Protocol Evaluating the effectiveness of a school-based group programme for parents of children at risk of ADHD: the ‘PArents, Teachers and CHildren WORKing Together (PATCHWORK)’ cluster RCT protocol

Abstract

IntroductionEarly intervention for childhood behavioural problems may help improve health and educational outcomes in affected children and reduce the likelihood of developing additional difficulties. The National Institute for Health and Clinical Excellence guidelines for attention deficit/hyperactivity disorder (ADHD), a common childhood behavioural disorder, recommend a stepped care approach for the identification and management of these problems. Parents of children with high levels of hyperactivity and inattention may benefit from intervention programmes involving behavioural management and educational approaches. Such interventions may be further enhanced by providing training and feedback to teachers about the strategies discussed with parents. In relation to children with high levels of hyperactivity, impulsiveness and inattention, we aim to test the feasibility and effectiveness of a parenting programme (with and without an accompanying teacher session) in primary schools.Methods and analysisThis clustered (at the level of school) randomised controlled trial (RCT) focuses on children in their first four school years (ages 4–8 years) in the East Midlands area of England. Parents will complete a screening measure, the Strengths and Difficulties Questionnaire, to identify children with high levels of hyperactivity/inattention. Three approaches to reducing hyperactivity and attention problems will be compared: a group programme for parents (parent-only intervention); group programme for parents combined with feedback to teachers (combined intervention); and waiting list control (no intervention). Differences between arms on the short version of Conners’ Parent and Teacher Rating Scales Revised will be compared and also used to inform the sample size required for a future definitive cluster RCT. A preliminary cost-effectiveness analysis will also be conducted.Ethics and disseminationThe outcomes of this study will inform policy makers about the feasibility, acceptability and effectiveness of delivering targeted behavioural interventions within a school setting. The study has received ethical approval from the University of Nottingham Medical School Ethics Committee.Trial registrationISRCTN87634685

Effectiveness and cost‐effectiveness of a brief school‐based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial

“…Further details are given in the trial protocol (Sayal et al . ). Eligible schools were large, mixed‐sex primary schools across three counties of the East Midlands, UK (Nottinghamshire, Derbyshire and Lincolnshire), incorporating a range of socio‐economic status.…”

“…As described in the trial protocol (Sayal et al . ), the outcome measures were completed 6 months after baseline. These included the short version of Conners' Parent and Teacher Rating Scales – Revised (Conners ).…”

“…As described in the trial protocol (Sayal et al . ), we anticipated that there would be a greater reduction in ADHD symptoms in children whose parents and/or teachers received the intervention compared with children in the no intervention (control) arm.…”

“…The study design was a three-arm cluster randomised controlled trial (the 'PATCHWORK' study -parents, teachers and children working together), with school as the unit of allocation and individual children as the unit of analysis (using measures completed by participating parents and teachers). Further details are given in the trial protocol (Sayal et al 2012 (Goodman 1999). The SDQ is a widely used measure of childhood mental health and includes four sub-scales relating to emotional problems, conduct problems, hyperactivity/inattention and peer relationships, with higher scores (scale of 0-10) indicating greater levels of severity.…”

Adaptation of the “Incredible Years Child Training Program” and Investigation of the Effectiveness of the Program

“…As this period is determinant in terms of development, many intervention programs such as "I Can Problem Solve" and "First Step to Success," aimed at supporting development, are targeted at children aged 3-6 (Baydar et al, 2010). Social and emotional intervention programs assist children exhibiting behavioral problems in fulfilling their educational attainment and healthy development, and also in reducing the possibility of other problematic conditions arising (Sayal et al, 2012). In the context of an interdisciplinary approach, studies have found that social-emotional intervention programs provide significant positive gain, encouraging competence and life skills to the benefit of children's mental health and sound condition (Tennant, Goens, Barlow, Day, & Stewart-Brown, 2007;Weare & Nind, 2011;Wells, Barlow, & Stewart-Brown, 2003).…”