Home-Based Parent Training in ADHD Preschoolers

描述(由申请人提供)：通过测试一种有前景的英国家庭干预措施的特定和非特定疗效[新森林育儿包(NFPP)]，解决患有ADHD的幼儿的非药物治疗需求。理论基础：ADHD起源于儿童早期，并预示着多种功能障碍。尽管心理刺激剂对患有ADHD的学龄前儿童有效，但家庭抵制使用。因此，为学龄前儿童建立有效的心理社会干预是公共卫生的优先事项。NFPP是唯一一种对学龄前儿童的ADHD和奇怪症状有即时和持续疗效的干预措施。这项研究评估了NFPP相对于标准育儿干预[帮助不合规儿童(HNCC)]和等待名单(WL)对照的优越性。HNCC已被证明可以改善学龄前儿童的对抗行为。它对ADHD症状的影响还没有经过测试。假设：在3岁ADHD儿童中，NFPP在减少ADHD症状方面优于HNCC和WL，在儿童对奖励的延迟耐受性方面优于NFPP；在减少奇怪症状方面NFPP优于WL；在ADHD症状上NFPP优于HNCC，并将持续到干预后的学年。我们将探讨照顾者的ADHD对治疗结果的调节作用，以及父母教养方式的变化是否在NFPP和HNCC的治疗效果中起中介作用。设计：将225名在家和学校患有ADHD的学龄前儿童(3.0-3-11)随机分为1)NFPP组，2)HNCC组，或3)WL组，为期8周。ADHD的衡量标准包括初级照顾者、教师、临床医生和直接观察儿童的评级。照顾者将接受ADHD诊断和一般精神病理学评估。多信息者、多方法，包括对亲子互动的观察，将在治疗结束时评估父母的行为和儿童的功能，并在治疗结束后进入学年。分析：ITT ANCOVA将测试即刻和后续治疗的差异。统计交互作用将探索假设的调节因素(即看守者ADHD)和治疗差异之间的关系。结构方程模型将探索变化在照顾者行为中的中介作用。

DESCRIPTION (provided by applicant): To address the need for non-pharmacological treatment in young children with ADHD through a test of specific and non-specific efficacy of a promising UK home-based intervention [New Forest Parenting Package (NFPP)]. Rationale: ADHD originates in early childhood and predicts multiple functional impairments. Although psychostimulants are effective in preschoolers with ADHD, families resist their use. Therefore, establishing effective psychosocial interventions for preschoolers represents a public health priority. NFPP is the only intervention with documented immediate and sustained efficacy for ADHD and ODD symptoms in preschoolers. The study evaluates NFPP's superiority to a standard parenting intervention [Helping Non-Compliant Children (HNCC)] and a wait-list (WL) control. HNCC has been shown to improve oppositional behaviors in preschoolers. Its effect on ADHD symptoms is untested. Hypotheses: In 3 year olds with ADHD, NFPP is superior to HNCC and WL in reducing ADHD symptoms, and children's delay tolerance for rewards; NFPP is superior to WL in reducing ODD symptoms; NFPP's superiority over HNCC on ADHD symptoms will be maintained into the school year following the intervention. We will explore the moderating effect of caretaker's ADHD on treatment outcome, and whether changes in parenting mediate treatment efficacy in NFPP and HNCC. Design: 225 preschoolers (3.0 - 3-11) with ADHD at home and school will be randomized to 1) NFPP, 2) HNCC, or 3) WL for 8 weeks. ADHD measures include ratings by primary caretaker, teacher, clinician and direct child observations. Caretakers will be assessed for ADHD diagnosis and general psychopathology. Multi-informant, multi-methods, including observations of parent- child interactions, will assess parental behavior and children's function at the end of treatment, and into the fall of the school year following treatment. Analyses: ITT ANCOVA's will test immediate and follow-up treatment differences. Statistical interactions will explore relationships between postulated moderators (i.e., caretaker ADHD) and treatment differences. Structural equation modeling will explore the mediating role of changes in caretaker behaviors.