Parenting as a Mechanism of Change in Psychosocial Treatment for Youth with ADHD, Predominantly Inattentive Presentation Efficacy of the Incredible Years Basic parent training programme as an early intervention for children with conduct problems and ADHD. An efficacy study of a combined parent and teacher management training programme for children with ADHD Social Skills Training in Children With Attention Deficit Hyperactivity Disorder: A Randomized-Controlled Clinical Trial Randomised social-skills training and parental training plus standard treatment versus standard treatment of children with attention deficit hyperactivity disorder - The SOSTRA trial protocol Combining Parent and Child Training for Young Children with ADHD A randomized controlled trial of a parent training and emotion socialization program for families of hyperactive preschool-aged children. Neurofeedback in ADHD: a single-blind randomized controlled trial Effectiveness of a School-Based Multicomponent Program for the Treatment of Children with ADHD A randomized, controlled trial of integrated home-school behavioral treatment for ADHD, predominantly inattentive type. Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial. [The prevalence of attention-deficit/hyperactivity disorder (ADHD) among children and adolescents in Germany. Initial results from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. Computerized training of working memory in children with ADHD--a randomized, controlled trial. Predictors of Boys’ ADHD Symptoms from Early to Middle Childhood: The Role of Father–Child and Mother–Child Interactions Parent-assisted transfer of children's social skills training: effects on children with and without attention-deficit hyperactivity disorder. Treating Parents with Attention-Deficit/Hyperactivity Disorder: The Effects of Behavioral Parent Training and Acute Stimulant Medication Treatment on Parent–Child Interactions Development and preliminary evaluation of an integrated treatment targeting parenting and depressive symptoms in mothers of children with attention-deficit/hyperactivity disorder. A two-site randomized clinical trial of integrated psychosocial treatment for ADHD-inattentive type. Children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment: impact on parental practices. Parent-based therapies for preschool attention-deficit/hyperactivity disorder: a randomized, controlled trial with a community sample. In a randomized case–control trial with 10-years olds suffering from attention deficit/hyperactivity disorder (ADHD) sleep and psychological functioning improved during a 12-week sleep-training program Social-Skills and Parental Training plus Standard Treatment versus Standard Treatment for Children with ADHD – The Randomised SOSTRA Trial Parental Influence on Children with Attention-Deficit/Hyperactivity Disorder: II. Results of a Pilot Intervention Training Parents as Friendship Coaches for Children
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 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 : 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 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 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 ) : 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 The present study evaluated the effectiveness of a parent training and emotion socialization program design ed specifically for hyperactive preschoolers . Participants were 31 preschool-aged children whose parents were r and omly assigned to a  parent training ( PT ) or waitlist ( WL ) control group .  PT parents took part in a 14-week parenting program that involved teaching parenting strategies for managing hyperactive and disruptive behavior as well as emotion socialization strategies for improving children 's emotion regulation . Compared to WL mothers , PT mothers reported significantly less child inattention , hyperactivity , oppositional defiance , and emotional lability ; were observed using significantly more positive and less negative parenting ; and reported significantly less maternal verbosity and unsupportive emotion socialization practice s. Results provide some support for the effectiveness of this parenting program for reducing attention-deficit hyperactivity disorder ( ADHD ) symptoms and associated problems in preschool-aged children Neurofeedback treatment has been demonstrated to reduce inattention , impulsivity and hyperactivity in children with attention deficit/hyperactivity disorder ( ADHD ) . However , previous studies did not adequately control confounding variables or did not employ a r and omized reinforcer-controlled design . This study addresses those method ological shortcomings by comparing the effects of the following two matched biofeedback training variants on the primary symptoms of ADHD : EEG neurofeedback ( NF ) aim ing at theta/beta ratio reduction and EMG biofeedback ( BF ) aim ing at forehead