A two-site randomized clinical trial of integrated psychosocial treatment for ADHD-inattentive type.

Abstract

This study evaluated the efficacy of the Child Life and Attention Skills (CLAS) program, a behavioral psychosocial treatment integrated across home and school, for youth with attention-deficit/hyperactivity disorder-inattentive type (ADHD-I). In a 2-site randomized controlled trial, 199 children (ages 7-11 years) were randomized to CLAS (N = 74), parent-focused treatment (PFT, N = 74), or treatment as usual (TAU, N = 51). We compared groups on parent and teacher ratings of inattention symptoms, organizational skills, social skills, and global improvement at posttreatment and also at follow-up during the subsequent school year. CLAS resulted in greater improvements in teacher-reported inattention, organizational skills, social skills, and global functioning relative to both PFT and TAU at posttreatment. Parents of children in CLAS reported greater improvement in organizational skills than PFT and greater improvements on all outcomes relative to TAU at posttreatment. Differences between CLAS and TAU were maintained at follow-up for most parent-reported measures but were not significant for teacher-reported outcomes. These findings extend support for CLAS across 2 study sites, revealing that integrating parent, teacher, and child treatment components, specifically adapted for ADHD-I, is superior to parent training alone and to usual care. Direct involvement of teachers and children in CLAS appears to amplify effects at school and home and underscores the importance of coordinating parent, teacher, and child treatment components for cross-setting effects on symptoms and impairment associated with ADHD-I.