Janine Coates1, John A Taylor2, Kapil Sayal3. 1. Division of Psychology, Nottingham Trent University, UK. 2. NIHR Collaboration for Leadership in Applied Health Research and Care Nottinghamshire, Derbyshire and Lincolnshire. 3. Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, UK kapil.sayal@nottingham.ac.uk.
Abstract
OBJECTIVE: To evaluate the evidence base relating to the effectiveness of parent-administered behavioral interventions for ADHD. METHOD: A systematic review of randomized controlled trials or non-randomized but adequately controlled trials for children with ADHD or high levels of ADHD symptoms was carried out across multiple databases. For meta-analyses, the most proximal ratings of child symptoms were used as the primary outcome measure. RESULTS: Eleven studies met inclusion criteria (603 children, age range = 33-144 months). Parenting interventions were associated with reduction in ADHD symptoms (Standardized Mean Difference [SMD] = 0.68; 95% confidence interval [CI] [0.32, 1.04]). There was no evidence of attenuation of effectiveness after excluding studies where medication was also used. Parenting interventions were also effective for comorbid conduct problems (SMD = 0.59; 95% CI [0.29, 0.90]) and parenting self-esteem (SMD = 0.93; 95% CI [0.48, 1.39]). CONCLUSION: These findings support clinical practice guidelines and suggest that parenting interventions are effective. There is a need to ensure the availability of parenting interventions in community settings.
OBJECTIVE: To evaluate the evidence base relating to the effectiveness of parent-administered behavioral interventions for ADHD. METHOD: A systematic review of randomized controlled trials or non-randomized but adequately controlled trials for children with ADHD or high levels of ADHD symptoms was carried out across multiple databases. For meta-analyses, the most proximal ratings of child symptoms were used as the primary outcome measure. RESULTS: Eleven studies met inclusion criteria (603 children, age range = 33-144 months). Parenting interventions were associated with reduction in ADHD symptoms (Standardized Mean Difference [SMD] = 0.68; 95% confidence interval [CI] [0.32, 1.04]). There was no evidence of attenuation of effectiveness after excluding studies where medication was also used. Parenting interventions were also effective for comorbid conduct problems (SMD = 0.59; 95% CI [0.29, 0.90]) and parenting self-esteem (SMD = 0.93; 95% CI [0.48, 1.39]). CONCLUSION: These findings support clinical practice guidelines and suggest that parenting interventions are effective. There is a need to ensure the availability of parenting interventions in community settings.
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