A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review, 29(2), 129-140

University at Buffalo, State University of New York, Department of Counseling, School, and Educational Psychology, Buffalo, NY 14214, USA.
Clinical psychology review (Impact Factor: 7.18). 12/2008; 29(2):129-40. DOI: 10.1016/j.cpr.2008.11.001
Source: PubMed


There is currently controversy regarding the need for and the effectiveness of behavior modification for children with attention-deficit hyperactivity disorder (ADHD) despite years of study and multiple investigations reporting beneficial effects of the intervention. A meta-analysis was conducted by identifying relevant behavioral treatment studies in the literature. One-hundred seventy-four studies of behavioral treatment were identified from 114 individual papers that were appropriate for the meta-analysis. Effect sizes varied by study design but not generally by other study characteristics, such as the demographic variables of the participants in the studies. Overall unweighted effect sizes in between group studies (.83), pre-post studies (.70), within group studies (2.64), and single subject studies (3.78) indicated that behavioral treatments are highly effective. Based on these results, there is strong and consistent evidence that behavioral treatments are effective for treating ADHD.

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    • "Research on non-pharmacological interventions in ADHD treatment has shown that psychological treatments that incorporate behavioral techniques prove effective. Hodgson, Hutchinson, and Denson (2014) replicated the work by Fabiano et al. (2009), corroborating the efficacy of seven non-pharmacological interventions that included behavioral modification, neurofeedback, school programs and parent training. Specifically, there is clear evidence of the effects of parent training, whose interventions should be tried before medication among preschoolers with ADHD and results remain even after intervention ended (Charach et al., 2013). "
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    ABSTRACT: The purpose of this study was to investigate the efficacy of neurofeedback, pharmacological treatment and behavioral therapy in Attention Deficit Hyperactivity Disorder (ADHD) through a controlled, randomized, multigroup design, with pre-, post- and follow-up treatment phases. The objectives of this study are: a) to analyze individual trajectories over time of each child in treatment, from specific measures of EEG (theta/beta ratio/TBR) considering age and sex and b) to determine the therapeutic effect on attentional and behavioral variables evaluated through the Integrated Visual and Auditory Continuous Performance Test. A total of 57 children (7-14 years) diagnosed with ADHD, were randomly assigned to one of the following experimental conditions: 1) 30 Theta/Beta training sessions, 2) Methylphenidate treatment and, 3) Behavior therapy administered according to a cognitive-behavioral protocol based on manuals. Data were analyzed using a Multilevel Longitudinal Regression Model. Results show that administered treatments are effective and cause similar effects on TBR variable, with no differences between them. However, significant differences were observed in the global attention (p=.002), auditory attention (p=.017) and visual attention (p=.028).
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    • "Beauchaine, Webster-Stratton, and Reid (2005) combined data from six randomized controlled trials (RCTs) of the Incredible Years parent training program and found that attention problems combined with CD neither moderated nor predicted outcomes of parent training when delivered in a group-based format . Moreover, in Fabiano et al.'s (2009) meta-analysis of behavioral treatment for ADHD, child comorbidity was not associated with study effect size. Some variables have been found to predict treatment outcomes in separate studies of ADHD and CP, and also in a few combined studies. "
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    ABSTRACT: To scale up evidence-based treatment of conduct problems, parent management training, Oregonmodel (PMTO) has been disseminated throughout Norway. This study examined whether Attention Deficit Hyperactivity Disorder (ADHD) predicted the outcomes of PMTO. Of 253 children and families, 97 were reported to have an ADHD diagnosis. Although different at intake, the groupswith and without ADHD had close to an equal change in behavioral status following treatment. Maternal depression and family income predicted the combined group’s behavior following PMTO. The study indicates that reductions in conduct problems following PMTO are of the same magnitude in children with or without ADHD. However, some characteristics may differentially predict outcomes for children with combined problems.
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    • "Further, relatively small effect sizes were obtained for academic and social outcomes in the Multimodal Treatment of ADHD (MTA) study that employed state-of-the-art psychopharmacological and/or behavioral treatments for 14 months (MTA Cooperative Group, 1999) with similar findings extended to 8 years post-treatment (Molina et al., 2009). In similar fashion, academic performance and/or achievement effect sizes associated with behavioral, psychopharmacological, and psychosocial interventions for children with ADHD have been uniformly in the small range (between 0.11 and 0.33) in several metaanalyses (DuPaul & Eckert, 1997; Fabiano et al., 2009; Van der Oord, Prins, Oosterlan, & Emmelkamp, 2008). Very few studies have explicitly examined the correspondence between treatment effects on ADHD symptoms and concomitant changes in academic functioning. "

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