Telephone‐assisted self‐help for parents of children with attention‐deficit/hyperactivity disorder who have residual functional impairment despite methylphenidate treatment: a randomized controlled trial
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Media type:
E-Article
Title:
Telephone‐assisted self‐help for parents of children with attention‐deficit/hyperactivity disorder who have residual functional impairment despite methylphenidate treatment: a randomized controlled trial
Published in:Journal of Child Psychology and Psychiatry
Language:
English
DOI:
10.1111/jcpp.12661
ISSN:
0021-9630;
1469-7610
Origination:
Footnote:
Description:
<jats:sec><jats:title>Background</jats:title><jats:p>Self‐help parenting interventions have been shown to be effective in the management of children with attention‐deficit/hyperactivity disorder (<jats:styled-content style="fixed-case">ADHD</jats:styled-content>) and may be useful when there are barriers to face‐to‐face therapist‐led parent trainings. Previous studies indicate that behavioral interventions might be a useful adjunct to medication in children with residual <jats:styled-content style="fixed-case">ADHD</jats:styled-content> symptoms, and regarding comorbid oppositional symptoms and multiple domains of functional impairment. In the present study, we examined whether a telephone‐assisted self‐help (<jats:styled-content style="fixed-case">TASH</jats:styled-content>) parenting behavioral intervention (written materials plus telephone counseling) enhanced the effects of methylphenidate treatment in children with <jats:styled-content style="fixed-case">ADHD</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In this randomized controlled trial, parents of 103 school‐aged children with <jats:styled-content style="fixed-case">ADHD</jats:styled-content> and residual functional impairment despite methylphenidate treatment were randomly assigned to either the enhancement group, which received the <jats:styled-content style="fixed-case">TASH</jats:styled-content> intervention as adjunct to routine clinical care (including continued medication), or to the active control group, which received routine clinical care only (including continued medication). Parent‐completed outcome measures at baseline and at 12 months (postassessment) included functional impairment, <jats:styled-content style="fixed-case">ADHD</jats:styled-content> symptoms, oppositional defiant disorder (<jats:styled-content style="fixed-case">ODD</jats:styled-content>) symptoms, parenting behavior, and parental satisfaction with the intervention (ClinicalTrials.gov: <jats:styled-content style="fixed-case">NCT</jats:styled-content>01660425; <jats:styled-content style="fixed-case">URL</jats:styled-content>: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="https://clinicaltrials.gov/ct2/show/NCT01660425">https://clinicaltrials.gov/ct2/show/NCT01660425</jats:ext-link>).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Intention‐to‐treat analyses of covariance (<jats:styled-content style="fixed-case">ANCOVA</jats:styled-content>s), which controlled for baseline data, revealed significant and moderate intervention effects for <jats:styled-content style="fixed-case">ODD</jats:styled-content> symptoms and negative parenting behavior at the postassessment, whereas per‐protocol analyses additionally showed significant and moderate effects on functional impairment (primary outcome). Parents expressed high satisfaction with the program.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The <jats:styled-content style="fixed-case">TASH</jats:styled-content> program enhances effects of methylphenidate treatment in families who complete the intervention. The discontinuation rate of about 30% and comparison between completing and discontinuing families suggest that the program may be more suitable for families with a higher educational level and fewer additional stresses.</jats:p></jats:sec>