Development of strategies to reduce the impact of the relative age effect on kindergarteners with ADHD

制定策略以减少相对年龄效应对患有多动症的幼儿园儿童的影响

• 批准号: 10057011
• 负责人: GREGORY A FABIANO
• 金额: $ 68.01万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10057011
• 关键词: Academic achievement; Address; Adult; Age; Aloe; Area; Attention deficit hyperactivity disorder; Attenuated; Behavior; Behavior Control; Behavioral; Characteristics; Child; Child Development; Chronic; Chronology; Clinical Trials; Coercion; Coupled; Data; Development; Diagnosis; Diagnostic; Distal; Education; Elderly; Exhibits; Family; Future; Growth; Health Benefit; Impairment; Intervention; Lifestyle-related condition; Literature; Maintenance; Measures; Modification; Neurocognitive; Outcome; Paper; Parents; Pharmaceutical Preparations; Policies; Prevention; Preventive Intervention; Process; Productivity; Public Health; Randomized; Recommendation; Risk; Schools; Stress; Symptoms; Teacher Professional Development; Testing; Time; Treatment outcome; age effect; base; career; college; comorbidity; early childhood; evidence base; executive function; expectation; experience; falls; first grade; functional disability; group intervention; improved; improved functioning; improved outcome; intervention effect; kindergarten; prevent; programs; scaffold; social; teacher; therapy development

PROJECT SUMMARY Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition, present from early childhood, which persists throughout the lifecourse. There is now clear evidence that children entering kindergarten, that are relatively young for the grade (e.g., born in the months immediately preceding the school entry cut-off) are at significantly more risk for receiving an ADHD diagnosis and being prescribed stimulant medication. These risks appear to be related solely to age of entry when other explanatory variables are controlled (Elder, 2010). This situation, termed the “Relative Age Effect” in this literature has potentially serious consequences for kindergarten children (e.g., greater likelihood of being prescribed psychoactive medication to control behavior; Elder, 2010). The present proposal aims to develop a teacher intervention to attenuate the impact of the relative age effect on young kindergarteners with elevated ADHD symptoms, and test the correspondence between the hypothesized mechanisms and treatment outcomes related to ADHD (e.g., symptoms, impairment). Following intervention development and refinement, 60 children entering kindergarten in the fall, and young for the grade, will be randomly assigned to (1) Kindergarten as Usual (KAU); (2) a Relative Age Effect prevention intervention administered immediately; or (3) a Relative Age Effect prevention intervention administered mid-year. In the intervention groups, teachers will be introduced to the relative age effect, receive information on how to anchor behavioral ratings in developmental norms, and implement a positive behavioral support to support growth in the child across the kindergarten school year. Primary aims will be to demonstrate the feasibility and acceptability of the intervention approach as well as the ability of the team to retain young children in a longitudinal trial. Further, the hypothesized mechanisms (e.g., improved neurocognitive functioning; improved teacher use of positive behavioral supports) will be measured and correspondence to hypothesized outcomes (e.g., reduced ADHD symptoms and impairment) will be evaluated. Data collected will be used to justify a larger efficacy-based trial to support the positive development of children with ADHD during this critical developmental transition.

项目摘要 注意力缺陷多动障碍（ADHD）是一种慢性疾病，从幼儿期开始， 这在整个生命过程中持续存在。现在有明确的证据表明，进入幼儿园的儿童， 对于年级来说相对年轻（例如，在入学截止日期前一个月内出生的儿童）， 接受ADHD诊断和服用兴奋剂药物的风险要高得多。这些 当控制其他解释变量时，风险似乎仅与入职年龄相关（Elder，2010）。 这种情况，在本文献中称为“相对年龄效应”，对以下方面具有潜在的严重后果： 幼儿园儿童（例如，更有可能被处方精神药物来控制行为; Elder，2010）。 目前的建议旨在发展一种教师干预措施，以减轻相对年龄的影响 对ADHD症状升高的年轻儿童的影响，并测试 与ADHD相关的假设机制和治疗结果（例如，症状、损伤）。以下 干预的发展和完善，60名儿童进入幼儿园在秋季，和年轻的年级， 将被随机分配到（1）幼儿园作为幼儿园（KAU）;（2）相对年龄效应预防干预 立即施用;或（3）年中施用的相对年龄效应预防干预。在 干预组中，教师将介绍相对年龄效应，如何接收信息锚 行为评级的发展规范，并实施积极的行为支持，以支持增长， 整个幼儿园学年。 主要目的是证明干预方法的可行性和可接受性 团队在纵向试验中留住幼儿的能力。此外，假设的机制 (e.g.,改善神经认知功能;改善教师使用积极的行为支持）将是 测量并对应于假设的结果（例如，减少ADHD症状和损害） 将被评估。收集的数据将用于证明更大规模的基于疗效的试验，以支持积极的 注意力缺陷多动症儿童在这一关键的发展转变。