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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 randomized 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.

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Synopsis Behavior management treatments are the most commonly used nonpharmacological approaches for treating ADHD and associated impairments. This review focuses on behavioral parent training interventions for school age children in the home setting and adjunctive treatments developed to extend effects across settings. The underlying theoretical basis and content of these interventions are described. Empirical support includes numerous randomized clinical trials, systematic reviews, and meta-analyses showing positive effects of these interventions on child compliance, ADHD symptoms and impairments, parent-child interactions, parenting and parenting stress. These studies support categorization of behavior management treatment as a well-established, evidence-based treatment for ADHD. Factors for consideration in clinical decision-making and future directions for research are provided.

ACCULTURATION, CULTURAL VALUES, AND LATINO PARENTAL BELIEFSABOUT THE ETIOLOGY OF ADHD Kathryn E. LawtonMarquette University, 2011Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent mental health disorders of childhood, but despite the availability of several evidencebased interventions, Latino children are more likely than non-minority children to have an unmet need for services related to ADHD. Because parental beliefs about the etiology of ADHD likely influence which services are sought, more research is needed to examine this aspect of help-seeking behavior in order to address the unmet need among Latino families. Specifically, research needs to focus on cultural factors that likely influence parental beliefs about the etiology of child behavior problems. Thus, the goal of the current study was to investigate the role of acculturation and cultural values of familismo, respeto, spirituality, and traditional gender roles in explaining parental etiological beliefs about ADHD in Latino parents. Participants in this study included 74 Latino parents. After watching a video portraying a Latino child exhibiting core symptoms and common functional problems associated with ADHD, parents completed a semi-structured interview that assessed etiological beliefs about the behavior of the child in the video, as well as a demographic questionnaire and measures of acculturation and cultural values. Neither Anglo orientation nor Latino orientation was significantly correlated with biopsychosocial or sociological/spiritual etiological beliefs. Additionally, none of the cultural values were significantly correlated with biopsychosocial etiological beliefs. The cultural values familismo and traditional gender roles were significantly positively correlated with sociological/spiritual beliefs. Exploratory analyses also were conducted to further examine sociological/spiritual beliefs. After controlling for SES, familismo and traditional gender roles accounted for 30.5% of the total variance in sociological/spiritual beliefs about ADHD. Finally, post hoc analyses were conducted to examine individual categories of etiological beliefs. The current study adds to our knowledge about how Latino parents understand child behavior and has important implications for both research and mental health services with Latino parents. The results support the inclusion of etiological beliefs and cultural factors in research examining help-seeking and access to mental health services among Latino families and suggest that the incorporation of alternative etiological beliefs about child behavior may be an important factor in culturally-appropriate mental health services.