A Randomised Controlled Trial of a Play-Based Intervention to Improve the Social Play Skills of Children with Attention Deficit Hyperactivity Disorder (ADHD).
A Randomised Controlled Trial of a Play-Based Intervention to Improve the Social Play Skills of Children with Attention Deficit Hyperactivity Disorder (ADHD).
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DOI：
10.1371/journal.pone.0160558
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Chen YW
中科院分区：
文献类型：
--
作者：
Wilkes-Gillan S;Bundy A;Cordier R;Lincoln M;Chen YW
需要采取有效的干预措施来解决多动症儿童的社交困难。这项随机对照试验检验了基于游戏的干预措施对于提高患有多动症的儿童在同伴互动中的社交游戏技能的有效性。患有 ADHD 的儿童（5 至 11 岁）被随机分为干预优先组 (n = 15) 或候补对照组 (n = 14)。分配到对照组的参与者在 10 周的等待期后接受了干预。孩子们邀请了一位发育正常的玩伴，多动症儿童的家长也参与其中。干预措施包括：六次诊所游戏课程、每周家庭模块和为期一个月的家庭随访。趣味性测试 (ToP) 由盲评员评分。家长报告的治疗依从性用于评估治疗保真度。组间统计数据用于比较先干预组（10 周干预期）和先控制组（10 周等待期）的变化。所有儿童接受干预后，使用重复测量方差分析、事后最小显着性差异检验和 Cohen’s-d 来衡量效果。使用弗里德曼方差分析分析了 Top 社交项目的变化。线性回归分析用于识别预测变化的变量。对照组在等待期间没有变化。先干预组的变化显着大于先控制组的变化（在等待期间）。将两组数据合并后发现，ADHD 儿童（n = 29）的平均 ToP 评分在干预后显着改善，干预前到干预后以及干预前到随访都有很大效果。儿童在随访中保持了治疗效果。干预后，所有顶级社交项目均显着改善。研究结果支持使用涉及父母和同伴介导的游戏来增强多动症儿童的社交游戏技能。试验注册：澳大利亚新西兰临床试验注册中心 ACTRN12614000973617
There is a need for effective interventions to address the social difficulties of children with ADHD. This randomised controlled trial examined the effectiveness of a play-based intervention for improving the social play skills of children with ADHD in peer-to-peer interactions. Children with ADHD (5 to 11 years) were randomised to an intervention-first (n = 15) or waitlist control-first group (n = 14). Participants allocated to the control-first group received the intervention after a 10-week wait period. Children invited a typically-developing playmate and parents of children with ADHD participated. The intervention involved: six clinic play-sessions, weekly home-modules and a one-month home follow up. The Test of Playfulness (ToP) was scored by a blinded rater. Parent reported treatment adherence was used to assess treatment fidelity. Between group statistics were used to compare the change of the intervention-first (10-week intervention period) and control-first (10-week wait period) groups. Once all children had received the intervention, repeated measures ANOVA, post hoc Least Significance Difference tests and Cohen’s-d were used to measure effect. Changes in ToP social items were analysed using Friedman’s ANOVA. Linear regression analyses were used to identify variables that predicted change. The control-first group did not change during the wait period. The change in the intervention-first group was significantly greater than the change in the control-first group (during the wait period). When the data from the two groups were combined, the mean ToP scores of the children with ADHD (n = 29) improved significantly following the intervention, with a large effect from pre to post intervention and from pre intervention to follow up. Children maintained treatment gains at follow up. All ToP social items improved significantly following the intervention. The findings support the use of play involving parent and peer mediated components to enhance the social play skills of children with ADHD. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12614000973617