registration: ClinicalTrials.gov # NCT01750996.
BMC Public Health 10/2013; 13(1):985. DOI:10.1186/1471-2458-13-985 · 2.26 Impact Factor
"Other studies about non-pharmacological interventions support the notion that early life socio-environmental actions to minimize the ADHD symptoms would prevent long-term difficulties for the 'normal' development of the child     . For example, parent interventions demonstrated to be useful in minimizing the ADHD symptoms    in addition to school-oriented programs  and other psychological interventions . ADHD is associated with impairments in the fronto-striatalbasal ganglia neurocircuitry . "
[Show abstract][Hide abstract] ABSTRACT: We studied the associations between Attention Deficit Hyperactivity Disorder (ADHD) symptoms and the neurobehavioral status in two population-based birth cohorts.
Children (n=467) were assessed by psychologists and teachers for neuropsychological functioning (McCarthy Scales, MCSA), inattention-hyperactivity symptoms (ADHD-DSM-IV form list) and social behavior (California Preschool Social Competence Scale, CPSCS). Regression models were used with covariate adjustment.
Sixteen percent of children had ADHD-DSM-IV symptoms. MCSA scores were linearly associated with ADHD symptom scores (general cognitive Beta=-0.6 [-1.0; -0.3] per symptom), specifically inattention scores (general cognitive Beta=-1.8 [-2.3; -1.2]). CPSCS scores were associated with ADHD symptoms (Beta=-2.19 [-2.5; -1.9]). MCSA scores of executive function, perceptive-performance and quantitative sub-areas had stronger associations with ADHD symptoms.
Preschooler ADHD symptoms are associated with concurrent decrements in neurocognitive and social competence functioning. The association patterns are similar to those found in older children with ADHD symptomology (Marks et al., 2005 , Seidman, 2006 , Sonuga-Barke et al., 2003 , Yochman et al., 2006 ).
European Psychiatry 09/2011; 26(6):381-9. DOI:10.1016/j.eurpsy.2010.03.013 · 3.44 Impact Factor
"For example, studies of behavioral parent training (BPT) for ADHD have demonstrated improvements in ADHD symptoms (Anastopoulos, Shelton, DuPaul, & Guevremont, 1993; Sonuga-Barke, Daley, Thompson, Laver-Bradbury, & Weeks, 2001; Cunningham, Bremner, & Boyle, 1995), as well as cooccurring oppositional problems and impairment in children (Erhardt & Baker, 1990; Pisterman et al., 1989; Pisterman et al., 1992). BPT also improves parental functioning (e.g., decreased stress, enhanced competence) (Anastopoulos et al., 1993; Pisterman et al., 1992; Sonuga-Barke et al., 2001). Moreover, behavior contingency management in the classroom yields improvements in teacher reports of children's functioning, observed behavior of children with ADHD in the classroom setting, as well as better academic productivity (Abramowitz, O'Leary, & Rosen, 1987; Fabiano et al., 2007; Pelham, Jr. et al., 1998; Hoffman & DuPaul, 2000). "
[Show abstract][Hide abstract] ABSTRACT: Attention-deficit/Hyperactivity Disorder (ADHD) is characterized by a pervasive pattern of developmentally inappropriate inattentive, impulsive and hyperactive behaviors that typically begin during the preschool years and often persist into adulthood. The most effective and widely used treatments for ADHD are medication and behavior modification. These empirically-supported interventions are generally successful in reducing ADHD symptoms, but treatment effects are rarely maintained beyond the active intervention. Because ADHD is now generally thought of as a chronic disorder that is often present well into adolescence and early adulthood, the need for continued treatment throughout the lifetime is both costly and problematic for a number of logistical reasons. Therefore, it would be highly beneficial if treatments would have lasting effects that remain after the intervention is terminated. This review examines the burgeoning literature on the underlying neural determinants of ADHD along with research demonstrating powerful influences of environmental factors on brain development and functioning. Based upon these largely distinct scientific literatures, we propose an approach that employs directed play and physical exercise to promote brain growth which, in turn, could lead to the development of potentially more enduring treatments for the disorder.
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