Review: Which components of behavioral parent and teacher training work for children with <scp>ADHD</scp>? – a metaregression analysis on child behavioral outcomes

Hornstra, Rianne; Groenman, Annabeth P.; Oord, Saskia Van der; Luman, Marjolein; Dekkers, Tycho J.; Veen-Mulders, Lianne van der; Hoekstra, Pieter J.; Hoofdakker, Barbara J. van den

doi:10.1111/camh.12561

Cited by 20 publications

(28 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For example, participants in both conditions participated in comprehensive psychoeducational evaluations, which included feedback sessions that provided psychoeducation about ADHD and associated difficulties as needed. However, psychoeducation alone has failed to improve ADHD-related emotion dysregulation and higher doses of psychoeducation may be iatrogenic for ADHD-related treatment outcomes (84)(85)(86). Additionally, both CET and ICT included routine contact with the study team.…”

Section: Discussionmentioning

confidence: 99%

Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial

et al. 2022

View full text Add to dashboard Cite

IntroductionApproximately 48–54% of children with attention-deficit/hyperactivity disorder (ADHD) have impairing difficulties with emotion regulation, and these difficulties are not ameliorated by first-line ADHD treatments. Working memory and inhibitory control represent promising intervention targets given their functional, if not causal, links with ADHD-related emotion dysregulation.MethodsThis preregistered randomized controlled trial tested whether two digital therapeutic training protocols that have been previously shown to improve working memory (Central Executive Training [CET]) and inhibitory control (Inhibitory Control Training [ICT]) can improve emotion regulation in a sample of 94 children with ADHD aged 8–13 years (M = 10.22, SD = 1.43; 76% White/non-Hispanic; 29 girls).ResultsResults of Bayesian mixed model ANOVAs indicated both treatment groups demonstrated significant decreases in emotion dysregulation relative to pre-treatment at immediate post-treatment (parent report; d = 1.25, BF10 = 8.04 × 1013, p < 0.001), at 1–2 months after completing treatment (teacher report; d = 0.99, BF10 = 1.22 × 106, p < 0.001), and at 2–4-months follow-up (parent report; d = 1.22, BF10 = 1.15 × 1014, p < 0.001). Contrary to our hypotheses, the CET and ICT groups demonstrated equivalent reductions in emotion dysregulation and maintenance of effects. Exploratory analyses revealed that results were robust to control for informant expectancies, ADHD medication status/changes, in-person vs. at-home treatment, child age, and time from treatment completion to post-treatment ratings.DiscussionTo determine whether working memory and inhibitory control are causally linked with ADHD-related emotion dysregulation, future studies should include active control conditions that do not train executive functions prior to making decisions about the clinical utility of CET/ICT for the treatment of emotion dysregulation in ADHD.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT03324464].

show abstract

Section: Discussionmentioning

confidence: 99%

Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The 15-week self-help parenting program consists of a manual and online program divided in 11 modules. It includes psycho-education regarding externalizing behavior and provides parents with behavioral parenting techniques to modify the externalizing behavior of their child (Dekkers et al, 2022;Hornstra et al, 2022;Kaminski et al, 2008). In depth guidance is provided on the behavioral techniques with detailed description of praising, playing with your child in a positive way, providing structure in time and in the child's environment, setting and maintaining clear rules and providing clear instructions, providing rewards, ignoring unwanted behavior, mildly punishing unacceptable behavior, and coping with temper tantrums.…”

Section: Materials Interventionmentioning

confidence: 99%

Efficacy of a Self-help Parenting Program on Parental Outcomes: a Randomized Controlled Trial

de Jong,

Hoofdakker,

Veen-Mulders

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

The efficacy of our newly developed self-help parenting program on children’s externalizing behavior was recently shown. The present study investigated its efficacy on parental outcomes, which is understudied in clinical trials. Using a randomized controlled trial, 110 parents were allocated to an intervention condition (either with or without telephonic support) or a waitlist condition. Outcomes included the Parenting Practices Interview (PPI; positive and negative parenting practices), Parenting Sense of Competence Scale (PSOC), Parenting Stress Index (PSI) and Eyberg Child and Behavior Inventory - Problem Scale (ECBI-P; the number of child behaviors that parents perceive as troublesome). All measures were collected at baseline (T0) and post intervention (after 15 weeks, T2); PPI and ECBI-P were also collected at week 8 (T1) and 28 (T3). Using longitudinal multi-level regression analyses, we compared the intervention and waitlist condition at T2. Furthermore, the support and no support conditions were exploratively compared at T2 and T3. Comparing intervention to waitlist, results showed medium-sized effects on PPI and ECBI-P scores and a small-sized effect on PSI scores, and no differences between the conditions on PSOC scores. No differences were found between the support and the no-support condition. The results indicate that our self-help program improved parenting practices and parents’ perception of child behavior, in addition to previous findings on child outcomes. This confirms that self-help parenting programs may be a promising alternative to face-to-face programs, although future studies should focus on determining for whom and in which settings which parenting programs are most helpful..

