A Controlled Study of Parent Training in the Treatment of ADHD in Young Children (D'SNAPP). http://clinicaltrial.gov/;NCT01684644.

Attention Deficit Hyperactivity Disorder (ADHD) is a lifespan disorder associated with considerable economic cost. While the economic burden of ADHD has been widely estimated, there is considerable variation in reported costs between studies, which typically focus on health outcomes only, lack adequate control and fail to correct for the influence of genetic and shared environmental factors. The aim of this study is to overcome these limitations to reach a fuller understanding of the economic burden of ADHD. Method: Using the Danish National Registers 5269 adults with a diagnosis of ADHD in adulthood who had not received a diagnosis in childhood were identified. Excluding cases with missing data, comorbid diagnoses, and cases without a same sex sibling free of any diagnosed psychiatric diagnoses, a final cohort was formed consisting of 460 sibling dyads. Using a cross-sectional method focusing on the year 2010, cost differences between each adult with ADHD and their sibling were calculated from data retrieved from health, education, crime, employment and social care registers. Results: Adults with ADHD had considerably lower disposable income and paid less tax than their siblings. They also received more state benefits, had higher costs for health, social care, and crime than their siblings. The total average costs difference for the year 2010 was 20,134 euros more than their sibling for each adult with ADHD. Conclusion: ADHD is associated with considerable costs which are borne by both the individual and the state and underlines the need to consider the wider economic impact of ADHD beyond income and healthcare utilisation costs.

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Abstract:The New Forest Parenting Programme (NFPP) is a parenting program developed for parents who have a child with attentiondeficit hyperactivity disorder (ADHD). It is a manualized program that is delivered in a parent's home over 8 weeks, or in a group format, or through a self-help manual. Three randomized controlled trials have been carried out in the United Kingdom. The NFPP group has adapted the program according to feedback from parents and therapists, and for use with different populations, both within the United Kingdom and internationally. The first international trial took place in New York, United States. Trials in Denmark, Hong Kong, and Japan followed. More recently, a trial of the self-help manual has been carried out in mainland China. This paper will outline the adaptions that were needed in order to be able to deliver the program in different countries with their own expectations of parenting, culture, and language. Training had to be differently focused; manuals and handouts had to be revised, translated and back-translated; and supervision had to be delivered at a distance to maintain the fidelity of the program. The international group will outline their experience of running trials in their own countries with the NFPP in a face-to-face format (Denmark), a group format (Hong Kong and Japan), and a self-help format (mainland China). Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent disorder affecting around 4% of preschool and school-aged children worldwide (Egger & Angold, 2006;Polanczyk, de Lima, Horta, Biederman, & Rohde, 2007). The presence of ADHD in preschool-aged children is associated with a clear risk of later educational difficulties (Washbrook, Propper, & Sayal, 2013) and ADHD leads to family-borne costs (e.g. time off work, cost of damage in the home) as well as increased health and education costs (Chorozoglou et al., 2015). The challenges of bringing up a child with ADHD are compounded when parents lack social and educational resources to cope with and manage that child's difficult and challenging behavior (Larsson, Sariaslan, Långström, D'Onofrio, & Lichtenstein, 2014). KeywordsParents who have ADHD themselves (Sonuga-Barke, Dalen, Daley, & Remington, 2002) or mental illness will find parenting a child with ADHD more difficult (Chronis et al., 2007).One of the main targets of the New Forest Parenting Programme (NFPP) is working with the parent to improve self-regulation in their child. Thus, it was important to discuss with the group leaders in each country in which we were going to train, what the influences were behind the development of self-regulation in the children in their culture. Parenting children with ADHD: Enhancing the development of self-regulationSelf-regulation develops over the first 4 years of a child's life as they gradually learn to comply with parental commands ("Do" commands and "Don't" commands), internalize social rules, and develop effortful control to control their impulses, emotions, and actions (Keller et al., 2004;Kochanska, C...

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