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Nguyen T, Elkins SR, Curtis DF. Peer-Based Intervention for Socioemotional Concerns Among Children with ADHD. Child Psychiatry Hum Dev 2023; 54:1386-1395. [PMID: 35307775 DOI: 10.1007/s10578-022-01345-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 11/03/2022]
Abstract
This study examined the potential benefits of peer-based dyadic interventions for improving the socioemotional functioning of children with ADHD. Participants included children ages 8-12 diagnosed with ADHD-combined type (n = 34) pooled from a larger randomized study comparing peer-based dyadic interventions. Self-concept and depressive symptoms were evaluated at pre- and post-treatment using single group design. Results showed significantly positive child responses to intervention for self-concept. Further, improvements in self-concept were not moderated by the type of dyadic intervention received or by treatment related changes in externalizing behaviors. The severity of reported depressive symptoms, however, did not significantly change. This suggests therapeutic interaction with peers, as demonstrated in peer-based dyadic intervention models, can improve self-concept in children with ADHD even when socioemotional concerns are not a primary target of treatment and independent of behavioral outcomes achieved. These preliminary findings support promoting prosocial peer behavior as a critical domain for ADHD intervention for children.
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Affiliation(s)
- Thu Nguyen
- Department of Clinical, Health, and Applied Sciences, University of Houston-Clear Lake, Houston, TX, 77058, USA.
- Department of Clinical, Health, and Applied Sciences, University of Houston-Clear Lake, 2700 Bay Area Blvd., Houston, TX, 77058, USA.
| | - Sara R Elkins
- Department of Clinical, Health, and Applied Sciences, University of Houston-Clear Lake, Houston, TX, 77058, USA
| | - David F Curtis
- Department of Behavioral and Social Sciences, University of Houston College of Medicine, Houston, TX, 77004, USA
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2
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Wong KP, Qin J. Effectiveness of Social Virtual Reality Training in Enhancing Social Interaction Skills in Children With Attention-Deficit/Hyperactivity Disorder: Protocol for a Three-Arm Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e48208. [PMID: 37721790 PMCID: PMC10546265 DOI: 10.2196/48208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders among children. Children with ADHD have challenges in understanding social cues and behavioral problems when entering a social setting. Virtual reality (VR) has been applied to improve cognitive behaviors in children with ADHD. Previous studies have not adopted VR to improve social interaction competence and appropriateness in children with ADHD. VR offers a more effective alternative to therapeutic strategies for children with ADHD. OBJECTIVE This study aims to examine the feasibility and effectiveness of social VR training in enhancing social interaction skills compared to traditional social skills training in children with ADHD. We hypothesize that participants in the social VR training group are likely to perform better on social interaction skills than those in the traditional social skills training group. METHODS In this nonblinded, 3-arm randomized controlled trial (RCT), 90 participants with ADHD recruited from the community will be randomized 1:1:1 to the social VR intervention group, traditional social skills training group, or waitlist control group. The child psychiatrist will conduct assessments for each participant at baseline and after the intervention. The Social Skills Rating Scale-Parent will be used to assess the social interaction skills of the participants before and after the intervention. Participants in the social VR intervention group and traditional social skills training group will receive twelve 20-minute training sessions for 3 weeks. The participants in the waitlist control group will receive no training. The primary outcome measure is training acceptability and compliance. The secondary outcome measures are the child psychiatrist's assessment and the Social Skills Rating Scale-Parent before and after the intervention. Another outcome measure is the Behavior Rating Inventory of Executive Function and Attention. Differences in the scale scores will be examined using a t test and an F test. RESULTS This study is set to commence in the fourth quarter of 2023. It is anticipated that participants in the social VR intervention group will exhibit superior social interaction skills than those in the traditional social skills training group. CONCLUSIONS To our knowledge, this RCT is the first study examining the feasibility and effectiveness of a social VR-based intervention for enhancing the social interaction skills of children with ADHD in Hong Kong. The VR-based social skills training is expected to provide a safer and more effective environment for children with ADHD to learn than the traditional approach. This study can lead to a full-scale RCT. TRIAL REGISTRATION ClinicalTrials.gov NCT05778526; https://clinicaltrials.gov/study/NCT05778526. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/48208.
