Effects of a school-based cognitive-behavioral intervention for ADHD children

Bloomquist, Michael L.; August, Gerald J.; Ostrander, Rick

doi:10.1007/bf00925822

Cited by 87 publications

(60 citation statements)

References 11 publications

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“…For the non-RCTs, the mean (SD) sample size was 38.1 (26.0) and comprised, on average, a mean (SD) of 23% (0.17) females. Some of the studies described participants as using medication for ADHD (n = 28: 19 RCTs;142,143,(159)(160)(161)(162)164,165,(167)(168)(169)172,173,177,178,180,182,183,186 9 non-RCTs 141,189,[192][193][194]197,[200][201][202] ) whereas some reported that no medication for ADHD was used (n = 11: 9 RCTs; 104,153,158,170,174,175,179,181,187 two non-RCTs 195,196 ). The reports for the remaining 15 studies did not clarify whether or not medication for ADHD was used (n = 15: 11 RCTs; [154][155][156][157]163,…”

Section: Study and Participant Information: Descriptive Statisticsmentioning

confidence: 99%

“…Ten studies 155,153,163,169,178,184,186,192,198,202 were dissertations or theses (n = 10: 7 RCTs; 3 non-RCTs); the remaining were journal articles (n = 42: 104,[141][142][143]153,154,[157][158][159][160][161][162][164][165][166][167][168]170,[172][173][174][175][176][177][179][180][181][182][183]185,[187][188]190,191,[193][194][195][196][197][199]…”

Section: Study and Participant Information: Descriptive Statisticsmentioning

confidence: 99%

“…189 Studies were from North America (n = 44: 104,141-143,153-169,171-176,178,179,181-184,188,189,191-194,197,198,200-202 33 RCTs; 11 non-RCTs); Europe (n = 6: 2 RCTs including one each from the Netherlands 185 and Sweden; 177 4 non-RCTs including 1 from Italy 199 and 3 from Spain 190,195,196 ); Asia (2 RCTs including 1 each from Iran 170 and Jordan 187 ); Africa (1 RCT) 186 and New Zealand (1 RCT). 180 Forty-two studies 104,[141][142][143]153,155,156,[159][160][161][162][163][164][165][166][167][168][170][171][172][173]177,180,[182][183][184][185][186][187]189,190,[192][193][194][195]…”

Section: Study and Participant Information: Descriptive Statisticsmentioning

confidence: 99%

“…The reports for the remaining 15 studies did not clarify whether or not medication for ADHD was used (n = 15: 11 RCTs; [154][155][156][157]163,166,171,176,184,185,188 4 non-RCTs 190,191,198,199 ). The majority of intervention programmes targeted children at elementary/primary school level (n = 40: 28 RCTs; 104,142,143,[153][154][155][156][157][161][162][163]165,[168][169][170]173,[175][176][177][178][179][181][182][183][185][186][187][188] 12 non RCTs [189][190][191][192][193]…”

Section: Study and Participant Information: Descriptive Statisticsmentioning

confidence: 99%

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Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research

