Predictors of Response to Behavioral Treatments Among Children With ADHD-Inattentive Type

Abstract

Objective: To examine baseline characteristics – child gender, IQ, age, internalizing problems, symptoms of hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), and sluggish cognitive tempo, and parent income, education, attention deficit/hyperactivity disorder (ADHD) severity, and anxiety/depression (A/D) -- associated with response to behavioral treatments for ADHD, predominantly inattentive type. Method: We employed data from 148 children (M = 8.7 years), 58% male, and 57% Caucasian in a randomized clinical trial. Positive treatment response was defined as (a) five or fewer inattentive symptoms, and (b) a decrease of at least three inattentive symptoms from baseline to post-treatment. Results: Child HI, parental A/D, and child IQ were associated with positive response, as follows: Child HI had a main effect in which it was negatively associated with treatment response (36% with two or more HI symptoms were positive responders versus 59% of those with one or fewer symptom) that was qualified by parental A/D and child IQ. When children had two or more symptoms of HI and higher parental A/D, positive response rate was low 25%; when children had two or more symptoms of HI, low parental A/D, and an IQ of 105 or more, positive response rate was 85%. Furthermore, the group with the poorest response rate (25%) had parents who self-reported greater ADHD severity, and the group with a relatively good rate of positive response (59%) had the lowest number of ODD symptoms. Conclusion: Likelihood of positive response to our behavioral treatment for ADHD-I is dependent on child and parent factors.

Parent Education for Young Children With Autism and Disruptive Behavior: Response to Active Control Treatment

“…Although PEP did not provide instruction on parent-child interaction, nearly 40% of children in PEP showed a positive response when assessed by an independent evaluator who was masked to treatment condition. In parent-mediated interventions for children with disruptive behavior (not accompanied by ASD), maternal mental health, child clinical characteristics, and parenting style, have been identified as predictors of treatment outcome (e.g., Beauchaine, Webster-Stratton, & Reid, 2005; Hoza et al, 2000; Owens, Hinshaw, McBurnett, & Pfiffner, 2016; Webster-Stratton & Hammond, 1990). Here, we explore the characteristics of children who benefited from PEP, whether parents of these children also benefited, and whether the observed benefits were similar to children who showed a positive response to PT.First, we examineddifferences in pre-treatment measures of child disruptive behavior, child adaptive behavior, and parent self-report measures in children who showed a positive response to PEP compared to those who did not.…”

Individual Variability in Reaction Time and Prediction of Clinical Response to Methylphenidate in Adult ADHD: A Prospective Open Label Study Using Conners’ Continuous Performance Test II

“…The literature presents variable and partly conflicting results concerning the use of clinical data to predict response to MPH. Age, weight, gender, comorbid anxiety or oppositional defiant disorder, IQ, academic achievement, disease duration, severity of symptoms, level of maternal ADHD symptoms, and prior atomoxetine use have all been shown to have some predictive effect (Buitelaar et al, 2011; Buitelaar, Van Der Gaag, Swaab-barnkvhld, & Kuipkr, 1995; Chazan et al, 2011; Fredriksen, Dahl, Martinsen, Klungsoyr, Haavik, et al, 2014; Ishii-Takahashi et al, 2015; Johnston et al, 2015; Setyawan et al, 2015; Treuer et al, 2014; Wong et al, 2017). It has been difficult to predict treatment response to stimulants using neuropsychological tests in ADHD patient as well, and results from these studies have also been conflicting (Coghill et al, 2007; Wong et al, 2017).…”

Maternal personality traits moderate treatment response in the Multimodal Treatment Study of attention-deficit/hyperactivity disorder

“…Family preferences, characteristics, and resources can influence the effects of interventions [4][5][6][7]. For example, some families may refuse medications or struggle to manage the demands of behavioral treatments amidst a chaotic home environment, psychosocial stressors, or parental psychopathology [6,[8][9][10]. Therefore, a "one size fits all" approach to treatment may lead to a mismatch between families and interventions [11,12].…”

“…Such parent/family variables are also relevant in the treatment of childhood ADHD. For example, high parental anxiety/depression predicted poor response to behavioral interventions in one RCT [6]. In the Multimodal Treatment Study of ADHD (MTA), higher parental education was associated with enhanced response of children's ADHD symptoms to combination treatment (Comb-medication management and multicomponent behavioral treatment); children from blue-collar and lower SES homes similarly benefited most from Comb in terms of oppositional-aggressive symptoms [10].…”

“…In addition, ethnicity moderated outcomes in the MTA, such that ethnic minority families (African American, Latino) benefitted most from Comb [ 19 ]. Although exceptions to these findings exist [ 20 ], parental psychosocial factors and psychiatric symptoms are implicated in the phenomenology and treatment response among children with ADHD [ 6 , 7 , 10 , 19 ].…”