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Behavioral interventions for children and adolescents with attention deficit hyperactivity disorder: a meta-analysis of randomized controlled trials across multiple outcome domains

Behavioral interventions for children and adolescents with attention deficit hyperactivity disorder: a meta-analysis of randomized controlled trials across multiple outcome domains
Behavioral interventions for children and adolescents with attention deficit hyperactivity disorder: a meta-analysis of randomized controlled trials across multiple outcome domains
OBJECTIVE: Behavioral interventions are recommended as attention-deficit/hyperactivity disorder (ADHD) treatments. However, a recent meta-analysis found no effects on core ADHD symptoms when raters were probably blind to treatment allocation. The present analysis is extended to a broader range of child and parent outcomes.

METHOD: A systematic search in PubMed, Ovid, Web of Knowledge, ERIC, and CINAHAL databases (up to February 5, 2013) identified published randomized controlled trials measuring a range of patient and parent outcomes for children and adolescents diagnosed with ADHD (or who met validated cutoffs on rating scales).

RESULTS: Thirty-two of 2,057 nonduplicate screened records were analyzed. For assessments made by individuals closest to the treatment setting (usually unblinded), there were significant improvements in parenting quality (standardized mean difference [SMD] for positive parenting 0.68; SMD for negative parenting 0.57), parenting self-concept (SMD 0.37), and child ADHD (SMD 0.35), conduct problems (SMD 0.26), social skills (SMD 0.47), and academic performance (SMD 0.28). With probably blinded assessments, significant effects persisted for parenting (SMD for positive parenting 0.63; SMD for negative parenting 0.43) and conduct problems (SMD 0.31).

CONCLUSION: In contrast to the lack of blinded evidence of ADHD symptom decrease, behavioral interventions have positive effects on a range of other outcomes when used with patients with ADHD. There is blinded evidence that they improve parenting and decrease childhood conduct problems. These effects also may feed through into a more positive parenting self-concept but not improved parent mental well-being.
1527-5418
835-847
Daley, David
651d0b29-8790-4a13-aa18-ad9a499d34e8
Van der Oord, Saskia
42c193fe-61ef-4f62-b0a9-aa47b20b1e60
Ferrin, Maite
1cf8f421-afd8-4e49-8490-19cc35b470fe
Danckaerts, Marina
e7e7618b-6dd0-4520-bf4e-865597928758
Doepfner, Manfred
9fcfbb07-0125-4ec5-a411-59af6ca80ce1
Cortese, Samuele
297167c9-18ee-4371-8be9-b0293a5b0c48
Sonuga-Barke, Edmund J.S.
bc80bf95-6cf9-4c76-a09d-eaaf0b717635
Daley, David
651d0b29-8790-4a13-aa18-ad9a499d34e8
Van der Oord, Saskia
42c193fe-61ef-4f62-b0a9-aa47b20b1e60
Ferrin, Maite
1cf8f421-afd8-4e49-8490-19cc35b470fe
Danckaerts, Marina
e7e7618b-6dd0-4520-bf4e-865597928758
Doepfner, Manfred
9fcfbb07-0125-4ec5-a411-59af6ca80ce1
Cortese, Samuele
297167c9-18ee-4371-8be9-b0293a5b0c48
Sonuga-Barke, Edmund J.S.
bc80bf95-6cf9-4c76-a09d-eaaf0b717635

Daley, David, Van der Oord, Saskia, Ferrin, Maite, Danckaerts, Marina, Doepfner, Manfred, Cortese, Samuele and Sonuga-Barke, Edmund J.S. (2014) Behavioral interventions for children and adolescents with attention deficit hyperactivity disorder: a meta-analysis of randomized controlled trials across multiple outcome domains. Journal of the American Academy of Child and Adolescent Psychiatry, 53 (8), 835-847. (doi:10.1016/j.jaac.2014.05.013). (PMID:25062591)

Record type: Article

Abstract

OBJECTIVE: Behavioral interventions are recommended as attention-deficit/hyperactivity disorder (ADHD) treatments. However, a recent meta-analysis found no effects on core ADHD symptoms when raters were probably blind to treatment allocation. The present analysis is extended to a broader range of child and parent outcomes.

METHOD: A systematic search in PubMed, Ovid, Web of Knowledge, ERIC, and CINAHAL databases (up to February 5, 2013) identified published randomized controlled trials measuring a range of patient and parent outcomes for children and adolescents diagnosed with ADHD (or who met validated cutoffs on rating scales).

RESULTS: Thirty-two of 2,057 nonduplicate screened records were analyzed. For assessments made by individuals closest to the treatment setting (usually unblinded), there were significant improvements in parenting quality (standardized mean difference [SMD] for positive parenting 0.68; SMD for negative parenting 0.57), parenting self-concept (SMD 0.37), and child ADHD (SMD 0.35), conduct problems (SMD 0.26), social skills (SMD 0.47), and academic performance (SMD 0.28). With probably blinded assessments, significant effects persisted for parenting (SMD for positive parenting 0.63; SMD for negative parenting 0.43) and conduct problems (SMD 0.31).

CONCLUSION: In contrast to the lack of blinded evidence of ADHD symptom decrease, behavioral interventions have positive effects on a range of other outcomes when used with patients with ADHD. There is blinded evidence that they improve parenting and decrease childhood conduct problems. These effects also may feed through into a more positive parenting self-concept but not improved parent mental well-being.

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More information

Accepted/In Press date: 2 June 2014
e-pub ahead of print date: 26 June 2014
Published date: 26 June 2014
Organisations: Psychology

Identifiers

Local EPrints ID: 369541
URI: http://eprints.soton.ac.uk/id/eprint/369541
ISSN: 1527-5418
PURE UUID: 8b025380-ca03-4465-a8cd-17ab744e3dc9

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Date deposited: 07 Oct 2014 11:05
Last modified: 14 Mar 2024 18:05

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Contributors

Author: David Daley
Author: Saskia Van der Oord
Author: Maite Ferrin
Author: Marina Danckaerts
Author: Manfred Doepfner
Author: Samuele Cortese
Author: Edmund J.S. Sonuga-Barke

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