Clinical trial NCT01547702: Classroom-based Distance Intervention for Teachers of Children With Attention Deficit Hyperactivity Disorder
Official title: Randomized-controlled Trial of a Classroom-based Distance Intervention for Teachers of Elementary School-aged Children With ADHD
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Attention Deficit Hyperactivity Disorder (ADHD)
Keywords: ADHD
attention
inattention
hyperactivity
classroom intervention
teacher education
web-based intervention
Lead sponsor: Dalhousie University
Sponsor class: OTHER
First posted: 2012-03-08
Enrollment: 116
Sex: ALL
Minimum age (years): 6
Maximum age (years): 12
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to evaluate, by way of randomized controlled trial, the effectiveness of a web-based, time-flexible, and teacher-directed "Teacher Help for ADHD" program in reducing the impact of ADHD symptoms in elementary students.

Detailed description: \*Please note that the information below is taken verbatim from our project's research summary.\*

Treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most well-researched areas in childhood psychopathology. ADHD is a highly prevalent (5% of school-aged children) and chronic disorder (ADHD will persist into adulthood for \~70% of children diagnosed with this disorder). ADHD has a substantial impact on daily life including difficulties with behavioural, academic, social and emotional functioning (DuPaul \& Weyandt, 2006).

Although medication is the most commonly used treatment, there are a number of important limitations including poor long-term effects, lack of effectiveness in improving academic skills, and lack of acceptability by parents and children (DuPaul, 2007). Therefore, a number of psychosocial interventions have been developed and empirically validated (parent training, social skills training, school-based interventions). School-based interventions have been shown to be effective; however, these are significantly underutilized and when implemented in an uncontrolled way, are often ineffective. This intervention program is comprised of evidence-based treatment strategies that are presented in a manner that will provide teachers with knowledge of the disorder and intervention strategies. The novel delivery of this program, through distance treatment modalities (e-mail and internet) will allow us to overcome many of the known barriers to treatment so that teachers will receive the necessary information in a timely and efficient manner. The specific research questions that will be addressed are:

1. Does the overall impairment of children with ADHD in the treatment group improve compared to those who are in the waitlist group?
2. Is the school-based intervention effective in reducing ADHD symptoms, improving behavioral functioning, and enhancing academic performance in the active treatment group compared to the waitlist group?
3. Do teachers in the treatment group develop more knowledge about ADHD and more positive and realistic attitudes about this disorder over the course of the intervention?
4. Is the intervention viewed as accessible to teachers and is there evidence of fidelity to the program?

The investigators expect that the program will reduce overall impairment, improve ADHD symptoms, behavioural, and academic functioning in the children and will enhance knowledge and reduce misconceptions of ADHD in teachers. If successful, this program will be disseminated to school boards in Nova Scotia and across Canada, and as such would have the potential to have a significant positive effect on the health and well-being of many children, teachers and parents.

Eligibility criteria: Inclusion Criteria:

* Student is in grades 1 to 6 in the public school English stream
* Student has been formally diagnosed with Attention Deficit Hyperactivity Disorder having a diagnosis of ADHD
* Student is either on a stable dose of medication or no medication with no plan to start/change medication in the next 5 months

Exclusion Criteria:

* Student has a significant other mental health issue (e.g., depression, anxiety, suicidal ideation, psychotic features, and severe conduct problems)
* Student is on an Individualized Program Plan (IPP) due to significant physical, behavioural, communication, or learning difficulties.
* Teacher participated in the Teacher Help for ADHD pilot study (conducted by Brittany Barnett, Master of Health Informatics Student under the supervision of Dr. Elik and Dr. Corkum, Dalhousie University)

Primary outcomes:
measure: The Impairment Rating Scale (IRS, Fabiano & Pelham, 2002)
timeFrame: Change from Baseline in ADHD symptom impairment at 6 weeks (length of intervention) and 12 weeks (follow-up)
Secondary outcomes:
measure: Knowledge of Attention Deficit Disorder Scale (KADDS; Sciutto, Terjesen, & Bender, 2000)
timeFrame: Change from Baseline in ADHD knowledge at 6 weeks (length of intervention) and 12 weeks (follow-up)
measure: Beliefs about Attention Deficit Hyperactivity Disorder (Kos, 2008)
timeFrame: Change from Baseline in ADHD beliefs at 6 weeks (length of intervention) and 12 weeks (follow-up)
measure: Instructional and Behavior Management Approaches Survey (IBMA; Martinussen, Tannock, & Chaban, 2011)
timeFrame: Change from Baseline in behaviour management approaches at 6 weeks (length of intervention) and 12 weeks (follow-up)
measure: Intention and Subjective Norm questionnaires (Based on Prochaska & DiClemente's Stages of Change Model, 1984)
timeFrame: Change from Baseline in intentions and subjective norms at 6 weeks (length of intervention) and 12 weeks (follow-up)
measure: Swanson, Kotkin, Agler, M-Flynn, and Pelham Scale (SKAMP; see Murray, Bussing, Fernandez, Hou, Garvan, Swanson, & Eyberg, 2009)
timeFrame: Functional impairment of ADHD symptoms will be measured in the Treatment group at 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, and 7 weeks
measure: Homework Problem Checklist (HPC; Anesko, Schoiock, Ramirez, & Levine, 1987)
timeFrame: Change from Baseline in homework problems at 6 weeks (length of program) and 12 weeks (follow-up)
measure: Parent and Teacher Satisfaction Ratings (adapted from Ervin, DuPaul, Kern, & Friman, 1998)
timeFrame: Treatment group will complete satisfaction questionnaires at 6 weeks
measure: Conners 3rd Edition Parent and Teacher Rating Scales (Full-length) (Conners 3-P, Conners 3-T; Conners, 2008)
timeFrame: Change from Baseline in problem behaviours at 6 weeks (length of program) and 12 weeks (follow-up)
measure: Home & School Situations Questionnaire (HSQ/SSQ; Barkley & Murphy, 2005)
timeFrame: Change from Baseline in behaviours at 6 weeks (length of program) and 12 weeks (follow-up)
measure: Academic Performance Rating Scale (APRS; DuPaul, Rapport, & Perriello, 1991)
timeFrame: Change from Baseline in academic performance at 6 weeks (length of program) and 12 weeks (follow-up)
Other outcomes:
Locations:
city: Halifax
country: Canada
facility: Dalhousie University
state: Nova Scotia
Study officials:
affiliation: Dalhousie University
name: Penny V Corkum, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: The Hospital for Sick Children
name: Nezihe Elik, PhD
role: PRINCIPAL_INVESTIGATOR
References: