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Parent training interventions for attention deficit hyperactivity disorder

Additional Info

  • Authors: Morris Zwi, Hannah Jones, Camilla Thorgaard, Ann York, Jane A. Dennis
  • Published date: 2012-01-03
  • Coordinating group(s): Social Welfare
  • Type of document: Review, User abstract
  • Title: Parent training interventions for attention deficit hyperactivity disorder
  • See the full review: https://onlinelibrary.wiley.com/doi/10.4073/csr.2012.2
  • English:

    Parent training might help children with ADHD and their parents

    Parent training programmes are psychosocial interventions for parents of children with ADHD aimed at providing parents with techniques they can use to manage their children's challenging behaviour. A new Campbell systematic review shows that parent training might improve the behaviour of children with ADHD and reduce parental stress.

    Although he tries, young William cannot concentrate at school. He fidgets in his chair and he rushes to the window whenever something is happening outside. At home it is as if he never Listens when he is told to do something, and there are often conflicts between him and his parents. William has ADHD, and it is hard on both him and his parents. Parent training, however, could perhaps help William and his parents. A new Campbell systematic review shows that parent training might improve the behaviour of ADHD children, and also reduce parental stress.

    Parent training programmes are psychosocial interventions aimed at providing parents with techniques they can use to manage their children's challenging behaviour. In order to assess the effect of parent training, a research team has produced a Campbell systematic review of the most robust international research results on the subject.

    Promising intervention in several areas

    The systematic review, which carefully evaluates the literature, concludes that parent training appears to be a promising intervention. Five trials that examine the effects of parental training met the inclusion criteria. Based on these studies, researchers found that parent training may improve the overall behaviour of the child. The review also assessed how parent training affects the parents, and concludes that it may boost their confidence in their parental abilities, and reduce parental stress.

    On other outcomes, the studies were too diverse for their results to be combined. In addition to the general behaviour of the child, the review authors also focused on the child’s behaviour at school and at home. Two studies focused on children’s behaviour at home, and one of the studies showed that there was no difference between the parent training intervention and the control group, while the other study concluded that the parent training intervention group did better than the control group. Two of the studies focused on behaviour at school. One study showed no differences between parent training and control condition, while the other study showed positive results for parent training, provided the child was not also suffering from ODD (Oppositional Defiant Disorder). In the latter study, the results were better for girls and for children on medication.

    What is parent training?

    Parent training programmes are psychosocial interventions aimed at providing parents with techniques they can use to manage their children’s challenging behaviour. Parent training is based on the philosophy that the adults around the child can positively impact the child’s behaviour. The idea is that the behaviour can be changed if its antecedents and consequences are changed.

    The design of parent training programmes varies, but the structure is basically the same and is based on the same techniques. In one of the vie studies, the programme was designed as follows: parent training was led by two psychologists and was conducted in groups of parents of up to six children in 12 sessions of two hours’ duration. The groups worked with tools such as structuring the environment, setting rules, giving instructions, anticipating misbehaviours, communicating, reinforcing positive behaviour, ignoring, employing punishment, and implementing a token system. Another important element was psychoeducation, i.e. education about ADHD and its symptoms. Before each training session, parents were to read a chapter in a book that was written specifically for this programme. In addition, in between the sessions, parents were asked to practice using the techniques to which they had been introduced. Some programmes seek to help parents help their children with more than just "rules” or school: for example, some programmes include social skill training to help children make and keep friends.

    Future perspectives

    ADHD is a condition that can have major consequences for the individual and society. Among other things, ADHD may lead to poor education and employment in adulthood. It may also lead to an increased risk of drug abuse and psychological problems. Therefore, it is important for everyone to find out how best to treat the disorder.

    For a long time, research has focused on medical treatment, but in recent years, researchers have started looking into psychosocial treatment such as parent training. The review authors point out that the overall quality of the studies was not as good as could be desired.

    Overall the authors find that the evidence base of the review is not sufficiently strong for recommendations for practice. However, the encouraging findings of the review are good reason to conduct enhanced future research in parent training.

    About the systematic review

    • The systematic review was prepared in an international collaboration between one Danish and four British researchers, who have analysed the best available knowledge.
    • The researchers have searched for quantitative studies in the form of controlled trials (RCTs) and quasi-randomised controlled trials.
    • On the basis of a comprehensive systematic literature search, the researchers identified 12,691 references. After screening these, 112 texts were selected for further examination. Five studies met all of the predetermined inclusion criteria and the systematic review is based on these.
    • The studies were conducted in the US (3), Canada (1) and the Netherlands (1) in the years 1993-2010.
    • Studies have between 24-96 participants, a total of 284 children aged 4-13 years.
    • Most children received medical treatment for ADHD at the time of the trial.
    • The review authors also wanted to investigate the effect of parent training on the child’s academic achievement, the parents’ understanding of ADHD, and any adverse effects of the treatment. However, none of the studies reported any data on these objectives.

