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Practitioner Review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with attention deficit hyperactivity disorder.

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Title: Practitioner Review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with attention deficit hyperactivity disorder.
Authors: Daley, David, Van Der Oord, Saskia, Ferrin, Maite, Cortese, Samuele, Danckaerts, Marina, Doepfner, Manfred, Van den Hoofdakker, Barbara J., Coghill, David, Thompson, Margaret, Asherson, Philip, Banaschewski, Tobias, Brandeis, Daniel, Buitelaar, Jan, Dittmann, Ralf W., Hollis, Chris, Holtmann, Martin, Konofal, Eric, Lecendreux, Michel, Rothenberger, Aribert, Santosh, Paramala
Source: Journal of Child Psychology & Psychiatry. Sep2018, Vol. 59 Issue 9, p932-947. 16p.
Subjects: Treatment of attention-deficit hyperactivity disorder, Education of parents, Behavior therapy, Child behavior, Mental depression, Emotions, Health services accessibility, Medical referrals, Treatment effectiveness, Parent attitudes, Health literacy, Clinical supervision, Adolescence, Children
Abstract: Background: Behavioural interventions are recommended for use with children and young people with attention deficit hyperactivity disorder (ADHD); however, specific guidance for their implementation based on the best available evidence is currently lacking. Methods: This review used an explicit question and answer format to address issues of clinical concern, based on expert interpretation of the evidence with precedence given to meta‐analyses of randomised controlled trials. Results: On the basis of current evidence that takes into account whether outcomes are blinded, behavioural intervention cannot be supported as a front‐line treatment for core ADHD symptoms. There is, however, evidence from measures that are probably blinded that these interventions benefit parenting practices and improve conduct problems which commonly co‐occur with ADHD, and are often the main reason for referral. Initial positive results have also been found in relation to parental knowledge, children's emotional, social and academic functioning – although most studies have not used blinded outcomes. Generic and specialised ADHD parent training approaches – delivered either individually or in groups – have reported beneficial effects. High‐quality training, supervision of therapists and practice with the child, may improve outcomes but further evidence is required. Evidence for who benefits the most from behavioural interventions is scant. There is no evidence to limit behavioural treatments to parents with parenting difficulties or children with conduct problems. There are positive effects of additive school‐based intervention for the inattentive subtype. Targeting parental depression may enhance the effects of behavioural interventions. Conclusions: Parent training is an important part of the multimodal treatment of children with ADHD, which improves parenting, reduces levels of oppositional and noncompliant behaviours and may improve other aspects of functioning. However, blinded evidence does not support it as a specific treatment for core ADHD symptoms. More research is required to understand how to optimise treatment effectiveness either in general or for individual patients and explore potential barriers to treatment uptake and engagement. In terms of selecting which intervention formats to use, it seems important to acknowledge and respond to parental treatment preferences. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Child Psychology & Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Practitioner Review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with attention deficit hyperactivity disorder.
