Parent-Child Interaction Therapy for ADHD: A Conceptual Overview and Critical Literature Review

ABSTRACT

Attention-Deficit/Hyperactivity Disorder (ADHD), a chronic disorder beginning in childhood, is identifiable and diagnostically valid during the preschool years. Compared to school-aged children, preschoolers have not received as much attention in the literature. Parent-Child Interaction Therapy (PCIT) is an empirically-supported parent training program for young children with disruptive behaviors that may also be effective in treating ADHD. The purpose of the current article was to explore the theoretical rationale for utilizing PCIT with this population and to conduct a literature review of published PCIT treatment outcome studies that measured ADHD symptoms. The literature demonstrates that children with ADHD have been included in PCIT research and evidence suggests that PCIT may be effective for young children with ADHD. However, future research is needed to specifically examine the effects of PCIT on ADHD.     

Training Children to Make Accurate Self-Evaluations: Effects on Behavior and the Quality of Self-Ratings

Research has shown that self-evaluation can have positive effects on children's behavior and academic performance. Components of self-evaluation that have not been fully examined include the accuracy and sensitivity of students' ratings before and after training, as well as the effects of accuracy training on performance. Four students exhibiting behavior consistent with Attention Deficit Hyperactivity Disorder (ADHD) participated in the study. The students' behavior during academic activities and accuracy of self-evaluations were examined before and after accuracy training in comparison to direct observations of behavior. None of the students accurately rated his behavior prior to training. Self-evaluation alone decreased disruptive behavior for only one student, whereas self-evaluation plus accuracy training decreased the disruptive behavior of all four students. Once accuracy training was withdrawn, the level of disruptive behavior increased for three of the four students. Implications of these results for the quality and utility of self-evaluation measures and the role of accuracy training in self-evaluation effects are discussed.     

Supporting Japanese Mothers of Children with ADHD: Cultural Adaptation of the New Forest Parent Training Programme

International practice guidelines recommend medication and behavioral intervention as evidenced‐based treatments for attention deficit hyperactivity disorder (ADHD). Currently in Japan, the availability of non‐pharmacological interventions for ADHD is limited. We report the results of a pilot and a proof‐of‐concept study for a new behavioral intervention for Japanese mothers of children with ADHD. The pilot study delivered a standard six‐session behavioral intervention and two parent‐support sessions. Participants approved the group format and requested additional support to change parenting practices and behavioral strategies targeting ADHD symptoms. For the proof‐of‐concept study, the intervention was revised to include five sessions of pre‐intervention support followed by six sessions of the New Forest Parent Training Programme (NFPP), an evidence‐based intervention for ADHD. The revised intervention, NFPP‐Japan, was associated with reductions in the mothers’ reports of children's ADHD symptoms and aggression, more effective parenting practices, and reduced parenting stress. The pilot and proof‐of‐concept studies indicate that it is possible to successfully modify Western behavioral interventions for Japanese mothers and to justify a randomized controlled trial evaluation of the NFPP‐Japan, which is currently underway.     

Differences Between ADHD Inattentive and Combined Types on the CPT

Two samples of school-age boys with attention-deficit/hyperactivity disorder (ADHD-Combined and ADHD-Inattentive Types) and a non-ADHD control group were administered an AX version of the continuous performance task (CPT) to examine specific sustained attention deficits. Three levels of time-on-task were included to study performance declines, and 3 interstimulus intervals were included to examine vigilance deficits. As predicted by R. A. Barkley's and H. C. Quay's behavior inhibition deficit models (R. A. Barkley, 1997; H. C. Quay, 1997), the performance of the ADHD-Combined Type (ADHD-C) participants deteriorated more quickly than the other samples. No significant evidence of vigilance deficits among the inattentive (ADHD-IA) sample was found. These findings suggest that distinct criteria for the two ADHD subtypes may be warranted when the CPT is used for diagnostic assessment, and sustained attention-related declines in performance may be typical of the ADHD-C Type only.     

Play Therapy With Abused Children: A Review of the Literature

The authors present a review and critique of the play therapy literature related to abused and neglected children, and they discuss seven characteristic play behaviors of maltreated children along with two common play themes. Recommendations for future research are also presented.     

The Predictive Validity of Parent and Teacher Reports of ADHD Symptoms

The objectives were to evaluate the ability of the Inattention and Hyperactivity–Impulsivity factors of the ADHD Rating Scale-IV to differentiate children with ADHD from a control group and to discriminate children with different subtypes of ADHD. Also, we sought to determine optimal cutoff scores on the teacher and parent versions of this scale for making diagnostic decisions about ADHD. In a sample of 92 boys and girls 6 to 14 years of age referred to a regional ADHD program, we assessed ADHD diagnostic status using categorical and dimensional approaches as well as parent- and teacher-report measures. Logistic regression analyses showed that the Inattention and Hyperactivity–Impulsivity factors of the ADHD Rating Scale-IV were effective in discriminating children with ADHD from a control group and differentiating children with ADHD, Combined Type from ADHD, Inattentive Type. Although both teacher and parent ratings were significantly predictive of diagnostic status, teacher ratings made a stronger contribution to the prediction of subtype membership. Using symptom utility estimates, optimal cutoff scores on the Inattention and Hyperactivity–Impulsivity scales for predicting subtypes of ADHD were determined.     