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Affiliation(s)
- Ka Po Wong
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Jing Qin
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
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Nurjanah S, Machmudah M, Zahroh C, Ainiyah N, Hasina SN, Kamariyah N. The Effect of Social Skill Training of Early Childhood Education During COVID-19 Pandemic. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The COVID-19 pandemic affects the education sector, therefore, the strategy implemented by the government was social distancing and the children’s education must be held at home and they focused on all gadgets A day, so it makes the children rarely interact socially, and also parents also find it difficult to teach social interactions with children.
AIM: The purpose of this study was to analyze the effect of social skills training on social skills of early childhood education during the COVID-19 pandemic.
METHODS: This type of research is an experiment with a true experimental design. The population in this study were all early childhood education students in Surabaya. The sample in this study was pre-school age children in early childhood education in Surabaya. The sampling technique is used by simple random sampling. The sample size in this study comprised of 120 students. The indicator to measure the childhood social skills, with seven criteria, was communicative, cooperative, self-effacing, responsible, empathetic, sociability skills, and self-control. This intervention runs in eight sessions.
RESULTS: The results of the independent t-test statistical test, p = 0.000 in the intervention group and p = 0.436 in the control group, p < 0.05, it can be concluded that there was a significant change in the level of social skill before and after being given social intervention skills training in the intervention group.
CONCLUSIONS: Social skills training has a behavior modification technique. Social skill training has a significant effect on the development of social skills in early childhood education during the COVID-19 pandemic.
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Kuhn M, Gonzalez E, Weil L, Izguttinov A, Walker S. Effectiveness of Child-Focused Interventions for Externalizing Behavior: a Rapid Evidence Review. Res Child Adolesc Psychopathol 2022; 50:987-1009. [PMID: 35212851 DOI: 10.1007/s10802-022-00904-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 10/19/2022]
Abstract
Parent behavior management training (BMT) is well established as an effective, evidence-based treatment for children with externalizing behavior. Despite the wealth of data supporting BMT, many community providers use a variety of child-focused and non-directive interventions to target behavior problems. There is lack of clarity as to whether the evidence supporting child-focused externalizing treatments is sufficiently compelling to support offering these treatments rather than or in addition to BMT. This rapid evidence review compares the effectiveness of BMT with several common child-focused interventions for externalizing behavior including cognitive behavioral (CBT), social skill (SS), and play/dynamic (PT) approaches. PubMed, PsychINFO, and Web of Science were searched for English-language articles from year 2000 onwards for each intervention type. Inclusion criteria were child age (12 and under), presence of a child-focused behavioral treatment condition, and externalizing behavior as an outcome variable. A total of 30 studies met inclusion criteria and were coded (13 CBT, 10 SS, 7 PT). Results supported social skills interventions with accompanying BMT as effective in improving externalizing problems, with generally moderate effect sizes. Individual social skills interventions were promising but needing further evaluation compared to treatment as usual. CBT treatments with and without accompanying BMT showed moderate effects over waitlist but produced less consistently significant effects compared to more robust controls. Play therapy approaches showed inconsistent effects and require further evaluation. This review supports social skills plus BMT treatments as a child-focused intervention with probable efficacy for child externalizing problems. Implications for policy and community practice are discussed.
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Affiliation(s)
- M Kuhn
- Seattle Children's Hospital and Research Institute, Seattle, WA, USA. .,University of Washington Child and Adolescent Psychiatry, Seattle, WA, USA.
| | - E Gonzalez
- Seattle Children's Hospital and Research Institute, Seattle, WA, USA.,University of Washington Child and Adolescent Psychiatry, Seattle, WA, USA
| | - L Weil
- University of Washington Evidence Based Practice Institute, Seattle, WA, USA
| | - A Izguttinov
- University of Washington Evidence Based Practice Institute, Seattle, WA, USA
| | - S Walker
- University of Washington Evidence Based Practice Institute, Seattle, WA, USA
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5
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Guo C, Assumpcao L, Hu Z. Efficacy of Non-pharmacological Treatments on Emotional Symptoms of Children and Adults with Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis. J Atten Disord 2022; 26:508-524. [PMID: 33759605 DOI: 10.1177/10870547211001953] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The present meta-analysis aimed to evaluate the efficacy of various non-pharmacological interventions on comorbid emotional symptoms such as depression, anxiety, and emotional dysregulation (ED) in children and adults with ADHD. METHOD Forty-four randomized controlled trials (23 studies with ADHD children and 21 studies with ADHD adults) were included. Risk of bias, heterogeneity assessment, and subgroup analyses were conducted. RESULTS We found that therapies targeting the relationship between children and others (i.e., parent-training [on ED and depression] and social skills training [on ED]) were efficacious in the treatment of emotional symptoms in children with ADHD at post-intervention. As for adults with ADHD, cognitive behavioral therapy was found to be effective for the improvement of emotional symptoms at both post-intervention and follow-up. CONCLUSION Our findings demonstrate that the efficacy of non-pharmacological interventions varies substantially across children and adults with ADHD. These results provide important implications for the selection of non-pharmacological interventions for children with ADHD.
