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Practitioner review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD)

Daley, David; Van Der Oord, Sakia; Ferrin, Maite; Cortese, Samuele; Danckaerts, Marina; Doepfne, Manfred; Van den Hoofdakker, Barbara J.; Coghill, David; Thompson, Margaret; Asherson, Philip; Banaschewski, Tobias; Brandeis, Daniel; Buitelaar, Jan; Dittmann, Ralf W.; Hollis, Chris; Holtmann, Martin; Konofal, Eric; Lecendreux, Michel; Rothenberger, Aribert; Santosh, Paramala; Simonoff, Emily; Soutullo, Cesar; Steinhausen, Hans Christoph; Stringaris, Argyris; Taylor, Eric; Wong, Ian C.K.; Zuddas, Alessandro; Sonuga-Barke, Edmund J.S.

Practitioner review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) Thumbnail


Authors

David Daley

Sakia Van Der Oord

Maite Ferrin

Samuele Cortese

Marina Danckaerts

Manfred Doepfne

Barbara J. Van den Hoofdakker

David Coghill

Margaret Thompson

Philip Asherson

Tobias Banaschewski

Daniel Brandeis

Jan Buitelaar

Ralf W. Dittmann

CHRIS HOLLIS chris.hollis@nottingham.ac.uk
Professor of Child and Adolescent Psychiatry and Digital Mental Health

Martin Holtmann

Eric Konofal

Michel Lecendreux

Aribert Rothenberger

Paramala Santosh

Emily Simonoff

Cesar Soutullo

Hans Christoph Steinhausen

Argyris Stringaris

Eric Taylor

Ian C.K. Wong

Alessandro Zuddas

Edmund J.S. Sonuga-Barke



Abstract

Background: Behavioural interventions are recommended for use with children and young people with ADHD, however specific guidance for their implementation based on the best available evidence is currently lacking.
Methods: This review used an explicit question and answer format to address issues of clinical concern, based on expert interpretation of the evidence with precedence given to meta-analyses of randomised controlled trials.
Results: On the basis of current evidence that takes into account whether outcomes are blinded, behavioural intervention cannot be supported as a front-line treatment for core ADHD symptoms. There is however, evidence from measures that are probably blinded that these interventions benefit parenting practices and improve conduct problems which commonly co-occur with ADHD, and are often the main reason for referral. Initial positive results have also been found in relation to parental knowledge, children’s emotional, social and academic functioning – although most studies have not used blinded outcomes. Generic as well as specialised ADHD parent training approaches - delivered either individually or in groups – have reported beneficial effects. High quality training, supervision of therapists and practice with the child, may improve outcomes but further evidence is required. Evidence for who benefits the most from behavioural interventions is scant. There is no evidence to limit behavioural treatments to parents with parenting difficulties or children with conduct problems. There are positive effects of additive school based intervention for the inattentive subtype. Targeting parental depression may enhance the effects of behavioural interventions.
Conclusion: Parent training is an important part of the multi-modal treatment of children with ADHD which improves parenting, reduces levels of oppositional and non-compliant behaviours and may improve other aspects of functioning. However, blinded evidence does not support it as a specific treatment for core ADHD symptoms. More research is required to understand how to optimise treatment effectiveness either in general or for individual patients and explore potential barriers to treatment uptake and engagement. In terms of selecting which intervention formats to use it seems important to acknowledge and respond to parental treatment preferences.

Citation

Daley, D., Van Der Oord, S., Ferrin, M., Cortese, S., Danckaerts, M., Doepfne, M., …Sonuga-Barke, E. J. (2018). Practitioner review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD). Journal of Child Psychology and Psychiatry, 59(9), 932-947. https://doi.org/10.1111/jcpp.12825

Journal Article Type Article
Acceptance Date Aug 29, 2017
Online Publication Date Oct 30, 2017
Publication Date Sep 1, 2018
Deposit Date Sep 4, 2017
Publicly Available Date Mar 29, 2024
Journal Journal of Child Psychology and Psychiatry
Print ISSN 0021-9630
Electronic ISSN 1469-7610
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 59
Issue 9
Pages 932-947
DOI https://doi.org/10.1111/jcpp.12825
Keywords ADHD, Behaviour therapy, Conduct disorder, Parent training, Treatment trials
Public URL https://nottingham-repository.worktribe.com/output/890881
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12825/full
Additional Information This is the peer reviewed version of the following article: Daley, D., Van Der Oord, S., Ferrin, M., Cortese, S., Danckaerts, M., Doepfner, M., Van den Hoofdakker, B. J., Coghill, D., Thompson, M., Asherson, P., Banaschewski, T., Brandeis, D., Buitelaar, J., Dittmann, R. W., Hollis, C., Holtmann, M., Konofal, E., Lecendreux, M., Rothenberger, A., Santosh, P., Simonoff, E., Soutullo, C., Steinhausen, H. C., Stringaris, A., Taylor, E., Wong, I. C.K., Zuddas, A. and Sonuga-Barke, E. J. (2017), Practitioner Review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with attention deficit hyperactivity disorder. J Child Psychol Psychiatr. doi:10.1111/jcpp.12825 which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12825/full This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

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