The effects of EMG-assisted relaxation training on the academic performance, locus of control, and self-esteem of hyperactive boys

Denkowski, Kathryn M.; Denkowski, George C.; Omizo, Michael M.

doi:10.1007/bf00998746

Cited by 28 publications

(29 citation statements)

References 38 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%

“…Treatment as usual refers to a usual school routine and/or treatment obtained in the community relative to the participants in the study's treatment arm. Eight RCTs 154,157,158,174,175,176,181,188 and 1 non-RCT 191 included comparators that were matched to the treatment group (i.e. irrelevant content, matched for time/contact).…”

Section: Study and Participant Information: Descriptive Statisticsmentioning

confidence: 99%

“…Within each treatment group, the number of intervention packages ranged from one to six. Using the total number of RCT treatment groups as the denominator (n = 47), 45% (n = 21 [154][155][156][157]162,165,166,[169][170][171]177,179,180,[183][184][185][186] ) included one package; 38% (n = 18 142,153,157,158,161,[163][164][165]167,168,[173][174][175][176][177]178,181,182,187,188 ) two treatment packages; 11% (n = 5 143,153,159,160 ) three treatment packages; 2% (n = 1 172 ) four treatment packages; and 4% (n = 2 104 ) six treatment packages.…”

Section: Interventionsmentioning

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%

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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: Interventionsmentioning

confidence: 99%

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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“…Denkowski, Denkowski, and Omizo (1983) randomly assigned hyperactive junior high school boys to six 25-minute EMG-assisted relaxation training sessions (n = 24) or to a control condition (n = 24); the treated group attained significantly higher reading and language performance and made a significant internal shift in locus of control. In 10 hyperactive boys age 6-12, Dunn and Howell (1982) found significant improvement in behavior observations, parent ratings, and psychological tests after 10 relaxation training sessions but none after 10 neutral sessions.…”

Section: Emg Biofeedback Relaxation Training and Hypnosismentioning

confidence: 99%

Treatment alternatives for Attention-Deficit! Hyperactivity Disorder (ADHD)

Arnold

1999

J Atten Disord

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Results:Twenty-three alternate Tx were identified, ranging in scientific documentation from discrediting controlled studies through mere hypotheses to positive controlled double-blind clinical trials. Many of them are applicable only to a restricted etiological subgroup. The oligoantigenic or few-foods diet has convincing double-blind evidence of efficacy in multiple trials for a properly selected subgroup. Enzyme-potentiated desensitization to foods, relaxation/EMG biofeedback, and deleading also have controlled evidence of efficacy. Glyconutritional supplementation, iron supplementation, magnesium supplementation, Chinese herbals, EEG biofeedback, meditation, mirror feedback, channel-specific perceptual training, and vestibular stimulation all have promising prospective pilot data. Single-vitamin megadosage has some intriguing pilot trial data. Zinc supplementation is hypothetically supported by systematic case-control data but has no systematic clinical trial. Laser acupuncture has promising unpublished pilot data. Essential fatty acid supplementation has promising systematic case-control data but clinical trials are equivocal. Recommended-Daily-Allowance vitamin supplementation, nonChinese herbals, homeopathic remedies, and antifungal therapy have no systematic data in ADHD. Megadose multivitamin combinations are probably ineffective for most patients and possibly dangerous. Simple sugar restriction and hypnosis seem ineffective. Amino acid supplementation, though mildly effective in the short term, is not effective beyond a few weeks. Thyroid Tx is effective in the presence of documented thyroid abnormality, but not otherwise. ConclusionSome alternate Tx of ADHD are effective or probably effective, but mainly for restricted etiologic subgroups. In some cases they are the Tx of choice, and initial evaluation should consider the relevant etiologies. A few have failed to prove effective in controlled trials. Most need research to determine whether they are effective and/or to define the applicable subgroup. Some of them, though not safer than standard Tx, may be preferable for an etiologic subgroup.

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School‐based interventions for attention‐deficit/hyperactivity disorder: A systematic review with multiple synthesis methods

Moore

Russell

Matthews

et al. 2018

Review of Education

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Non‐pharmacological interventions for attention‐deficit/hyperactivity disorder are useful treatments, but it is unclear how effective school‐based interventions are for a range of outcomes and which features of interventions are most effective. This paper systematically reviews randomised controlled trial evidence of the effectiveness of interventions for children with ADHD in school settings. Three methods of synthesis were used to explore the effectiveness of interventions, whether certain types of interventions are more effective than others and which components of interventions lead to effective academic outcomes. Twenty‐eight studies (n = 1807) were included in the review. Eight types of interventions were evaluated and a range of different ADHD symptoms, difficulties and school outcomes were assessed across studies. Meta‐analyses demonstrated beneficial effects for interventions that combine multiple features (median effect size g = 0.37, interquartile range 0.32, range 0.09–1.13) and suggest some promise for daily report card interventions (median g = 0.62, IQR = 0.25, range 0.13–1.62). Meta‐regression analyses did not give a consistent message regarding which types of interventions were more effective than others. Finally, qualitative comparative analysis demonstrated that self‐regulation and one‐to‐one intervention delivery were important components of interventions that were effective for academic outcomes. These two components were not sufficient though; when they appeared with personalisation for individual recipients and delivery in the classroom, or when interventions did not aim to improve child relationships, interventions were effective. This review provides updated information about the effectiveness of non‐pharmacological interventions specific to school settings and gives tentative messages about important features of these interventions for academic outcomes.

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The effects of EMG-assisted relaxation training on the academic performance, locus of control, and self-esteem of hyperactive boys

Cited by 28 publications

References 38 publications

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

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

Treatment alternatives for Attention-Deficit! Hyperactivity Disorder (ADHD)

School‐based interventions for attention‐deficit/hyperactivity disorder: A systematic review with multiple synthesis methods

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