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Affiliation(s)
- Chao Guo
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, P.R. China.,Institute of Psychological Science, Hangzhou Normal University, P.R. China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, P.R. China
| | - Leonardo Assumpcao
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, P.R. China.,Institute of Psychological Science, Hangzhou Normal University, P.R. China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, P.R. China
| | - Zhiguo Hu
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, P.R. China.,Institute of Psychological Science, Hangzhou Normal University, P.R. China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, P.R. China
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6
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Hua Y, Zhao Q, Shen J, Liu Y, Zheng L, Zhang M. Program for education and enrichment of relational skills (PEERS) training for social skills and depressed mood intervention in young adult with depression: Study protocol for a randomized controlled trial. Front Psychiatry 2022; 13:993124. [PMID: 36172511 PMCID: PMC9510920 DOI: 10.3389/fpsyt.2022.993124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Depression is a common psychiatric disorder characterized by persistent low mood, reduced interest, and slowed thinking. Young adults are the main first-onset group for depression in all categories of the population. Program for education and enrichment of relational skills (PEERS) training, a program for the Education and Enrichment of Relational Skills, has been used in Europe and America for people with various types of social disorders with good results. A Chinese adaptation of the PEERS training program may be a new approach to help youth with depression return to society as soon as possible. This study aimed to construct and optimize a social skills training program for Chinese young adults with depression and to validate the impact of the program. MATERIALS AND METHODS AND ANALYSIS The aim of this trial protocol is to evaluate the efficacy of the localized PEERS training program on social competence, depressed mood in a Chinese young adult population with depression. The primary outcome will be a change in self-reported depressive symptoms from baseline to week 3 post-randomization to week 6 post-randomization measured using the Liebowitz social anxiety scale (LSAS). Secondary outcomes include the rate of decline in severe social anxiety, the Social Avoidance and Distress Scale (SAD), the Social Self-Efficacy Scale (PSSE), and the Hamilton Depression Scale (HAMD-17). Data for each assessment will be collected at baseline, week 3 of the trial, and week 6 of the trial. ETHICS AND DISSEMINATION Ethics approval was obtained from the Hospital Ethics Committee. Findings will be disseminated through scientific journals, conferences, and university courses. TRIAL REGISTRATION NUMBER [http://www.chictr.org.cn/], identifier [ChiCTR2100046050].
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Affiliation(s)
- Yuting Hua
- Huzhou University, Huzhou, Zhejiang, China
| | | | | | - Yujin Liu
- Huzhou University, Huzhou, Zhejiang, China
| | - Lei Zheng
- Huzhou University, Huzhou, Zhejiang, China
| | - Mei Zhang
- Huzhou University, Huzhou, Zhejiang, China
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Yang KH, Lane HY, Chang YC, Tzang RF. Exploring the Effects of Pharmacological, Psychosocial, and Alternative/Complementary Interventions in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder: Meta-Regression Approach. Int J Neuropsychopharmacol 2021; 24:776-786. [PMID: 34086891 PMCID: PMC8538900 DOI: 10.1093/ijnp/pyab034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/23/2021] [Accepted: 06/03/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND There have been various therapies for attention-deficit/hyperactivity disorder (ADHD), but the previous meta-analysis of ADHD efficacy remains unclear. This study aims to systemically meta-regress the effect sizes (ES) of psychostimulant pharmacotherapy (methylphenidate and lisdexamfetamine), non-stimulant pharmacotherapy (atomoxetine and alpha-2 agonists), psychosocial therapy (parental behavioral therapy [PBT]), combination therapy (psychostimulant plus PBT), and alternative/complementary interventions to determine the right treatment for ADHD. METHODS We searched various ADHD interventions from the MEDLINE and PubMed databases (National Center for Biotechnology Information) between January 1, 1980, and July 30, 2018. Following the meta-analysis of random effects, the meta-regression analyses were used to explore factors potentially influencing treatment efficacy. The confounding variables included type of treatment, type of study, age, type of symptom scale used, and year of publication. RESULTS A total of 107 trials (n = 9883 participants) were included. After adjustment, compared with the psychostimulant therapy (28 trial, 2134 participants), non-stimulant pharmacotherapy (28 trials, 4991 participants) and alternative/complement intervention (25 trials, 1195 participants) were less effective by the ES of -0.384 (P = .004) and -0.419 (P = .028), respectively. However, compared with psychostimulant, PBT (19 trials, 1122 participants; ES = -0.308, P = .095) and the combination of psychostimulant and PBT (7 trials, 441participants; ES = -0.196, P = .209) did not differ significantly. CONCLUSIONS Psychostimulant therapy surpassed non-stimulant pharmacotherapy and alternative/complement intervention. Psychostimulant therapy, PBT, and the combination of psychostimulant therapy and PBT appear to be similar in efficacy according to this meta-regression.