Richardson

Moore

Gwernan‐Jones

et al. 2015

Health Technol Assess

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BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by age-inappropriate levels of inattention, impulsivity and hyperactivity. School can be particularly challenging for children with ADHD. Few reviews have considered non-pharmacological interventions in school settings.ObjectivesTo assess the effectiveness of non-pharmacological interventions delivered in school settings for pupils with, or at risk of, ADHD and to explore the factors that may enhance, or limit, their delivery.Data sourcesTwenty electronic databases (including PsycINFO, MEDLINE, EMBASE, Education Resources Information Centre, The Cochrane Library and Education Research Complete) were searched from 1980 to February–August 2013. Three separate searches were conducted for four systematic reviews; they were supplemented with forward and backwards citation chasing, website searching, author recommendations and hand-searches of key journals.Review methodsThe systematic reviews focused on (1) the effectiveness of school-based interventions for children with or at risk of ADHD; (2) quantitative research that explores attitudes towards school-based non-pharmacological interventions for pupils with ADHD; (3) qualitative research investigating the attitudes and experiences of children, teachers, parents and others using ADHD interventions in school settings; and (4) qualitative research exploring the experience of ADHD in school among pupils, their parents and teachers more generally. Methods of synthesis included a random-effects meta-analysis, meta-regression and narrative synthesis for review 1, narrative synthesis for review 2 and meta-ethnography and thematic analysis for reviews 3 and 4.ResultsFor review 1, 54 controlled trials met the inclusion criteria. For the 36 meta-analysed randomised controlled trials, beneficial effects (p < 0.05) were observed for several symptom and scholastic outcomes. Mean weighted effect sizes ranged from very small (d+ < 0.20) to large (d+ ≥ 0.80), but substantial heterogeneity in effect size estimates across studies was reported. Moderator analyses were not able to clarify which intervention features were linked with effectiveness. For review 2, 28 included studies revealed that educators’ attitudes towards interventions ranged in positivity. Most interventions were rated positively or neutrally across different studies. The only intervention that consistently recorded positive attitudes from educators was daily report cards. For review 3, 33 studies met the inclusion criteria. Key findings included tensions regarding the preferred format of interventions, particularly how structured interventions were and the extent to which they are tailored to the child with ADHD. There were mixed views about the impact of interventions, although it was clear that interventions both influence and are influenced by the relationships held by children with ADHD and participants’ attitudes towards school and ADHD. For review 4, 34 studies met the inclusion criteria. Key findings included the importance of causal attributions that teachers, parents and pupils made about ADHD symptoms, the decisions teachers made about treatment, the self-perceptions pupils developed about themselves, the role of the classroom environment and stigma in aggravating ADHD symptoms, and the significant barrier to treatment posed by the common presence of conflict in relationships between pupils–teachers, parents–teachers and pupils–peers in relation to ADHD. An overarching synthesis of the four reviews highlighted the importance of the context affecting interventions. It suggested that ADHD psychoeducation and relationship-building skills are potential implications for interventions.LimitationsThe breadth of both interventions and outcomes in the reviewed studies presented a challenge for categorisation, analysis and interpretation in reviews 1–3. Across reviews, relatively few studies were conducted in the UK, limiting the applicability of findings to UK education. In reviews 1 and 2, the poor methodological quality of some included studies was identified as a barrier to establishing effectiveness or comparing attitudes. In review 3 the descriptive analysis used by the majority of studies constrained theorising during synthesis. Studies in review 4 lacked detail regarding important issues like gender, pupil maturity and school level.ConclusionFindings suggest some beneficial effects of non-pharmacological interventions for ADHD used in school settings, but substantial heterogeneity in effect sizes was seen across studies. The qualitative reviews demonstrate the importance of the context in which interventions are used. Future work should consider more rigorous evaluation of interventions, as well as focus on what works, for whom and in which contexts. Gaps in current research present opportunities for the development and testing of standardised tools to describe interventions, agreement on gold-standard outcome measures assessing ADHD behaviour and testing a range of potential moderators alongside intervention trials.Study registrationThis study is registered as PROSPERO CRD42011001716.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Study and Participant Information: Descriptive Statisticsmentioning

confidence: 99%

Section: Study and Participant Information: Descriptive Statisticsmentioning

confidence: 99%

Section: Study and Participant Information: Descriptive Statisticsmentioning

confidence: 99%

Section: Study and Participant Information: Descriptive Statisticsmentioning

confidence: 99%

See 2 more Smart Citations

Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research

Richardson

Moore

Gwernan‐Jones

et al. 2015

Health Technol Assess

View full text Add to dashboard Cite

show abstract

“…Similarly, more recently developed "cognitive-behavioral" treatments (e.g. self-monitoring, verbal self-instruction, problem-solving training, self-reinforcement) have also failed to promote improvement in the primary symptoms of ADHD or significant changes in the behavior or academic functioning of children diagnosed with ADHD (Abikoff et al, 1988;Bloomquist, August, & Ostrander, 1991;Brown, Borden, Wynne, Spunt, & Clingerman, 1987; National Institute of Health [NIH], 1998). However, children and teens who are being subjected to parental neglect or abuse will often respond favorably to individual and family therapy (as well as community-based interventions from Child Protective Agencies) that address these issues.…”

Section: Adjunctive Treatmentsmentioning

confidence: 99%