muscle relaxation . Thirty-five children with ADHD ( 26 boys , 9 girls ; 6–14 years old ) were r and omly assigned to either the therapy group ( NF ; n = 18 ) or the control group ( BF ; n = 17 ) . Treatment for both groups consisted of 30 sessions . Pre- and post-treatment assessment consisted of psychophysiological measures , behavioural rating scales completed by parents and teachers , as well as psychometric measures . Training effectively reduced theta/beta ratios and EMG levels in the NF and BF groups , respectively . Parents reported significant reductions in primary ADHD symptoms , and inattention improvements in the NF group were higher compared to the control intervention ( BF , dcorr = −.94 ) . NF training also improved attention and reaction times on the psychometric measures . The results indicate that NF effectively reduced inattention symptoms on parent rating scales and reaction time in neuropsychological tests . However , regarding hyperactivity and impulsivity symptoms , the results imply that non-specific factors , such as behavioural contingencies , self-efficacy , structured learning environment and feed-forward processes , may also contribute to the positive behavioural effects induced by neurofeedback training The objective of this study was to evaluate the efficacy of a multicomponent program for treating attention-deficit/hyperactivity disorder ( ADHD ) carried out by teachers in a classroom context . Dependent measures included neuropsychological tasks , behavioral rating scales for parents and teachers , direct observation of behavior in the classroom , and academic records of children with ADHD . Fifty children with ADHD participated in the study . The teachers of 29 of the 50 students  were trained in the use of behavior modification techniques , cognitive behavior strategies , and instructional management strategies . The other 21 students formed the  control group . Parents ' and teachers'ratings detected improvements in primary symptoms ( inattention — disorganization , hyperactivity — impulsivity ) and in behavioral difficulties usually associated with ADHD ( e.g. , antisocial behavior , psychopathological disorders , anxiety ) . Furthermore , the results showed increased academic scores , enhanced classroom behavioral observations , and improved teachers ' knowledge about the strategies directed toward responding to the children 's educational needs 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 BACKGROUND National Institute for Health and Care Excellence guidelines recommend a stepped care approach for the identification and management of children with , or at risk of , attention-deficit/hyperactivity disorder ( ADHD ) . We investigated the effectiveness , cost-effectiveness and acceptability of a group parenting intervention programme ( + /- a teacher session ) for children at risk of ADHD . METHODS In a three-arm cluster r and omised controlled trial , 12 primary schools were r and omly assigned to  control , parent-only and combined ( parent + teacher ) intervention arms . Eligible children had high levels of parent-rated hyperactivity/inattention ( n = 199 ) . At 6 month follow-up , the primary outcome measure was the parent-completed Conners ' Rating Scale - Revised ( ADHD index ) . Secondary outcomes included the Conners ' sub-scales ( hyperactivity , cognitive problems/inattention and oppositional behaviour ) , the teacher-completed Conners ' Rating Scale - Revised , child health-related quality of life , parental burden and parental mental health . The cost-effectiveness analyses reflected a health and personal social services perspective . TRIAL REGISTRATION IS RCT N87634685 . RESULTS Follow-up data were obtained from 76 parents and 169 teachers . There was no effect of the parent-only ( mean difference = -1.1 , 95 % CI -5.1,2.9 ; p = 0.57 ) or combined interventions ( mean difference = -2.1 , 95 % CI -6.4,2.1 ; p = 0.31 ) on the ADHD index . The combined intervention was associated with reduced parent-reported hyperactivity symptoms ( mean difference = -5.3 ; 95 % CI -10.5,-0.01 ; p = 0.05 ) and the parent-only intervention with improved parental mental health ( mean difference = -1.9 ; 95 % CI -3.2,-0.5 ; p = 0.009 ) . The incremental costs of the parent-only and the combined interventions were £ 73 and £ 123 , respectively . Above a willingness-to-pay of £ 31 per one-point improvement in the ADHD index , the parent-only programme had the highest probability of cost-effectiveness . Participants found the interventions acceptable . CONCLUSIONS For children at risk of ADHD , this school-based parenting programme was not associated with improvement in core ADHD symptoms . Secondary analyses suggested a possible reduction in parent-reported hyperactivity and parental mental health problems . Future research should compare targeted interventions against watchful waiting and specialist referral The cardinal