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Affiliation(s)
- Kung-Han Yang
- Department of Applied Mathematics, Chinese Culture University, Taipei, Taiwan
| | - Hsien-Yuan Lane
- Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan,Graduate Institute of Biomedical Sciences, China Medical University Medical College, Taichung, Taiwan,Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, Taipei, Taiwan
| | - Ruu-Fen Tzang
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan,Correspondence: Ruu-Fen Tzang, MD, Department of Psychiatry, Mackay Memorial Hospital, Number 92, Sec. 2, Zhong Shan N Road, Taipei 104, Taiwan ()
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A Strength-Based Intervention to Increase Participation in Leisure Activities in Children with Neuropsychiatric Disabilities: A Pilot Study. Occup Ther Int 2020; 2020:1358707. [PMID: 32454804 PMCID: PMC7154983 DOI: 10.1155/2020/1358707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 03/10/2020] [Indexed: 11/18/2022] Open
Abstract
The aim is to evaluate the feasibility of an intervention model with a client-centered goal-directed approach with the aim to enhance the child's participation in leisure activities, self-efficacy, and activity performance. A pilot intervention using a client-centered goal-directed approach and a single-subject design was performed. Two Swedish boys with neuropsychiatric diagnosis aged 12 and 14 years old were included, and 3 leisure activity goals were identified. The intervention was carried out over 8 weeks and took place in the adolescent's everyday environment and at the pediatric rehabilitation center. The goal attainment of participation goals (GAS), the perceived performance ability according to the Canadian Occupational Performance Measure (COPM), the self-efficacy, and the participants' satisfaction were used to study the effect. The participants succeeded in attaining their leisure goals as specified by the GAS by achieving +2 on one goal and +1 on the other two goals. They estimated higher performance ability and self-efficacy in their goal performance. Participants, parents, and therapists were overall satisfied and found the intervention to be applicable and helpful in optimizing leisure participation. The intervention model with a client-centered goal-directed approach in which participants define their own leisure activity goals appears to be effective in increasing participation in leisure activities.
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Lan YT, Liu XP, Fang HS. Randomized control study of the effects of executive function training on peer difficulties of children with attention-deficit/hyperactivity disorder C subtype. APPLIED NEUROPSYCHOLOGY. CHILD 2020; 9:41-55. [PMID: 30526074 DOI: 10.1080/21622965.2018.1509003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/25/2018] [Accepted: 08/03/2018] [Indexed: 06/09/2023]
Abstract
Objective: Attention-deficit/hyperactivity disorder C subtype (ADHD-C) is associated with social rejection and peer difficulties. The present study evaluates the comparative efficacy of group executive function training (GEFT) with social skills training (SST) in children with ADHD-C in China.Methods: A randomized, controlled treatment outcome study that comprised of 52 boys and 29 girls (age range: 9-12 years old) was conducted. The primary variable (peer relationship), secondary variables (executive functions [EFs] and social skills) and ADHD symptoms (inattention and hyperactive) were measured before and after the intervention and 3-month follow-up.Results: First, both GEFT and SST had instant effects on peer relationship. Second, GEFT mainly improved their EFs and self-control dimension of social skills. At the same time, ADHD symptoms were reduced. SST mainly improved their social skills, but had no effect on EFs and ADHD symptoms. Third, GEFT had better long-term effects than SST on peer relationship.Conclusion: Executive function training produced more effective and lasting changes on peer difficulties of ADHD children.
