Effectiveness of Specific Techniques in Behavioral Teacher Training for Childhood ADHD Behaviors: Secondary Analyses of a Randomized Controlled Microtrial

Abstract

Behavioral teacher training is an effective intervention for children with attention-deficit/hyperactivity disorder (ADHD). Intervention effectiveness may be enhanced by including intervention components that carry the strongest evidence for their effectiveness. A previous article of this group showed that both antecedent- (i.e., stimulus-control) and consequent-based (i.e., contingency management) techniques were highly effective in reducing daily teacher-rated, individually selected problem behaviors in a specific situation of the child. Effects were observed up to three months post intervention. Here, we tested whether effects were also present in teacher-rated and masked DSM-based assessments that comprise the full range of ADHD and oppositional defiant disorder (ODD) symptoms, as well as on teacher-rated impairment. Teachers of 90 children with (subthreshold) ADHD (6–12 years) were randomly assigned to one of three conditions: a short (two sessions), individualized intervention consisting of either a) antecedent-based techniques or b) consequent-based techniques; or c) waitlist. Multilevel analyses showed that both sets of techniques were effective in reducing teacher-rated ADHD symptoms and impairment immediately after the intervention and up to three months later, as compared to waitlist. Masked observations of ADHD behavior were in line with teacher ratings, with effects being most pronounced for inattention. No effects on teacher-rated or masked ODD behavior were found. This study showed that antecedent- and consequent-based techniques were effective in improving classroom ADHD symptoms and impairment. Long-term changes in teacher-rated ADHD are promising. These results extend previous findings and show the potential of short individually tailored interventions in classroom settings as treatment of ADHD symptoms.

Professional Development: Improving Teachers’ Knowledge and Self-Efficacy Related to Emotional and Behavioral Disorders

“…Furthermore, teacher self-efficacy displayed a marked increase immediately after the training, followed by a slight decline after 5 weeks. This increase is in line with that reported by previous studies on the effectiveness of professional development programs for improving teacher knowledge concerning EBDs (Aguiar et al, 2014; Alshehri et al, 2020; Barbaresi & Olsen, 1998; Corkum et al, 2019; Froelich et al, 2012; Jarque Fernández et al, 2021; Jones et al, 2008; Jongh & Wium, 2021; Kallas et al, 1997; Lasisi et al, 2017; Latouche & Gascoigne, 2019; Maag & Larson, 2004; Miranda et al, 2002; Staff et al, 2022; Syed & Hussein, 2010; Veenman et al, 2019). This increase in knowledge may be a result of the training presented to the participants in this study that was designed, developed, and conducted to meet their overall needs.…”

The Clinical Manifestation, Executive Dysfunction, and Caregiver Strain in Subthreshold Attention-Deficit/Hyperactivity Disorder

“…53 In this sense, interventions directly targeting functional problems, behavioral training for example, should also be recommended. 54 Finally, our results showed that cognitive inflexibility of sADHD increased objective caregiver strain, whose effect was partially mediated through its effect on children's anxiety problems. In comparison, the impaired working memory of sADHD increased objective and subjective aspects of caregiver strain, which is totally mediated by its effect on learning problems of children.…”

“…The above results are in line with previous longitudinal research, demonstrating that functional sequela including ODD and school disciplinary problems, rather than ADHD symptoms, contributed to the lifetime maternal caregiver strain in adolescents and early adults with ADHD [ 53 ]. In this sense, interventions directly targeting functional problems, behavioral training for example, should also be recommended [ 54 ].…”

Use of School-Based Interventions for ADHD, Professional Support, and Burnout Symptoms among Teachers in Iceland

“…Indeed, such evaluations should incorporate teacher observations of a student’s behavior and academic functioning (Pliszka & AACAP Work Group on Quality Issues, 2007; Wolraich et al, 2019). Furthermore, teachers are often responsible for providing this group of students appropriate interventions and accommodations in the classroom to support their academic, behavioral, social, and emotional functioning (DuPaul et al, 2020; Mikami et al, 2022; Staff et al, 2022).…”