Home-Based Parent Training in ADHD Preschoolers

描述（由申请人提供）：通过对一种有前途的英国家庭干预[新森林育儿包（NFPP）]的特异性和非特异性疗效进行测试，解决ADHD幼儿对非药物治疗的需求。理由：ADHD起源于儿童早期，可预测多种功能障碍。虽然精神兴奋剂对患有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措施是公共卫生的优先事项。NFPP是唯一一种对学龄前儿童ADHD和ODD症状具有即时和持续疗效的干预措施。这项研究评估了NFPP的优势，标准的父母干预[帮助不服从儿童（HNCC）]和等待名单（WL）控制。HNCC已被证明可以改善学龄前儿童的对立行为。它对ADHD症状的影响未经测试。假设条件：在3岁ADHD奥尔兹中，NFPP在减少ADHD症状和儿童对奖励的延迟耐受方面上级HNCC和WL; NFPP在减少ODD症状方面上级WL; NFPP对ADHD症状的优势将保持到干预后的学年。我们将探讨照顾者ADHD对治疗结果的调节作用，以及养育方式的改变是否会介导NFPP和HNCC的治疗效果。设计：225名在家中和学校患有ADHD的学龄前儿童（3.0 - 3-11）将被随机分为1）NFPP，2）HNCC或3）WL，为期8周。ADHD措施包括主要看护人，教师，临床医生和直接儿童观察的评级。将对看护者进行ADHD诊断和一般精神病理学评估。多信息提供者、多方法，包括观察父母-子女互动，将在治疗结束时评估父母行为和儿童的功能，并在治疗后的学年秋季进行评估。分析：ITT ANCOVA将检验即刻和随访治疗差异。统计交互将探索假设的主持人之间的关系（即，注意力缺陷多动症（ADHD）和治疗差异。结构方程模型将探讨在看护行为的变化的中介作用。

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.