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Affiliation(s)
- Yan-Ting Lan
- School of Psychology, Beijing Normal University, Beijing, China
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, China
| | - Xiang-Ping Liu
- School of Psychology, Beijing Normal University, Beijing, China
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, China
| | - Hong-Shan Fang
- Department of Chinese Language and Literature, Beijing Normal University, Beijing, China
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10
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AdCom study-adolescent communication group therapy for externalising disorders. Ir J Med Sci 2019; 189:261-265. [PMID: 31422547 DOI: 10.1007/s11845-019-02076-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 07/24/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Communication difficulties are associated with oppositional symptoms in young people. We hypothesise that a communication group intervention will reduce oppositional symptoms in young people. Previous research on communication and social skills training in young people with externalising disorders is limited. AIMS We aimed to (1) develop and describe a group communication intervention to promote social competence in adolescents with behaviour difficulties, for use in CAMHS with those with attention-deficit/hyperactivity disorder (ADHD)/externalising disorders, and (2) collect pilot data on the effectiveness of this intervention. METHODS We developed and delivered a programme of eight sessions to eight adolescents aged 12 to 13 years. We describe the intervention and challenges running the programme. We present pilot study data on pre- and post-oppositional symptoms. RESULTS Our programme was relatively well attended; pilot data indicated a small reduction in oppositional symptoms in all participants. Challenges in running the group were noted. CONCLUSIONS Our pilot study data suggest that further research is needed to study the effects of a communication group intervention on oppositional symptoms in a larger number of adolescents.
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Pereira Júnior ADC, Castilho ECD, Borges TL, Santos PLD, Carvalho AMP, Miasso AI. An Integrative Review of Non-Pharmacological Therapeutic Interventions in Children with Mental Health Problems. Compr Child Adolesc Nurs 2019; 43:245-259. [PMID: 31161805 DOI: 10.1080/24694193.2019.1621961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We provide an integrative review of non-pharmacological interventions for children with mental health problems. A total of 262 studies were found in three databases, of which 12 met the inclusion criteria, indicating a shortage of research on the subject. The most frequently used type of intervention was cognitive-behavioural therapy-based interventions, and attention deficit hyperactivity disorder was the most frequent problem. Non-pharmacological interventions help to improve the symptoms of childhood mental health problems, so there is a need to carry out further research on this issue in Brazil and the rest of Latin America.
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Affiliation(s)
| | | | - Tatiana Longo Borges
- Ribeirão Preto College of Nursing, University of São Paulo , Ribeirão Preto, Brazil
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12
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Willis D, Siceloff ER, Morse M, Neger E, Flory K. Stand-Alone Social Skills Training for Youth with ADHD: A Systematic Review. Clin Child Fam Psychol Rev 2019; 22:348-366. [DOI: 10.1007/s10567-019-00291-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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13
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Goode AP, Coeytaux RR, Maslow GR, Davis N, Hill S, Namdari B, LaPointe NMA, Befus D, Lallinger KR, Bowen SE, Kosinski A, McBroom AJ, Sanders GD, Kemper AR. Nonpharmacologic Treatments for Attention-Deficit/Hyperactivity Disorder: A Systematic Review. Pediatrics 2018; 141:peds.2018-0094. [PMID: 29848556 DOI: 10.1542/peds.2018-0094] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/07/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Nonpharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD) encompass a range of care approaches from structured behavioral interventions to complementary medicines. OBJECTIVES To assess the comparative effectiveness of nonpharmacologic treatments for ADHD among individuals 17 years of age and younger. DATA SOURCES PubMed, Embase, PsycINFO, and Cochrane Database of Systematic Reviews for relevant English-language studies published from January 1, 2009 through November 7, 2016. STUDY SELECTION We included studies that compared any ADHD nonpharmacologic treatment strategy with placebo, pharmacologic, or another nonpharmacologic treatment. DATA EXTRACTION Study design, patient characteristics, intervention approaches, follow-up times, and outcomes were abstracted. For comparisons with at least 3 similar studies, random-effects meta-analysis was used to generate pooled estimates. RESULTS We identified 54 studies of nonpharmacologic treatments, including neurofeedback, cognitive training, cognitive behavioral therapy, child or parent training, dietary omega fatty acid supplementation, and herbal and/or dietary approaches. No new guidance was identified regarding the comparative effectiveness of nonpharmacologic treatments. Pooled results for omega fatty acids found no significant effects for parent rating of ADHD total symptoms (n = 411; standardized mean difference -0.32; 95% confidence interval -0.80 to 0.15; I2 = 52.4%; P = .10) or teacher-rated total ADHD symptoms (n = 287; standardized mean difference -0.08; 95% confidence interval -0.47 to 0.32; I2 = 0.0%; P = .56). LIMITATIONS Studies often did not reflect the primary care setting and had short follow-up periods, small sample sizes, variations in outcomes, and inconsistent reporting of comparative statistical analyses. CONCLUSIONS Despite wide use, there are significant gaps in knowledge regarding the effectiveness of ADHD nonpharmacologic treatments.
