Abstract
Multimodal intervention incorporating psychosocial intervention and medication is recommended for school-aged children with attention deficit hyperactivity disorder (ADHD). This randomized controlled trial (RCT) investigates the adjunctive benefit of the self-help version of the New Forest Parenting Programme (NFPP-SH) when offered in addition to treatment as usual (TAU) compared with TAU alone. Fifty-two children, receiving medication for ADHD as part of their usual care, were randomized to receive NFPP-SH + TAU or TAU alone. When used in adjunct to TAU, NFPP-SH may have beneficial effects for parenting efficacy (F = 6.28, p = 0.02), child social performance in school and negative comments made by parents during a recorded speech sample. However, the self-help intervention did not have any additional effect on child behaviour. This study provides further support for self-help interventions as potentially low-intensity and cost-effective alternatives to therapist-led parenting interventions. The findings require replication in larger samples before any firm conclusions about adjunctive efficacy of NFPP-SH can be drawn but underline the potential for self-help within routine treatment (ClinicalTrials.gov Identifier: NCT02174952).
Highlights
Parenting interventions are recommended as part of a multimodal treatment approach for school-aged children with attention deficit hyperactivity disorder (ADHD) (NICE, 2018)
This study presents findings from the first randomized controlled trial (RCT) of the New Forest Parenting Programme (NFPP)-SH when used in adjunct to treatment as usual (TAU) including pharmacotherapy
The analyses provided some evidence of the adjunctive benefit of the NFPP-SH
Summary
Parenting interventions are recommended as part of a multimodal treatment approach for school-aged children with attention deficit hyperactivity disorder (ADHD) (NICE, 2018). Based on social learning principles, parenting interventions include strategies for parents aimed at increasing the frequency of adaptive child behaviours while reducing the occurrence of non-compliant or disruptive behaviour Their efficacy as treatments for ADHD has been questioned in a meta-analysis that found effect sizes for ADHD symptoms dropped to near zero when using outcome data from objective informants ‘probably blind’ to treatment allocation (Sonuga-Barke et al, 2013). Dose et al (2017) have found evidence of telephone-assisted SH having additional benefit for teacher-reported ODD symptoms and negative parenting behaviour These studies provide preliminary support of the potential of SH interventions for aspects of parent and child well-being when children are receiving medication for ADHD symptoms; these findings require replication with varying forms of SH intervention (Dose et al, 2017). The trial was designed as a pragmatic trial; few inclusion/exclusion criteria were applied in order to ensure the applicability of the findings to real-world clinical settings
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