Parent and child neurocognitive functioning predict response to behavioral parent training for youth with ADHD

Abstract

Parental cognitive functioning is thought to play a key role in parenting behavior and may inform response to behavioral intervention. This open-label pilot study examined the extent to which parent and child cognition impacted response to behavioral parent training for children with ADHD. Fifty-four participants (27 parent-child dyads; M = 10.6 and 45.2 for children and parents, respectively) completed tasks assessing visuospatial and phonological working memory, inhibitory control, and choice-reaction speed at pre-treatment. Drift diffusion modeling decomposed choice-reaction time data into indicators of processing speed (drift rate) and response caution (boundary separation). Parents completed a 10-week manualized behavioral parent training program. Primary outcomes were pre- and post-treatment child ADHD and conduct problem severity, and parent-reported relational frustration and parenting confidence. Bayesian multiple regressions assessed parent and child cognitive processes as predictors of post-treatment outcomes, controlling for pre-treatment behavior. Better child visuospatial and phonological WM and higher parental response caution were associated with greater reductions in inattention. For conduct problems, better parental self-regulation (stronger inhibitory control and greater response caution) predicted fewer post-treatment conduct problems. Higher parental response caution also predicted lower post-treatment relational frustration and higher parental confidence. Bayesian evidence supported no relation between parent and child cognitive functions and treatment-related changes in hyperactivity. This pilot study demonstrates that cognitive processes central to etiologic theories of ADHD and models of parenting behavior can be successfully integrated into treatment outcome research to inform which families are most likely to benefit from behavioral interventions. This study demonstrates the feasibility of bridging the translational research gap between basic and applied clinical science and facilitates research on the role of cognition in psychosocial interventions.

Which Child Will Benefit From a Behavioral Intervention for ADHD? A Pilot Study to Predict Intervention Efficacy From Individual Reward Sensitivity

“…We found no evidence for the predictive value of heart rate measures or neuropsychological task performance on pre/posttreatment change. Other studies have previously tried to identify and quantify clinically relevant biomarkers of reward sensitivity ( Fosco et al, 2018 ; Luman et al, 2007 ; Tripp & Wickens, 2008 ; van de Wiel et al, 2004 ; Volkow et al, 2001 ). To date, there is no evidence for robust links between neurobiological markers and clinically relevant outcome measures.…”

De Cognitieve Test Applicatie (COTAPP): geavanceerde computertest voor het meten van aandacht, informatieverwerking en executieve functies bij kinderen

“…Deze functies kunnen echter een belangrijke verklaring geven wanneer de schoolresultaten minder goed of beter zijn dan verwacht op basis van enkel de intelligentie (Blair en Razza 2007;Gerst et al 2015). Bovendien kan het niveau van deze cognitieve functies informatie geven over welke aanpak op school of in een behandeling het meest zal helpen (Fosco et al 2018;Molitor en Langberg 2017;Rommelse et al 2016;Van der Oord et al 2012). Tevens kan het testen van cognitieve functies ingezet worden voor wetenschappelijk onderzoek of om het ontwikkelingsverloop en/of behandeleffect in kaart te brengen.…”

ADHD: Reviewing the Causes and Evaluating Solutions

“…As for conduct problems, better parental self-regulation was associated with a better result in this area. However, none of the measured cognitive functions in children or parents were associated with improvements in hyperactivity [ 164 ]. Moreover, behavioral parent training improves coexistence at home, since a reduction in the frequency and severity of problematic situations is produced, along with a reduction of stress in parents [ 165 ].…”