Reliable change in parent-rated scores on the Brown Attention-Deficit Disorder Scales® from pre- to post-participation in the Brain Balance® program

Abstract

The development of attention can be influenced through various nonpharmacologic approaches such as training and practice. More research is needed on these approaches in children and adolescents with attentional difficulties. To this end, we investigated the effect of 3 months of participation in the Brain Balance® (BB) program (a multimodal childhood training program) on attentional issues in children and adolescents, using the Brown Attention-Deficit Disorder Scales® (BADDS) administered as a parental questionnaire before and after program participation. At baseline, participants (N = 71; aged 4–18 years; 69% male) had BADDS scores that were approximately 1.5 standard deviations above the normative BADDS sample. A Wilcoxon test indicated that scores differed significantly from pre- to post-program, with an average decline of 7 T-score points. The probability of a BB participant improving from pre- to post-program was 81%. The Reliable Change Index (RCI) indicated that 36 participants (49.3%) observed a large enough change to meet the criteria for reliable change, 34 participants (46.6%) did not meet the criteria for reliable change, and three participants (4.1%) observed reliable deterioration. Finally, logistic regression showed that baseline BADDS scores significantly predicted reliable change, such that a one-unit increase in baseline BADDS T-score was associated with a 15% odds increase in reliable change. This suggests that children with more severe ADHD symptoms at baseline are more likely to observe a decrease in symptoms over the course of the BB program than are children with less severe symptoms. Age (but not gender) was also a significant predictor, such that younger participants were more likely to observe reliable change. These data provide evidence of statistically significant reliable change in attentional functioning in BB participants from pre- to post-program, especially for participants who are younger in age or have more pronounced attentional issues at baseline.