symptoms of attention-deficit/hyperactivity disorder ( ADHD ) are inattention , hyperactivity and impulsivity . Etiologically , ADHD is mainly put down to genetic causes ; it entails a considerable range of psychosocial problems for those affected and their social environment . The parents of a total of 7,569 boys ( B ) and 7,267 girls ( G ) aged 3 - 17 who took part in the German Health Interview and Examination Survey for Children and Adolescents ( KiGGS ) answered a self-administered question naire including an ADHD diagnosis question and the  Strengths and Difficulties Question naire ( SDQ )  . In addition behavioural observations of 7,919 children ( aged 3 - 11 ) were carried out during the medical and physical tests . Participants whose parents reported that they had ever been given an ADHD diagnosis by a doctor or psychologist were classified as ADHD cases . Participants were classified as suspected cases of ADHD if they had a value of > or = 7 on the SDQ inattention/hyperactivity scale . ADHD had ever been diagnosed in 4.8 % of the children and adolescents altogether ( B : 7.7 % , G : 1.8 % ) . Another 4.9 % of the participants can be considered as suspected cases . Already 1.8 % of the preschoolers had been given an ADHD diagnosis . At primary school age ( 7 - 10 years old ) the frequency of diagnosis rises sharply . At age 11 - 17 , ADHD had ever been diagnosed in 1 in 10 boys and 1 in 43 girls . ADHD had been diagnosed significantly more frequently among participants of low socio-economic status ( SES ) than among participants of high SES . A diagnosis of ADHD is reported less often for migrants , they rank more frequently among the suspected cases . The discrepancy between confirmed and suspected cases of ADHD among migrants may point to lower diagnosis rates or lower utilization of medical services . The short- and long-term medical , social and health-economic effects of ADHD illustrate the major public health relevance of the disorder . As for prevention , the high share of genetic factors in ADHD etiology primarily suggests secondary prevention ( early support and early diagnosis ) and tertiary prevention measures . Further analysis of the KiGGS data could prospect ively identify risk groups more precisely and refine preventional approaches 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 This prospect i ve 3 year longitudinal study investigated preschool paternal and maternal parenting predictors of Attention-Deficit/Hyperactivity Disorder(ADHD ) in a community sample of 93 school-age boys . Participants were recruited on the basis of inattention-hyperactivity at age 4 and fathers and mothers were observed interacting with their sons . Teachers , fathers , and mothers reported children 's ADHD symptoms and impairment . Results from dimensional analysis showed that less observed paternal sensitivity and maternal positive regard predicted higher levels of inattentiveness in middle childhood , and that intrusive paternal behavior was predictive of hyperactive-impulsive behavior at school . In categorical analysis , less maternal warmth and sensitivity were predictive of later ADHD . These predictions held after statistical adjustment for the effects of preschool ADHD behaviors and conduct problems . At follow-up , parents of boys with ADHD reported more negative child-parent relationship perceptions than comparison parents . Findings highlight the importance of examining responsive parenting behaviors of both fathers and mothers in relation to multi-informant ratings of ADHD symptoms OBJECTIVE Previous research has demonstrated that peer rejection is a significant part of the clinical presentation of many children with attention-deficit hyperactivity disorder ( ADHD ) . Outcome studies of treatment interventions have typically failed to show generalization of treatment gains to the home and classroom . This has been especially true for children who have comorbid oppositional defiant disorder ( ODD ) . The present study was intended to demonstrate generalization of an outpatient social skills training program when parents were trained in skills relevant to their child 's social adjustment . METHOD Thirty-five children with ADHD and 14 children without ADHD were given  12 sessions of treatment ( treatment group ) . Outcome was compared with 12 children with ADHD and 12 children without ADHD who were on a waitlist for treatment ( waitlist group ) .  