Using Cognitive Behavior Therapy in Clinical Work With African American Children and Adolescents: A Review of the Literature

A comprehensive review of the literature on clinical work with African American youth with cognitive behavior therapy (CBT) is presented. The strengths and limitations of CBT in relation to this population are outlined. Although CBT shows promise in helping, research on the efficacy and effectiveness of CBT in this group is lacking. Se presenta una reseña exhaustiva de la literatura sobre trabajo clínico con jóvenes Afroamericanos usando terapia cognitiva conductual (TCC). Se perfilan los puntos fuertes y las limitaciones de la TCC en relación a esta población. A pesar de que la TCC muestra signos prometedores para servir de ayuda, no hay suficiente investigación sobre la eficacia y efectividad de la TCC en este grupo.     

The Siblings of Individuals with Mental Retardation: A Quantitative Integration of the Literature

The sibling relationship has recently become the focus of much research in developmental psychology. The family system perspective implies the presence of a sibling with mental retardation will impact on the psychological development and functioning of their typically developing siblings. Past reviews of the literature have found this impact to be negative but there is the suggestion of positive consequences to having a sibling with mental retardation. The present meta-analysis sought to quantitatively integrate 25 studies and 79 effect sizes from the literature on the siblings of individuals with mental retardation. A small negative effect for having a sibling with mental retardation was discovered that could not be attributed to a publication bias or some other artifact. This negative effect was greatest for direct observation measures, measures of psychological functioning, especially depression, and for children. Limitations to this meta-analysis and directions for future research are discussed.     

The Therapeutic Effect of Physical Fitness on Measures of Personality: A Literature Review

The authors review the literature concerning the effects of physical fitness on various measures of personality and offer specific suggestions for future research in this area.     

Measuring Parental Treatment Adherence in a Multimodal Treatment Program for Children with ADHD: A Preliminary Investigation

This study evaluated the clinical significance of measuring between session parental adherence on child and parent outcomes for 51 children (age 4 to 8.5 years) with attention deficit/hyperactivity disorder (ADHD) in a multimodal group training program. Three group treatment conditions: (a) child-only treatment (C1), (c) child and parent training (C2), and (c) C2 + Parent Adherence Measure [PAM (C3)] were compared to assess the clinical significance of measuring parental adherence on child behavioral problems, socialization skills, and parental efficacy. Parents administered the PAM (C3) displayed, in general, better outcomes on child and parent measures than the other two conditions. Results suggest that a multimodal group training program for young children with ADHD is favorable to child group training only. This study offers preliminary support for the clinical utility of measuring parental adherence in a child ADHD multimodal group training program.     

A Comparison of Teacher and Parent Delivered Consequences: Improving Classroom Behavior in Low-Income Children with ADHD

Both teacher and parent delivered consequences have been shown to be effective in improving the classroom behavior of children with Attention Deficit Hyperactivity Disorder (ADHD). However, there is a delay between the behavior and delivery of parent provided consequences. The delay may make the consequences less salient and effective, for children with ADHD. The current study compared the effectiveness of parent delivered consequences (PC) to teacher delivered consequences (TC) for increasing academic performance and appropriate classroom behavior in African American, low income, elementary students with ADHD. Results indicate that the two interventions are equally effective in improving children's on-task behavior and classwork productivity.     

情绪对信任的影响:来自元分析的证据

采用元分析方法探讨情绪对信任的影响。通过中英文献检索,共有21篇文章70个独立样本符合元分析标准（N=4745）。其中积极情绪对信任的影响有47个独立样本,消极情绪对信任的影响有23个独立样本。元分析的结果表明,相对于中性情绪,积极情绪对信任起到一定的促进作用,呈中等效应量（d=0.49）;消极情绪对信任起到一定的抑制作用,呈较小效应量（d=-0.23）。调节效应检验发现,情绪的诱发方式、信任对象熟悉性以及信任测量方式的调节作用均不显著。     

Improving Social Skills of Adults With Autism Spectrum Disorder Through Physical Activity,Sports, and Games: A Review of the Literature

Socialization skill deficiencies among adults with autism spectrum disorder (ASD) can lead to depression, anxiety, aggression, and physical health problems. Clinical interventions must treat primary deficiencies and prevent secondary conditions. A treatment model emphasizing the integration of physical activity with social intervention strategies for adults with ASD is proposed.     

Classroom observations of students with and without ADHD: Differences across types of engagement

The current study examined the behaviors related to academic engagement exhibited by students with ADHD during instruction in math and reading. A total of 155 students (92 ADHD, 63 recruited controls) in grades 1 through 4 participated in the study. Results revealed that students with ADHD exhibited statistically significant lower rates of academic engagement and higher rates of off-task behaviors than recruited controls and randomly selected peer comparisons. Specifically, students with ADHD exhibited statistically significant lower rates of passive academic engagement (PET) than recruited controls and peer comparisons; however no group differences were found with regard to active engaged time (AET). In addition, students with ADHD exhibited lower rates of AET than PET, a finding observed among both recruited controls and randomly selected peer comparisons. Implications for research and practice are discussed.     

