Article

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

ABSTRACT

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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    • "A recent spate of suicides amongst FIFO workers in Western Australia (nine in 2013–2014) has resulted in a parliamentary enquiry into the stresses faced by workers, and has highlighted the impact of the FIFO lifestyle on workers and their families (Herbert 2014). Historically, group based parenting programs have been found to be successful in improving short-term parenting skills (Furlong et al. 2012) and psychosocial wellbeing of parents (Barlow et al. 2012; Furlong et al. 2012; Zwi et al. 2011) which is critical for the psychological development of the child (Barlow et al. 2012). More recently, parenting interventions have moved into online delivery. "
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    ABSTRACT: The objective of this study was to explore the parenting patterns of families exposed to the fly-in-fly-out (FIFO) work pattern in raising adolescent children, and develop and test the usefulness of a parenting resource specific to this family structure. A mixed methods research design was employed using semi-structured telephone interviews and questionnaires to collect information on parental monitoring, behaviour management, relationship quality, communication strategies, and parent and adolescent mental health. Twenty-one Western Australian at-home parents with FIFO partners, 23 FIFO workers, and 41 adolescent children of FIFO parents participated in the study. Responding parents and their children were generally coping well with the challenges of the FIFO work pattern. Parenting strategies such as open and meaningful communication; family time spent together; routines; social support networks and setting boundaries were discussed as strategies that were adopted by the participants interviewed to parent their adolescent children. FIFO families face increased challenges in providing consistent parenting strategies given the cyclical presence and absence of one parent. They are typically unable to dedicate time to attending face to face or group parenting sessions and can be reluctant to ask for help when the FIFO work pattern becomes problematic. An online parenting resource provides an effective tool to communicate successful parenting strategies for FIFO families with adolescents.
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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.
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    • "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. "

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