ADHD: Treatments

Question 1

EFFECTIVE INTERVENTION CONCEPTUAL FRAMEWORK

Answer 1

• aim it to improve activity/participation NOT JUST test scores
  WHO (2007)
• mental health condition awareness
• impairments to body structures/functions
• pp restrictions
• activity limitations
• environmental/personal factors

Question 2

CHILDREN

Answer 2

PHARMACOTHERAPY
NON-PHARMACOLOGICAL INTERVENTIONS

Question 3

KIDS: PHARMACOTHERAPY

Answer 3

TARVER ET AL. (2014)
- ie. methylphenidate/atomoxetine
- not recommended <5Y
- for kids environmental changes (ie. parent-training programmes) = recommended 1st
- no improvement -> methylphenidate = 1st line
- BUT effects = unmaintained
- many parent reluctant to put kids on meds due to side-effects

Question 4

KIDS: NON-PHARMACOLOGICAL INTERVENTIONS

Answer 4

TARVER ET AL. (2014)
- dietary treatments
- parenting interventions (ie. New Forest Parent Training Programme)
- school-based interventions
- psychosocial interventions (ie. CBT/anger management/social skills/problem solving)
- cognitive (WM) training interventions

Question 5

EFFECTIVE INTERVENTIONS

Answer 5

KRASNY-PACINI ET AL. (2018)
- ecologically valid (can be implemented/improve kids’ daily life)
- generalises to naturally occurring tasks (if intervention = strategy-based it may require support to show young person how approaches/prompts can be used)
- transfers to kids’ natural context (training/support in clinic MUST be translated)
- lasting effects over time (reminder/booster sessions if needed)

Question 6

(REVISED) NEW FOREST PARENT TRAINING PROGRAMME

Answer 6

THOMPSON ET AL. (2009)
- improve parental style (understanding/constructive/positive)
- help parents communicate (clear/consistent)
- improve odd management (beh principles/preventative strategies/contingencies)
- improve regulation via interaction/games (joint play/turn taking/scaffolding)

Question 7

(REVISED) NEW FOREST PARENT TRAINING PROGRAMME: RESULTS

Answer 7

THOMPSON ET AL. (2009)
- randomised controlled trial (8w revised NFPP VS TAU) found:
1. ADHD/ODD symptoms (questionnaires/direct observation)
2. maternal mental health
3. quality of mother-child interactions
- n = 41 kids; 30-77M
- 21 = NFPP; 20 = TAU

Question 8

MATERNAL ADHD x INTERVENTION

Answer 8

SONUGA-BARKE (2002)
- 83 3Y preschool kids & mums (8w parenting programme)
- 3 groups of mothers on Adult ADHD Rating Scale (low/medium/high symptoms)
- assessments as T1 (baseline)/T2 (immediate)/T3 (15w follow-up)
- kids of mothers w/high ADHD symptoms showed lowed improvement post intervention

Question 9

RUSSELL (2019)

Answer 9

• intervention type/outcome/informants categorised
• study quality adapted Cochrane bias risk tool
• difs between intervention/controls on post-test