Early Intervention for Preschoolers at Risk for Attention-Deficit/Hyperactivity Disorder: Preschool First Step to Success

Abstract

This study evaluated the efficacy of the Preschool First Step (PFS) to Success early intervention for children at risk for attention deficit hyperactivity disorder (ADHD). PFS is a targeted intervention for children 3–5 years old with externalizing behavior problems and addresses secondary prevention goals and objectives. As part of a larger multisite, randomized controlled trial, the efficacy of the PFS program was evaluated on a subsample of 45 children who also had elevated comorbid ADHD symptoms as rated by parents and teachers. The PFS program was found to produce significantly higher social skills, and significantly fewer behavior problems across a variety of teacher-and parent-reported measures at postintervention. Effect sizes for teacher-reported effects were large across a variety of social competency indicators, including those specific to ADHD. Effect sizes for parent-reported social skills and problem behaviors were medium. Although not specifically designed for preschoolers at risk for comorbid ADHD, this generic behavioral intervention appeared to be successful for this population. Implications and limitations of the study are discussed.

Efficacy Validation of the Revised First Step Program: A Randomized Controlled Trial

“…Utilizing the same sample, we then separately examined the affect of First Step on subsamples of preschoolers at risk for comorbid psychiatric disorders. Children at risk for ADHD, for example, did particularly well (ESs ranged from 0.6 to 1.2) not only on the same outcome measures noted previously but also on measures specific to ADHD (Feil et al, 2016). Children in a subsample at risk for comorbid autism spectrum disorder (ASD) also did well but were slightly more variable in their outcomes especially in regard to ASD-specific measures (Frey et al, 2015).…”

“…First, research demonstrating these effects with a community-implementation sample (i.e., school-based as compared to a research-based implementation) would increase external validity and be a significant resource to behavioral and educational providers. It might also be interesting to conduct subsample analyses to examine the FSN effects on students with risk status for ADHD, ASD, or comorbid anxiety disorders and, therefore, replicate previous findings in this regard (Feil et al, 2016; Frey et al, 2015; Seeley et al, 2016). Additionally, it is important to examine (a) longer-term behavioral and academic outcomes using longitudinal tracking methods, (b) the trajectory of behavioral and academic outcomes over time, and (c) the parallel trajectory of behavioral and academic outcomes in relation to one another.…”

The Right to Dignity or Disorder? The Case for Attention Deficit Hyperactivity Diversity

“…Along with the ADHD label children and their families receive social supports, treatment options, educational accommodations in school, an explanation for their difficulties and access to knowledge and understanding. For children with ADHD, intervention may be essential to provide support and avoid negative outcomes 42 . However, on the other hand, labelling may result in social oppression and exclusionary practices, which can harm the child's dignity, and in so doing prevent their participation in things like school and future employment.…”

Combined association of BTEX and material hardship on ADHD‐suggestive behaviours among a nationally representative sample of US children

“…Typically, diagnosis occurs in children older than 7 years of age due to difficulty ascertaining ADHD‐related behaviours in younger children. Identifying behaviours associated with ADHD can provide a path to earlier diagnosis and intervention . Previous research suggests ADHD aetiology and degree of severity involves genetic, environmental, and social factors .…”

“…However, there remains a gap in the literature illuminating whether the relationships between ambient air pollutants, material hardship, and neurocognitive outcomes also occur in the broader United States paediatric population. Additionally, it is not clear whether these relationships can be identified earlier in childhood, before ADHD diagnosis …”