Home-based parent training for school-aged children with attention-deficit/hyperactivity disorder and behavior problems with remaining impairing disruptive behaviors after routine treatment: a randomized controlled trial

Abstract

The objective is to investigate the effectiveness of home-based behavioral parent training for school-aged children with attention-deficit/hyperactivity disorder (ADHD) and behavior problems with remaining impairing disruptive behaviors after routinely offered treatments in clinical practice. In a randomized controlled study including 73 referred children with ADHD and impairing disruptive symptoms after routine clinical pharmacotherapy and/or clinic-based parent training had been tried or, at least, offered, home-based behavioral parent training ( n \u2009=\u200926 ) was compared to a waiting list ( n \u2009=\u200923) and a care-as-usual home-based treatment ( n \u2009=\u200924). It was unknown to families which of the home-based treatments that they received. Using mixed models for repeated measures, we examined the effectiveness on the primary outcome measure of children’s severity of disruptive behaviors and on a number of secondary outcome measures [the degree to which parents experienced the disruptive behaviors as troublesome, ADHD symptoms, oppositional-defiant disorder (ODD) symptoms, and internalizing problems]. Compared to the waiting list, children receiving home-based parent training improved significantly more regarding severity of disruptive behaviors (ES\u2009=\u20090.75), ADHD symptoms (ES\u2009=\u20090.89), ODD symptoms (ES\u2009=\u20090.65), and internalizing problems (ES\u2009=\u20090.60). Compared to care-as-usual, home-based parent training was more effective in reducing disruptive behaviors (ES\u2009=\u20090.57), ADHD symptoms (ES\u2009=\u20090.89), and ODD symptoms (ES\u2009=\u20090.88). Significantly more reduction of children’s internalizing problems was not found. In conclusion, children with ADHD and residual behavioral problems after routine treatment may benefit from home-based behavioral parent training.