Abstract
ObjectiveThe acceptance of drug treatment for younger children with attention-deficit/hyperactivity disorder (ADHD) in China remains low. Here, we explored the clinical benefits of a non-pharmaceutical intervention method combining a group and executive function training and an online parent training program, termed group executive functioning and online parent training (GEF-OPT), for school-aged students with ADHD through a randomized controlled trial.MethodA total of 145 children (aged 6–8 years) were formally registered and randomized to the intervention group (n = 73) and waitlist group (n = 72). The enrolled children received eight sessions of GEF-OPT treatment, which consists of a hospital-based children executive function (EF) training program and an online parent training program. Treatment outcome was assessed by a parent/teacher report questionnaire and neurophysiological experiment.ResultsAfter eight sessions of intervention, children in the intervention group showed a significant improvement in inattentive symptom compared to the waitlist group (14.70 ± 4.35 vs. 16.03 ± 2.93; p = 0.024), but an insignificant difference in hyperactive-impulsivity (9.85 ± 5.30 vs. 10.69 ± 5.10; p = 0.913). Comorbid oppositional defiant disorder was significantly reduced in the intervention group (7.03 ± 4.39 vs. 8.53 ± 4.41; p = 0.035). Children in the intervention group had greater reduction in the scores of behavioral regulation index (inhibition, emotional control) and metacognition index (working memory, planning/organization, monitoring) in executive function than those in the waitlist group (p < 0.05). Significant effects were also found in learning problem of Weiss Functional Impairment Scale–Parent form and parental distress between two groups at post-treatment (p < 0.05). In line with this, the result of go/no-go task showed significant improvements in accuracy change (4.45 ± 5.50% vs. 1.76 ± 3.35%; p = 0.001) and reaction time change (47.45 ± 62.25 s vs. 16.19 ± 72.22 s; p = 0.007) in the intervention group compared with the waitlist group.ConclusionWe conclude that participants in the GEF-OPT program improved outcomes for inattentive symptom, executive function, learning problems, and parental distress. GEF-OPT is a promising non-pharmaceutical therapeutic option for younger children.Trial RegistrationChiCTR2100052803.
Highlights
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood, characterized by hyperactivity, impulsivity, and inattention that are not commensurate with the developmental level
Given that parents are more willing to accept nonpharmacological interventions for school-aged children with ADHD, we explored the clinical benefits of non-pharmacological interventions combining the group executive functioning and online parent training (GEF-OPT) for ADHD children aged 6– 8 years old
A total of 187 (3.7%) students aged 6–8 years were diagnosed with ADHD
Summary
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood, characterized by hyperactivity, impulsivity, and inattention that are not commensurate with the developmental level. ADHD impedes the development of children’s learning and social abilities and brings a heavy burden on their families and society [1]. A meta-analysis indicates that the prevalence of ADHD among children and adolescents in China is 6.26%, generally consistent with the worldwide prevalence [2]. Many treatment guidelines emphasize the importance of multimodal treatment for ADHD, which consists of combining drug treatment and non-drug treatment (i.e., parent training and social skills training) [9,10,11]
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