Effectiveness of a Tailored Occupational Therapy Intervention for Women With ADHD
Condition: Attention Deficit Hyperactivity Disorder
MeSH terms: Hyperkinesis; Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      Although woman are diagnosed with Attention-deficit hyperactivity disorder (ADHD) at a 1:3
      ratio with men, recent research suggests that woman may experience the same levels of adult
      ADHD as men but are underdiagnosed because symptoms may be less severe and/or mistaken for
      anxiety and depression. Women with ADHD typically experience problems in managing worker,
      student, spousal, and parenting roles dues to disorganization, poor time management,
      difficulty regulating internal and external stressors, and difficulty maintaining daily
      schedules and routines. Intervention effectiveness research has largely focused on
      pharmacological treatment of ADHD symptoms; however, while such pharmacological treatment
      tends to enhance concentration and reduce motor restlessness, it does not address the skills
      needed to successfully carry out daily life roles and activities dependent upon time
      management, prioritization of tasks, and regulation of emotional responses within the home,
      school/work, and community environments. In this study, the investigators aim to determine
      whether a 7-week tailored occupational therapy intervention addressing organization, time
      management, stress management, and sensory regulation in the home, school/work, and community
      environments can increase satisfaction in desired daily life activities, and reduce ADHD
      symptoms and stress levels in women with ADHD.
    

Detailed description: 
      Attention-deficit hyperactivity disorder (ADHD) is believed to be neurologically based and
      characterized by enduring attentional problems, motor restlessness, and cognitive and motor
      impulsivity that impact one's ability to function optimally in daily life activities. ADHD is
      commonly diagnosed in childhood at a prevalence rate of 11% and a male to female ratio of
      3:1. The prevalence of adult ADHD varies from 4 to 6% and it is estimated that two-thirds of
      adult ADHD disorders are extensions of childhood ADHD. Researchers have suggested that the
      male to female prevalence ratio is inaccurate and that females experience ADHD at similar
      levels to males but are underdiagnosed. While boys with ADHD are often identified by their
      teachers because of motor impulsivity and inattention, girls with ADHD who may experience
      attentional problems and impulsivity without significant hyperactivity, may fail to be
      identified by teachers as needing evaluation and treatment. Some studies have found that
      female children and adolescents who experience the ADHD symptoms of inattention,
      disorganization, poor time management, and distractibility are more likely to be misdiagnosed
      with depression and anxiety. When depression and anxiety occur in children and adolescents
      with undiagnosed ADHD symptoms, they may result from the inability to manage ADHD symptoms as
      they impact functional performance in the home, school, and community.

      Much of the research exploring ADHD has been devoted to children and adolescents. The
      research examining adult ADHD has thus far largely attempted to describe the phenomenon of
      adult ADHD. Research investigating intervention effectiveness for adult ADHD has primarily
      focused on pharmacological treatment. The small body of research examining
      non-pharmacological treatment has found moderate effectiveness for pharmacological
      intervention combined with cognitive behavioral therapy and psychoeducation.

      Missing from this body of literature is research specifically examining interventions for
      women with ADHD, who present symptoms that are both overlapping with and unique from their
      male counterparts.

      Studies have found that women with ADHD tend to have difficulty maintaining and succeeding in
      employment, school, and parenting and spousal roles. The ability to organize and implement
      tasks associated with each role, follow daily schedules and routines needed to support
      desired roles, prioritize and manage tasks in a timely manner, and regulate internal and
      external stressors to maintain consistent emotional responses may be difficult for with women
      with ADHD.

      In this study, the investigators aim to provide a 7-week tailored intervention for women with
      ADHD who have difficulty carrying out student, worker, spousal, and parenting roles due to
      poor time management, organization of their physical environments, management of internal and
      external stressors, and regulation of internal and external stimulation.

      This intervention effectiveness study will use randomization and control. Twenty-four women
      who self-report diagnoses of ADHD will be recruited to participate and randomly assigned to
      either the intervention group (n=12) or control group (n=12). The intervention group will
      receive the 6-week intervention; the control group will not receive intervention (bit will
      receive an organization toolkit at study end).
    

Intervention name(s): Occupational Therapy Intervention for Women with ADHD
Intervention type(s): Behavioral
Intervention description(s): The intervention will run for 7 weeks and consist of the following 1-hour sessions. Each intervention session will be facilitated by two CUMC occupational therapy students in each participant's home environment (or another environment of the participant's choosing such as the work or school environment).
Implementation of organizational, time management, stress management, and sensory regulation strategies for the home, school/work, and community environments.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Two group randomized controlled study
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: ADHD; Occupational Therapy