Nineteen children with ODD were in the treatment group and five in the waitlist . Stimulant medication was prescribed for all children with ADHD . RESULTS Subjects with ADHD showed improvement comparable with that of subjects without ADHD on all teacher- and parent-reported measures of peer adjustment and social skills , except teacher-reported withdrawal . Children with ODD had outcome comparable with that of children without ODD . Effect sized ranged from 0.93 to 1.34 indicating that the average treatment group subject was better off than 83.4 % of waitlist subjects on outcome measures . CONCLUSIONS The present results suggest that children with ADHD are best heiped by a combination of social skills training for themselves , collateral training for their parents and stimulant medication 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 OBJECTIVE More than 50 % of mothers of children with attention-deficit/hyperactivity disorder ( ADHD ) have a lifetime history of major depressive disorder ( MDD ) . Maternal depressive symptoms are associated with impaired parenting and predict adverse developmental and treatment outcomes for children with ADHD . For these reasons , we developed and examined the preliminary efficacy of an integrated treatment targeting parenting and depressive symptoms for mothers of children with ADHD . This integrated intervention incorporated elements of 2 evidence -based treatments : behavioral parent training ( BPT ) and cognitive behavioral depression treatment . METHOD Ninety-eight mothers with at least mild depressive symptoms were r and omized to receive either st and ard BPT ( n = 51 ) or the integrated parenting intervention for ADHD ( IPI-A ; n = 47 ) . Participants were assessed at baseline , posttreatment , and 3- to 6-month follow-up on measures of ( a ) self-reported maternal depressive symptoms , ( b ) observed positive and negative parenting , and ( c ) observed and mother-reported child disruptive behavior and mother-reported child and family impairment . RESULTS The IPI-A produced effects of small to moderate magnitude relative to BPT  on maternal depressive symptoms , observed negative parenting , observed child deviance , and child impairment at posttreatment and on maternal depressive symptoms , child disruptive behavior , child impairment and family functioning at follow-up . Contrary to expectations , the BPT group demonstrated moderate to large effects relative to IPI-A on observed positive parenting at follow-up . CONCLUSIONS This treatment development study provides encouraging preliminary support for the integrated intervention targeting parenting and depressive symptoms in mothers of children with ADHD . Future studies should examine whether this integrated intervention improves long-term developmental outcomes for children with ADHD . ( PsycINFO Data base Record ( c ) 2013 APA , all rights reserved ) OBJECTIVE This study evaluated the efficacy of the Child Life and Attention Skills ( CLAS ) program , a behavioral psychosocial treatment integrated across home and school , for youth with attention-deficit/hyperactivity disorder-inattentive type ( ADHD-I ) . METHOD In a 2-site r and omized controlled trial , 199 children ( ages 7 - 11 years ) were r and omized to  CLAS ( N = 74 ) , parent-focused treatment ( PFT , N = 74 ) , or treatment as usual ( TAU , N = 51 ) . We compared groups on parent and teacher ratings of inattention symptoms , organizational skills , social skills , and global improvement at posttreatment and also at follow-up during the subsequent school year . RESULTS CLAS result ed in greater improvements in teacher-reported inattention , organizational skills , social skills , and global functioning relative to both PFT and TAU at posttreatment . Parents of children in CLAS reported greater improvement in organizational skills than PFT and greater improvements on all outcomes relative to TAU at posttreatment . Differences between CLAS and TAU were maintained at follow-up for most parent-reported measures but were not significant for teacher-reported outcomes . CONCLUSIONS These findings extend support for CLAS across 2 study sites , revealing that integrating parent , teacher , and child treatment components , specifically adapted for ADHD-I , is superior to parent training alone and to usual care . Direct involvement of teachers and children in CLAS appears to amplify effects at school and home and underscores the importance of coordinating parent , teacher , and child treatment components for cross- setting effects on symptoms and impairment associated with OBJECTIVE To test the hypothesis that multimodal psychosocial intervention , which includes parent training , combined with methylpheni date significantly enhances the behavior of parents of children with attention-deficit/hyperactivity disorder ( ADHD ) , compared with methylpheni date alone and compared with methylpheni date and nonspecific psychosocial treatment ( attention control ) . METHOD One hundred three children with ADHD ( ages 7 - 9 ) , free of conduct and learning disorders , who responded to short-term methylpheni date therapy were r and omized for 2 years to receive either ( 1 ) methylpheni date treatment alone ; ( 2 ) methylpheni date plus psychosocial treatment that included parent training and counseling , social skills training , academic assistance , and psychotherapy ; or ( 3 ) methylpheni date plus attention