The results revealed that findings are becoming increasingly nuanced with variations in levels of evidence related to ages of the children and characteristics of the specific treatment .
In addition , we focused our critique on generalization of treatment effects across setting s and time and on sample diversity ( with regard to ethnicity and levels of parent education ) in relation to the population .
Children of parents with higher levels of education than average appear to be overrepresented in the literature .
The purpose of this research was to up date the series of articles on evidence -based treatment for children and adolescents with attention deficit/hyperactivity disorder that have appeared in this journal ( Evans , Owens & Bunford , 2014 ; Pelham & Fabiano , 2008 ; Pelham , Wheeler , & Chronis , 1998 ) .
Does intensive multimodal treatment for maternal ADHD improve the efficacy of parent training for children with ADHD? A randomized controlled multicenter trial.
BACKGROUND This is the first r and omized controlled multicenter trial to evaluate the effect of two treatments of maternal attention-deficit hyperactivity disorder ( ADHD ) on response to parent-child training targeting children 's external psychopathology . METHODS Mother-child dyads ( n = 144 ; ADHD according to DSM-IV ; children : 73.5 % males , mean age 9.4 years ) from five specialized university outpatient units in Germany were central ly r and omized to multimodal maternal ADHD treatment [ group psychotherapy plus open methylpheni date medication ; treatment group ( TG ) : n = 77 ] or to clinical management [ supportive counseling without psychotherapy or psychopharmacotherapy ; control group ( CG ) : n = 67 ] . After 12 weeks , the maternal ADHD treatment was supplemented by individual parent-child training for all dyads . The primary outcome was a change in the children 's externalizing symptom scores ( investigator blinded to the treatment assignment ) from baseline to the end of the parent-child training 6 months later . Maintenance therapy continued for another 6 months . An intention-to-treat analysis was performed within a linear regression model , controlling for baseline and center after multiple imputations of missing values . RESULTS Exactly , 206 dyads were assessed for eligibility , 144 were r and omized , and 143 were analyzed ( TG : n = 77 ; CG : n = 66 ) . After 6 months , no significant between-group differences were found in change scores for children 's externalizing symptoms ( adjusted mean TG-mean CG=1.1 , 95 % confidence interval -0.5 - 2.7 ; p = .1854 ) , although maternal psychopathology improved more in the TG . Children 's externalizing symptom scores improved from a mean of 14.8 at baseline to 11.4 ( TG ) and 10.3 ( CG ) after 6 months and to 10.8 ( TG ) and 10.1 ( CG ) after 1 year . No severe harms related to study treatments were found , but adverse events were more frequent in TG mothers than in CG mothers . CONCLUSIONS The response in children 's externalizing psychopathology did not differ between maternal treatment groups . However , multimodal treatment was associated with more improvement in maternal ADHD . Child and maternal treatment gains were stable ( CCT-IS RCT N73911400 )
The results revealed that findings are becoming increasingly nuanced with variations in levels of evidence related to ages of the children and characteristics of the specific treatment .
In addition , we focused our critique on generalization of treatment effects across setting s and time and on sample diversity ( with regard to ethnicity and levels of parent education ) in relation to the population .
Children of parents with higher levels of education than average appear to be overrepresented in the literature .
The purpose of this research was to up date the series of articles on evidence -based treatment for children and adolescents with attention deficit/hyperactivity disorder that have appeared in this journal ( Evans , Owens & Bunford , 2014 ; Pelham & Fabiano , 2008 ; Pelham , Wheeler , & Chronis , 1998 ) .