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Affiliation(s)
- Adam P Goode
- Duke Orthopaedic Surgery.,Duke Clinical Research Institute, and
| | - Remy R Coeytaux
- Department of Family and Community Medicine and.,Center of Integrative Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Gary R Maslow
- Departments of Psychiatry and Behavioral Sciences.,Pediatrics, and
| | - Naomi Davis
- Departments of Psychiatry and Behavioral Sciences
| | - Sherika Hill
- Departments of Psychiatry and Behavioral Sciences
| | | | | | - Deanna Befus
- Center of Integrative Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Kathryn R Lallinger
- Duke Clinical Research Institute, and.,Duke Evidence-Based Practice Center, Durham, North Carolina; and
| | - Samantha E Bowen
- Duke Center for Autism and Brain Development, School of Medicine, Duke University, Durham, North Carolina
| | | | - Amanda J McBroom
- Duke Clinical Research Institute, and.,Duke Evidence-Based Practice Center, Durham, North Carolina; and
| | - Gillian D Sanders
- Duke Clinical Research Institute, and.,Duke Evidence-Based Practice Center, Durham, North Carolina; and
| | - Alex R Kemper
- Division of Ambulatory Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
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Peer Inclusion in Interventions for Children with ADHD: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7693479. [PMID: 29744363 PMCID: PMC5878915 DOI: 10.1155/2018/7693479] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/09/2018] [Indexed: 02/07/2023]
Abstract
Objective To assess the effectiveness of peer inclusion in interventions to improve the social functioning of children with ADHD. Methods We searched four electronic databases for randomized controlled trials and controlled quasi-experimental studies that investigated peer inclusion interventions alone or combined with pharmacological treatment. Data were collected from the included studies and methodologically assessed. Meta-analyses were conducted using a random-effects model. Results Seventeen studies met eligibility criteria. Studies investigated interventions consisting of peer involvement and peer proximity; no study included peer mediation. Most included studies had an unclear or high risk of bias regarding inadequate reporting of randomization, blinding, and control for confounders. Meta-analyses indicated improvements in pre-post measures of social functioning for participants in peer-inclusive treatment groups. Peer inclusion was advantageous compared to treatment as usual. The benefits of peer inclusion over other therapies or medication only could not be determined. Using parents as raters for outcome measurement significantly mediated the intervention effect. Conclusions The evidence to support or contest the efficacy of peer inclusion interventions for children with ADHD is lacking. Future studies need to reduce risks of bias, use appropriate sample sizes, and provide detailed results to investigate the efficacy of peer inclusion interventions for children with ADHD.
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Shin YM, Kim EJ, Kim Y, Bhang SY, Lee E, Lee CS, Chang HY, Hong M, Shin D. The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (IV) - Non-Pharmacologic Treatment -. Soa Chongsonyon Chongsin Uihak 2017. [DOI: 10.5765/jkacap.2017.28.2.84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Yun Mi Shin
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
| | - Eui-Jung Kim
- Department of Psychiatry, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Yunsin Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Soo Young Bhang
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Eulji Hospital, Seoul, Korea
| | - Eunha Lee
- The ADD Centre and Biofeedback Institute of Toronto, Toronto, Canada
| | - Cheol-Soon Lee
- Department of Psychiatry, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Hyoung Yoon Chang
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
| | - Minha Hong
- Department of Psychiatry, Seonam University School of Medicine, Myongji Hospital, Goyang, Korea
| | - Dongwon Shin
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
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