Diverse multi-week physical activity programs reduce ADHD symptoms: A systematic review and meta-analysis

ObjectivePhysical activity (PA) has been proposed as an adjunct treatment and secondary prevention intervention for attention-deficit hyperactivity/impulsivity disorder (ADHD) and oppositional defiant disorder (ODD). However, meta-analyses testing effects on symptoms and functional impairment have yielded conflicting results.MethodsA systematic search of eight databases yielded 15 randomized controlled trial and 2 quasi-experimental design studies—including N = 881 youth (M = 9.75 years, 71% male)—that tested the effects of multi-week PA programs on symptoms and impairment of children with [or at-risk for] ADHD and/or ODD.ResultsRandom effects meta-analyses favored PA groups on omnibus ADHD measures (g = −0.42, 95%CI[-0.62;-0.21]), combined ADHD symptoms (g = −0.50, 95%CI[-0.82;-0.17]), inattention (g = −0.41,95%CI[-0.82; 0.00]), and hyperactivity/impulsivity (g = −0.30, 95%CI[-0.56;-0.04]). Heterogeneity was moderate across studies (I² = 49%, 95%CI[12%-to-70%]). Significant differences favored PA programs whether inclusion required diagnosis, programs augmented frontline treatments, and active or passive comparison groups were utilized.ConclusionDiverse PA programs can reduce ADHD symptoms, especially where they intentionally pursue this end.     

COMT基因对注意控制神经基础的调控效应：影像遗传学研究的元分析

为探索注意控制能力个体差异的遗传来源, 当前研究主要关注儿茶酚胺氧位甲基转移酶(catechol-O-Methyltransferase, COMT)基因对参与注意控制加工的前额叶脑区的调控作用。为进一步回答COMT基因是否也对全脑范围的注意脑区具有调控作用, 本文对17篇遗传影像学研究进行元分析。结果发现, COMT基因Val/Val (vv)基因型的被试在注意控制任务下, 不仅前额叶脑区的激活水平高于Met/Met(mm)基因型的被试, 在前扣带回和后扣带回等前额叶之外的脑区激活水平也高于mm基因型的被试, 而且在这些脑区的效应值(vv>mm)都较大(Cohen’s d > 0.8)。由此, 元分析结果表明：COMT基因不仅调控前额叶脑区, 而且对形成注意控制网络的多个脑区都有调控效应。此结果提示注意控制能力的个体差异可能部分的来自于COMT基因对注意控制网络的调控作用。     

Equine-Facilitated Psychotherapy With Children and Adolescents: An Update and Literature Review

During the past several years, there has been a large increase in the number of studies of equine-facilitated psychotherapy (EFP) with children and adolescents. However, due to the diversity of methods, samples, and publication types represented in the literature, it may be difficult for EFP practitioners to synthesize the existing research into useful guidelines and treatment recommendations for patients. This article summarizes and tabulates investigation findings by methods, theoretical underpinnings, and treatment populations. This review of 47 recent publications suggests that EFP is a useful modality with children and adolescents. In the large majority of reviewed papers, benefits were found for a variety of presenting problems and disorders. The most often studied populations were “at-risk” youth and children with an Autism Spectrum Disorder diagnosis. Recommendations for counselors and directions of future EFP research are made.     

The direct way may not be the best way: Children with ADHD and their understanding of self-presentation in social interactions

Knowledge and use of self-presentational tactics is an important social skill. We examined understanding of the function of three different self-presentational tactics (self-promotion, ingratiation and blasting) in 11 8–12-year-old boys with attention-deficit/hyperactivity disorder (ADHD) and 11 matched comparison children. Children were given six different self-presentation stories, two for each one of the three different tactics. After each story, they were asked to evaluate the effects of the self-presentational tactic used. Children with ADHD rated self-promotion and blasting as more positive and more effective—and ingratiation as less positive and less effective—than children in the control group. This implicates that children with ADHD prefer simple and direct self-presentational strategies (like self-promotion), and, therefore, may not as easily understand more subtle strategies (like ingratiation). They also seem to be more inclined to use negatively connoted strategies (like blasting). We suggest that this limited understanding of self-presentational strategies in children with ADHD may explain some of their problems in social interactions. Therefore, social skill interventions in children with ADHD should incorporate elements focusing on use and understanding of different self-presentational strategies.     

学习不良儿童家庭资源的元分析

对过去20年关于学习不良儿童家庭资源的研究结果进行的元分析显示,儿童各种家庭资源的效应值变异程度不大。总体来说,学习不良儿童和一般儿童的家庭资源差异显著。一般儿童的父母文化程度和教养方式优于学习不良儿童的父母文化程度和教养方式。但是,两类儿童的父母期望没有显著差异。