Parental Occupation Executive Training (POET): An Efficient Innovative Intervention for Young Children with Attention Deficit Hyperactive Disorder

Exploring Co-Regulation-Related Factors in the Mothers of ADHD Children-Proof of Concept Study

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) is a complex neurological condition interfering with family relationships and co-regulation capabilities. Therefore, exploring factors underpinning parental co-regulation ability is crucial for future fostering relationships in families of children with ADHD.

OBJECTIVE

This preliminary study aims to characterize and compare the executive-functions, anxiety, self-efficacy, and sensory modulation in mothers of children with and without ADHD.

METHOD

Mothers of children with (study group) and without (control-comparison, group) ADHD completed online self-reports, measuring executive-functions; parental self-efficacy; anxiety; and sensory modulation.

RESULTS

The study group (N = 40) had lower self-efficacy compared to the control group (N = 27; p = 0.018), and the control group had lower sensory responsiveness (p = 0.025). Within both groups the Behavior Rating Inventory of Executive Function-Adult (BRIEF-A) Global Executive Function Composite score (GEC) and the Beck Anxiety Inventory (BAI) were moderately correlated. Further, within the study group correlations were found between the BRIEF-A-GEC and the Sensory Responsiveness Questionnaire (SRQ)-Aversive scores (r = 0.37, p ≤ 0.01), and between the BRIEF-A Behavioral-Rating-Index and the parental self-efficacy scores (r = 0.31, p ≤ 0.05). Within the control group, negative correlations were found between the BRIEF-A-GEC and SRQ-Hedonic scores (r= -0.44, p < 0.05).

CONCLUSION

Self-efficacy, executive-functions, high sensory responsiveness and anxiety traits are interwoven and may impact parental co-regulation ability.

Children with ADHD Symptomatology: Does POET Improve Their Daily Routine Management?

Children with attention-deficit/hyperactivity disorder (ADHD) struggle with executive delays while managing their daily tasks. This is a secondary analysis of existing data from open-label research examining the efficacy of Parental Occupational Executive Training (POET). It further examines POET's efficacy in increasing young children's (3.83 to 7.08 years) executive control over daily routines, and in decreasing their ADHD symptoms. Additionally, the second analysis investigates which of the children's increased capabilities is better associated with the change in their daily routine management following the intervention. Parents of children with ADHD symptomatology (N = 72, 55 boys) received eight POET sessions. They completed standardised ADHD symptomatology, executive management of daily routines, and executive functions (EF) questionnaires at pretest, post-test, and 3-month follow-up. Children's ADHD symptoms and their management of daily routines significantly improved following the POET intervention. The children's score changes in EF accounted for 37% of the variance in their improved routine management. These findings suggest that interventions aiming to increase children's executive control over their daily routines should improve their broader array of EF besides decreasing core ADHD symptoms.

Interventions for Executive Function in High-Risk Infants and Toddlers

This review summarizes the current state of evidence regarding interventions for executive function in high-risk infants and toddlers. Currently, there is a paucity of data in this area, with the interventions that have been studied highly variable in their content, dosage, target, and results. Self-regulation is the executive function construct targeted the most, with mixed results. The few studies that report later child outcomes in prekindergarten/school-aged children are encouraging, overall indicating improved cognition and behavior in the children of parents who received a parenting style intervention.

The Effects of Telehealth Parent Coaching on Occupational Performance and Executive Function of Children with Attention-Deficit/Hyperactivity Disorders, and Parent Self-Efficacy: A Preliminary Study

This study examined the effectiveness of telehealth parent coaching on occupational performance and executive functions of children with attention-deficit/hyperactivity disorders (ADHD) and executive function deficits and parent self-efficacy. A one group pretest-posttest design was implemented with nine parents of children with ADHD ages 7-12 years old. The intervention consisted of ten, 60-minute, individual sessions, one per week delivered via telehealth. The parent program had three coaching components: goal setting, education, and the problem-solving process. Using strategies from the Four-Quadrant Model of Facilitated Learning, the results showed statistical improvement in performance and satisfaction of occupational performance and all executive functions scores of children except for the Shift and Emotional Control. Parent self-efficacy was also improved. These preliminary results suggest that the telehealth parent coaching program may potentially support a family who has a child with ADHD and executive function deficits.

An Exploratory Study of Executive Function Development in Children with Autism, after Receiving Early Intensive Behavioral Training

Objective: To examine the development of executive functions, in preschool children with autism spectrum disorders (ASD), receiving early intensive behavioral training (EIBI). Method: Executive functions (EF) were assessed with The Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P), by parents and preschool teachers at the time of diagnostic assessment and after 15 months of EIBI intervention. Ten children with ASD (M = 2.9 years, nine males) participated in the study. Reliable Change Index scores were computed for each of the participants in order to investigate any significant change in BRIEF-P T-scores. Results: Three children showed a significant improvement in EF, based on parent ratings. Four children showed a significant improvement in EF based on preschool teacher ratings. Conclusion: Findings indicating a reliable improvement in one third of preschool children with ASD receiving EIBI are encouraging but need to be replicated in larger scale controlled studies.