Select language:

Parent training might help children with ADHD and their parents

Parent training programmes are psychosocial interventions for parents of children with ADHD aimed at providing parents with techniques they can use to manage their children's challenging behaviour. A new Campbell systematic review shows that parent training might improve the behaviour of children with ADHD and reduce parental stress.

Although he tries, young William cannot concentrate at school. He fidgets in his chair and he rushes to the window whenever something is happening outside. At home it is as if he never Listens when he is told to do something, and there are often conflicts between him and his parents. William has ADHD, and it is hard on both him and his parents. Parent training, however, could perhaps help William and his parents. A new Campbell systematic review shows that parent training might improve the behaviour of ADHD children, and also reduce parental stress.

Parent training programmes are psychosocial interventions aimed at providing parents with techniques they can use to manage their children's challenging behaviour. In order to assess the effect of parent training, a research team has produced a Campbell systematic review of the most robust international research results on the subject.

Promising intervention in several areas

The systematic review, which carefully evaluates the literature, concludes that parent training appears to be a promising intervention. Five trials that examine the effects of parental training met the inclusion criteria. Based on these studies, researchers found that parent training may improve the overall behaviour of the child. The review also assessed how parent training affects the parents, and concludes that it may boost their confidence in their parental abilities, and reduce parental stress.

On other outcomes, the studies were too diverse for their results to be combined. In addition to the general behaviour of the child, the review authors also focused on the child’s behaviour at school and at home. Two studies focused on children’s behaviour at home, and one of the studies showed that there was no difference between the parent training intervention and the control group, while the other study concluded that the parent training intervention group did better than the control group. Two of the studies focused on behaviour at school. One study showed no differences between parent training and control condition, while the other study showed positive results for parent training, provided the child was not also suffering from ODD (Oppositional Defiant Disorder). In the latter study, the results were better for girls and for children on medication.

What is parent training?

Parent training programmes are psychosocial interventions aimed at providing parents with techniques they can use to manage their children’s challenging behaviour. Parent training is based on the philosophy that the adults around the child can positively impact the child’s behaviour. The idea is that the behaviour can be changed if its antecedents and consequences are changed.

The design of parent training programmes varies, but the structure is basically the same and is based on the same techniques. In one of the vie studies, the programme was designed as follows: parent training was led by two psychologists and was conducted in groups of parents of up to six children in 12 sessions of two hours’ duration. The groups worked with tools such as structuring the environment, setting rules, giving instructions, anticipating misbehaviours, communicating, reinforcing positive behaviour, ignoring, employing punishment, and implementing a token system. Another important element was psychoeducation, i.e. education about ADHD and its symptoms. Before each training session, parents were to read a chapter in a book that was written specifically for this programme. In addition, in between the sessions, parents were asked to practice using the techniques to which they had been introduced. Some programmes seek to help parents help their children with more than just "rules” or school: for example, some programmes include social skill training to help children make and keep friends.

Future perspectives

ADHD is a condition that can have major consequences for the individual and society. Among other things, ADHD may lead to poor education and employment in adulthood. It may also lead to an increased risk of drug abuse and psychological problems. Therefore, it is important for everyone to find out how best to treat the disorder.

For a long time, research has focused on medical treatment, but in recent years, researchers have started looking into psychosocial treatment such as parent training. The review authors point out that the overall quality of the studies was not as good as could be desired.

Overall the authors find that the evidence base of the review is not sufficiently strong for recommendations for practice. However, the encouraging findings of the review are good reason to conduct enhanced future research in parent training.

About the systematic review

  • The systematic review was prepared in an international collaboration between one Danish and four British researchers, who have analysed the best available knowledge.
  • The researchers have searched for quantitative studies in the form of controlled trials (RCTs) and quasi-randomised controlled trials.
  • On the basis of a comprehensive systematic literature search, the researchers identified 12,691 references. After screening these, 112 texts were selected for further examination. Five studies met all of the predetermined inclusion criteria and the systematic review is based on these.
  • The studies were conducted in the US (3), Canada (1) and the Netherlands (1) in the years 1993-2010.
  • Studies have between 24-96 participants, a total of 284 children aged 4-13 years.
  • Most children received medical treatment for ADHD at the time of the trial.
  • The review authors also wanted to investigate the effect of parent training on the child’s academic achievement, the parents’ understanding of ADHD, and any adverse effects of the treatment. However, none of the studies reported any data on these objectives.

See the full review

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