Parent training interventions for Attention Deficit Hyperactivity Disorder (ADHD) in children aged 5 to 18 years

Richmond Royal Hospital, South West London & St George's NHS Mental Health Trust, Kew Foot Road, Richmond, Surrey, UK, TW9 2TE.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 12/2011; 12(12):CD003018. DOI: 10.1002/14651858.CD003018.pub3
Source: PubMed


Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder. For a child to be diagnosed with ADHD, adults such as parents, carers, healthcare workers or teachers must have noticed higher levels of inattention, hyperactivity and impulsivity in the child before the age of seven years compared to children of similar age. The inattention, hyperactivity and impulsivity must be observed in a range of situations, for a substantial period of time and cause impairment to the child’s learning or social development. Parent training programmes aim to equip parents with techniques to manage their child's 'difficult' or ADHD-related behaviour (that is their inattention and hyperactivity-impulsivity). We found five randomised controlled studies that met our inclusion criteria. Four set out to improve children's general behaviour and one focused specifically on how parents could help their children make friends. All studies were small and their quality varied. Results from these studies were somewhat encouraging as far as parental stress and general child behaviour were concerned, but were uncertain with regard to other important outcomes including ADHD-related behaviour. No study provided data on the key outcomes of achievement in school, harmful effects or parent knowledge of ADHD. There was no evidence to say whether parent training is better delivered in groups or individually. The evidence we found was limited in terms of the size of the trials and in their quality, and therefore we do not think it can be used as the basis for guidelines of treatment of ADHD in clinics or schools. We believe more research is needed and that it should ensure better reporting of the study procedures and results.

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Available from: Morris Zwi, Mar 05, 2015
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    • "2012 is not included in the figures as these data could not be made comparable to the other reports because the specific number of studies contributing to each effect size (i.e., k 1 ) reported by Lee and colleagues could not be determined). Interventions included within meta-analyses were varied with some focusing solely on particular settings (e.g., school; DuPaul and Eckert 1997, 2012) and others focusing solely on a particular type of intervention (e.g., parent training without any associated child intervention; Zwi et al. 2011). To provide supporting information for a discussion of the aggregate results, each meta-analysis is briefly summarized in Table 1. "
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    ABSTRACT: The present report synthesizes outcomes across meta-analyses of psychosocial (i.e., non-pharmacological) treatments for ADHD. A total of 12 meta-analyses were identified that met search criteria. The meta-analyses were notable in that there was surprisingly little overlap in studies included across them (range of overlap was 2-46 %). Further, there was considerable diversity across the meta-analyses in terms of the inclusion/exclusion criteria, types of psychosocial treatments reviewed, methodological characteristics, and magnitude of reported effect sizes, making it difficult to aggregate findings across meta-analyses or to investigate moderators of outcome. Effect sizes varied across the outcomes assessed, with meta-analyses reporting positive and significant effect sizes for measures of some areas of child impairment (e.g., social impairment) and small and more variable effect sizes for distal and/or untargeted outcomes (e.g., academic achievement). Results are reviewed in light of the larger literature on psychosocial interventions for ADHD, and specific recommendations for future meta-analyses of psychosocial treatments for ADHD are offered.
    Clinical Child and Family Psychology Review 02/2015; 18(1). DOI:10.1007/s10567-015-0178-6 · 4.75 Impact Factor
    • "Bezogen auf die einzelnen erfassten Ergebnisse zeigten sich nach der Behandlung moderate Effekte auf das Verhalten des Kindes und das Erziehungsverhalten sowie ein großer Effekt auf den erlebten Erziehungsstress und die wahrgenommene Erziehungskompetenz. Zum Follow-Up sanken die Effektstärken in den kleinen bis moderaten Bereich. In einer vorhergehenden nur auf fünf Studien basierenden Meta-Analyse (Zwi et al., 2011) zeigte sich kein signifikanter Effekt auf die externalisierende, aber ein signifikanter moderater Effekt auf die internalisierende Symptomatik. Charach et al. (2013) wiesen in ihrer Meta- Analyse (n = 5) moderate Effekte für Elterntrainings auf die ADHS-Kernsymptome bei Kindern unter sechs Jahren nach. "

    Kindheit und Entwicklung 01/2015; 24(1):6-19. DOI:10.1026/0942-5403/a000154 · 3.50 Impact Factor
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    • "The severity of these symptoms and its enduring nature are known to impair a person’s capacity to effectively function. Treatment programs using behavioral and pharmacotherapeutic approaches are well established [3,4]. The Multimodal Treatment study (MTA) of ADHD identified advantages of multimodal treatment [1,5,6]. "
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    ABSTRACT: A randomized and controlled clinical study was performed to evaluate the use of neurofeedback (NF) to treat attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. The ADHD population was selected from an outpatient clinic for Child and Adolescent Mental Health in Norway. Ninety-one of the 275 children and adolescents ranging in age from 6 to 18 years (10.5 years) participated in 30 sessions of an intensive NF program. The reinforcement contingency was based on the subjects' production of cortical beta1 activity (15-18 Hz). The ADHD participants were randomized into three groups, with 30 in the NF group, 31 controls in a group that was given methylphenidate, and 30 in a group that received NF and methylphenidate. ADHD core symptoms were reported by parents using the parent form of the Clinician's Manual for Assessment by Russell A. Barkley. Ninety-one children and adolescents were effectively randomized by age, sex, intelligence and distribution of ADHD core symptoms. The parents reported significant effects of the treatments, but no significant differences between the treatment groups were observed. NF was as effective as methylphenidate at treating the attentional and hyperactivity symptoms of ADHD, based on parental reports. Current Controlled Trials NCT01252446.
    BMC Psychiatry 08/2012; 12(1):107. DOI:10.1186/1471-244X-12-107 · 2.21 Impact Factor
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