control treatment . Parents rated their knowledge of parenting principles and negative and positive parenting behavior . Children rated their parents ' behavior . RESULTS Psychosocial treatment led to significantly better knowledge of parenting principles but did not enhance parenting practice s , as rated by parents and children . Significant improvement in mothers ' negative parenting occurred across all treatments and was maintained . CONCLUSIONS In nonconduct-disordered , stimulant-treated children with ADHD , parent training does not improve self-rated parental behavior . The benefits of brief stimulant treatment for negative parental behavior are sustained with extended treatment OBJECTIVE To evaluate two different parent-based therapies for preschool attention-deficit/hyperactivity disorder ( ADHD ) in a community sample . METHOD Three-year-old children displaying a preschool equivalent of ADHD ( n = 78 ) were r and omly assigned to either a parent training ( PT ; n = 30 ) , a parent counseling and support ( PCO&S ; n = 28 ) , or a waiting-list control group ( n = 20 ) . The PT group received coaching in child management techniques . The PC&S group received nondirective support and counseling .  Measures of child symptoms and mothers ' well-being were taken before and after intervention and at 15 weeks follow-up . RESULTS ADHD symptoms were reduced ( F2,74 = 11.64 ; p < .0001 ) and mothers ' sense of well-being was increased by PT relative to both other groups ( F2,74 = 10.32 ; p < .005 ) . Fifty-three percent of children in the PT group displayed clinical ly significant improvement ( chi 2 = 4.08 ; p = .048 ) . CONCLUSIONS PT is a valuable treatment for preschool ADHD . PC&S had little effect on children 's behavior . Constructive training in parenting strategies is an important element in the success of parent-based interventions . Psychostimulants are not a necessary component of effective treatment for many children with preschool ADHD Abstract Objectives . We tested the hypothesis that sleep training would improve emotional , social and behavioural functioning in children with attention-deficit/hyperactivity disorder ( ADHD ) compared to children with ADHD without such intervention and to healthy controls . Methods . Forty children with ADHD were r and omly assigned to intervention and control conditions . Parents of 20 children with ADHD were instructed and thoroughly supervised in improving their children 's sleep schedules and sleep behaviour .  Parents of the other 20 children with ADHD and parents of 20 healthy children  received general information about sleep hygiene . At baseline and 12 weeks later , parents and children completed question naires related to children 's sleep and psychological functioning . Results . Relative to the control groups , children in the intervention group improved sleep quantitatively and qualitatively ( F values < 3.33 , P values < 0.05 ) . The intervention group children reported improvements in mood , emotions , and relationships ( F values < 2.99 , P values < 0.05 ) . Parents reported that their children improved in physical and psychological wellbeing , mood , emotions , relationships , and social acceptance ( F values < 3.02 , P values < 0.05 ) . Conclusions . Training and monitoring parents of children with ADHD in regulating and supervising children 's sleep schedules leads to positive changes in the emotions , behaviour and social lives of these children 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 We report findings from a pilot intervention that trained parents to be “ friendship coaches ” for their children with Attention-Deficit/Hyperactivity Disorder ( ADHD ) . Parents of 62 children with ADHD ( ages 6–10 ; 68 % male ) were r and omly assigned to receive the parental friendship coaching ( PFC ) intervention , or to be in a no-treatment control group .  Families of 62 children without ADHD were included as normative comparisons . PFC was administered in eight , 90-minute sessions to parents ; there was no child treatment component . Parents were taught to arrange a social context in which their children were optimally likely to develop good peer relationships . Receipt of PFC predicted improvements in children ’s social skills and friendship quality on play date s as reported by parents , and peer acceptance and rejection as reported by teachers unaware of treatment status . PFC also predicted increases in observed parental facilitation and corrective feedback , and reductions in criticism during the child ’s peer interaction , which mediated the improvements in children ’s peer relationships . However , no effects for PFC were found on the number of play date s hosted or on teacher report of child social skills . Findings lend initial support to a treatment model that targets parental behaviors to address children ’s peer problems
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 .