Parenting as a Mechanism of Change in Psychosocial Treatment for Youth with ADHD, Predominantly Inattentive Presentation

Abstract

We investigated whether parenting and child behavior improve following psychosocial treatment for Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Presentation (ADHD-I) and whether parenting improvements mediate child outcomes. We analyzed data from a randomized clinical trial investigating the efficacy of a multicomponent psychosocial intervention (Child Life and Attention Skills, CLAS, n = 74) in comparison to Parent-Focused Treatment (PFT, n = 74) and treatment as usual (TAU, n = 51) for youth with ADHD-I (average child age = 8.6 years, range 7-11 years, 58% boys). Child and parent/family functioning were assessed prior to treatment, immediately following treatment, and at follow-up into the subsequent school year using parent and teacher reports of inattention, organization, social skills, academic competency (teachers only), parenting daily hassles, and positive and negative parenting behaviors (parents only). Both treatment groups improved on negative parenting and home impairment, but only CLAS families also improved on positive parenting as well as academic impairment. Improvements in positive and negative parenting mediated treatment effects on child impairment independent of improvements in child inattention, implicating parenting as an important mechanism of change in psychosocial treatment for ADHD-I. Further, whereas parent-focused training produces improvements in negative parenting and impairment at home for children with ADHD-I, a multicomponent approach (incorporating child skills training and teacher consultation) more consistently produces improvements at school and in positive parenting, which may contribute to improvements in social skills into the next school year.

What explains the link between childhood ADHD and adolescent depression? Investigating the role of peer relationships and academic attainment

“…This indicates that the development of interventions targeting the impact of children's ADHD on their peer relationships and academic attainment may have the added benefit of reducing depression risk, in addition to treating core ADHD symptoms. For instance, a number of existing psychosocial interventions available for those with ADHD that target social skills and academic skills [66][67][68] may have the potential to reduce depression risk, though this needs to be formally tested.…”

Inattention in primary school is not good for your future school achievement—A pattern classification study

“…Positive contributions from parents and teachers seem to be essential (see e.g., [ 34 ]). Whereas parent-focused training produces improvements in negative parenting and impairment at home, incorporation of child skill training and teacher consultation may be necessary to produce improvements at school [ 35 ].…”

Brain-computer-interface-based intervention re-normalizes brain functional network topology in children with attention deficit/hyperactivity disorder

“…Attention deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed neuropsychiatric disorders of childhood affecting 3–10% of children 1 . Inattention is the common presentation of ADHD, representing approximately 38–57% of all ADHD cases in the community 2 . Children with inattention symptoms usually present with passive, lethargic attention problems or a deficit of sustained attention, such as procrastination, hesitation, and forgetfulness 2 .…”

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“…Therefore, despite the potential benefit of drug therapy for ADHD in children, medication must be dispensed with caution. Other standard therapy includes psychosocial or behavioral treatment, which may improve the social interaction problems, but have unknown efficacy for inattention problems 2 , 6 . Recently, electroencephalography (EEG)-based neurofeedback systems have been developed as an alternative modality for attention training and shown the effectiveness of recovery of function 7 , 8 .…”