show abstract

“…Behavioral parent training is the rst psychosocial treatment of choice for reducing behavioral di culties in preschool and school aged children (Akwa GGZ, 2019;Brestan & Eyberg, 1998 In behavioral parent training, parents are taught techniques to curtail children's behavioral di culties by avoiding or breaking coercive parent-child interactions (McMahon & Forehand, 2003). Parenting programs have moderate short-term effects on child conduct problems (Leijten et al, 2020), oppositional behavior (Bakker et al, 2017;McCart et al, 2006), inattentive and hyperactive/impulsive behavior (Daley et al, 2017;Hornstra et al, 2022a), and parenting (Dekkers et al, 2022a). The longer-term effects of behavioral parent training are less consistent: A meta-analysis on behavioral parent training for children with attention de cit/hyperactivity disorder (ADHD) found mostly sustained effects ve months to one year after the intervention (Doffer et al, 2023), while a meta-analysis on behavioral parent training for children with disruptive behaviors (e.g., tantrums, arguing, rule-breaking) shows a large heterogeneity in results, with some studies showing sustained effects and other studies showing fade-out effects or sleeper effects three years after the intervention (Van Aar et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…To address this need, this randomized controlled trial evaluates the effectiveness of a brief and individually tailored behavioral parent training program with optional booster sessions for children with behavioral di culties. The program is based on intervention elements that were effective in reducing children's behavioral di culties in the broader literature and our earlier work: antecedent techniques (i.e., stimulus control techniques) and consequent techniques (i.e., contingency management techniques) (Hornstra et al, 2022a;Kaminski et al, 2008;Leijten et al, 2019). Antecedent techniques are aimed at changing child behavior by manipulating the antecedents of this behavior (e.g., by setting clear rules and providing structure) and consequent behavioral techniques are aimed at changing child behavior by manipulating their consequences (e.g., by praising desired behavior and ignoring undesired behavior).…”

Section: Introductionmentioning

confidence: 99%

The Short- and Longer-Term Effects of Brief Behavioral Parent Training Versus Care as Usual in Children with Behavioral Difficulties: Study Protocol for a Randomized Controlled Trial

Doornik,

Oord,

Luijckx

et al. 2024

Preprint

View full text Add to dashboard Cite

Background The access to and uptake of evidence-based behavioral parent training for children with behavioral difficulties (i.e., oppositional, defiant, aggressive, hyperactive, impulsive, and inattentive behavior) are currently limited because of a scarcity of certified therapists and long waiting lists. These problems are in part due to the long and sometimes perceived as rigid nature of most evidence-based programs and result in few families starting behavioral parent training and high dropout rates. Brief and individually tailored parenting interventions may reduce these problems and make behavioral parent training more accessible. This protocol paper describes a two-arm, multi-center, randomized controlled trial on the short- and longer-term effectiveness and cost-effectiveness of a brief, individually tailored behavioral parent training program for children with behavioral difficulties. Methods Parents of children aged 2–12 years referred to a child mental healthcare center are randomized to (i) three sessions of behavioral parent training with optional booster sessions or (ii) care as usual. To evaluate effectiveness, our primary outcome is the mean severity of five daily ratings by parents of four selected behavioral difficulties. Secondary outcomes include measures of parent and child behavior, well-being, and parent-child interaction. We explore whether child and parent characteristics moderate intervention effects. To evaluate cost-effectiveness, the use and costs of mental healthcare and utilities are measured. Finally, parents’ and therapists’ satisfaction with the brief program are explored. Measurements take place at baseline (T0), one week after the brief parent training, or eight weeks after baseline (in case of care as usual) (T1), and six months (T2) and twelve months (T3) after T1. Discussion The results of this trial could have meaningful societal implications for children with behavioral difficulties and their parents. If we find the brief behavioral parent training to be more (cost-)effective than care as usual, it could be used in clinical practice to make parent training more accessible. Trial registration: The trial is prospectively registered at ClinicalTrials.gov (NCT05591820) on October 24th, 2022 and updated throughout the trial.

show abstract

Review: Which components of behavioral parent and teacher training work for children with ADHD? – a metaregression analysis on child behavioral outcomes

Cited by 20 publications

References 65 publications

Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial

Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial

Efficacy of a Self-help Parenting Program on Parental Outcomes: a Randomized Controlled Trial

The Short- and Longer-Term Effects of Brief Behavioral Parent Training Versus Care as Usual in Children with Behavioral Difficulties: Study Protocol for a Randomized Controlled Trial

Contact Info

Product

Resources

About