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  Data: <searchLink fieldCode="AR" term="%22Daley%2C+David%22">Daley, David</searchLink><br /><searchLink fieldCode="AR" term="%22Van+Der+Oord%2C+Saskia%22">Van Der Oord, Saskia</searchLink><br /><searchLink fieldCode="AR" term="%22Ferrin%2C+Maite%22">Ferrin, Maite</searchLink><br /><searchLink fieldCode="AR" term="%22Cortese%2C+Samuele%22">Cortese, Samuele</searchLink><br /><searchLink fieldCode="AR" term="%22Danckaerts%2C+Marina%22">Danckaerts, Marina</searchLink><br /><searchLink fieldCode="AR" term="%22Doepfner%2C+Manfred%22">Doepfner, Manfred</searchLink><br /><searchLink fieldCode="AR" term="%22Van+den+Hoofdakker%2C+Barbara+J%2E%22">Van den Hoofdakker, Barbara J.</searchLink><br /><searchLink fieldCode="AR" term="%22Coghill%2C+David%22">Coghill, David</searchLink><br /><searchLink fieldCode="AR" term="%22Thompson%2C+Margaret%22">Thompson, Margaret</searchLink><br /><searchLink fieldCode="AR" term="%22Asherson%2C+Philip%22">Asherson, Philip</searchLink><br /><searchLink fieldCode="AR" term="%22Banaschewski%2C+Tobias%22">Banaschewski, Tobias</searchLink><br /><searchLink fieldCode="AR" term="%22Brandeis%2C+Daniel%22">Brandeis, Daniel</searchLink><br /><searchLink fieldCode="AR" term="%22Buitelaar%2C+Jan%22">Buitelaar, Jan</searchLink><br /><searchLink fieldCode="AR" term="%22Dittmann%2C+Ralf+W%2E%22">Dittmann, Ralf W.</searchLink><br /><searchLink fieldCode="AR" term="%22Hollis%2C+Chris%22">Hollis, Chris</searchLink><br /><searchLink fieldCode="AR" term="%22Holtmann%2C+Martin%22">Holtmann, Martin</searchLink><br /><searchLink fieldCode="AR" term="%22Konofal%2C+Eric%22">Konofal, Eric</searchLink><br /><searchLink fieldCode="AR" term="%22Lecendreux%2C+Michel%22">Lecendreux, Michel</searchLink><br /><searchLink fieldCode="AR" term="%22Rothenberger%2C+Aribert%22">Rothenberger, Aribert</searchLink><br /><searchLink fieldCode="AR" term="%22Santosh%2C+Paramala%22">Santosh, Paramala</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Child+Psychology+%26+Psychiatry%22">Journal of Child Psychology & Psychiatry</searchLink>. Sep2018, Vol. 59 Issue 9, p932-947. 16p.
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  Data: <searchLink fieldCode="DE" term="%22Treatment+of+attention-deficit+hyperactivity+disorder%22">Treatment of attention-deficit hyperactivity disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Education+of+parents%22">Education of parents</searchLink><br /><searchLink fieldCode="DE" term="%22Behavior+therapy%22">Behavior therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Child+behavior%22">Child behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Emotions%22">Emotions</searchLink><br /><searchLink fieldCode="DE" term="%22Health+services+accessibility%22">Health services accessibility</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+referrals%22">Medical referrals</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+attitudes%22">Parent attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Health+literacy%22">Health literacy</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+supervision%22">Clinical supervision</searchLink><br /><searchLink fieldCode="DE" term="%22Adolescence%22">Adolescence</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink>
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  Label: Abstract
  Group: Ab
  Data: Background: Behavioural interventions are recommended for use with children and young people with attention deficit hyperactivity disorder (ADHD); however, specific guidance for their implementation based on the best available evidence is currently lacking. Methods: This review used an explicit question and answer format to address issues of clinical concern, based on expert interpretation of the evidence with precedence given to meta‐analyses of randomised controlled trials. Results: On the basis of current evidence that takes into account whether outcomes are blinded, behavioural intervention cannot be supported as a front‐line treatment for core ADHD symptoms. There is, however, evidence from measures that are probably blinded that these interventions benefit parenting practices and improve conduct problems which commonly co‐occur with ADHD, and are often the main reason for referral. Initial positive results have also been found in relation to parental knowledge, children's emotional, social and academic functioning – although most studies have not used blinded outcomes. Generic and specialised ADHD parent training approaches – delivered either individually or in groups – have reported beneficial effects. High‐quality training, supervision of therapists and practice with the child, may improve outcomes but further evidence is required. Evidence for who benefits the most from behavioural interventions is scant. There is no evidence to limit behavioural treatments to parents with parenting difficulties or children with conduct problems. There are positive effects of additive school‐based intervention for the inattentive subtype. Targeting parental depression may enhance the effects of behavioural interventions. Conclusions: Parent training is an important part of the multimodal treatment of children with ADHD, which improves parenting, reduces levels of oppositional and noncompliant behaviours and may improve other aspects of functioning. However, blinded evidence does not support it as a specific treatment for core ADHD symptoms. More research is required to understand how to optimise treatment effectiveness either in general or for individual patients and explore potential barriers to treatment uptake and engagement. In terms of selecting which intervention formats to use, it seems important to acknowledge and respond to parental treatment preferences. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of Child Psychology & Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/jcpp.12825
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