What is the research about?

Behavioural interventions often are recommended as treatment for ADHD, even though there is insufficient evidence to show they work well in real life. However, there is enough evidence to support the continuation of research into whether or not they are effective in changing problem behaviour. Since parents have substantial influence on children’s development , this review sought to evaluate published trials of behavioural interventions that measured three key patient and parent outcomes:

• The impact of behavioural interventions on parents’ responses to children with ADHD was investigated.

• The possible improvements in parenting competence, and decrease in mental health problems in adults dealing with children with ADHD.

• The impact of behavioural interventions on other aspects of children’s lives, such as social skills, academic performance, and oppositional behaviours.


What did the researchers do?

The review’s authors retrieved studies that were broadly related to behavioural intervention applied to children or their parents. They found 32 studies that had enough data relating to behavioural intervention and outcomes to use for analysis. Researchers used statistical techniques to calculate the effectiveness of different forms of behavioural intervention.


What did the researchers find?

The findings of the review, based on the three initial goals, were that:

• Behavioural interventions tend to involve positive changes in parenting or parents’ self-concept.

• Increasing positive parenting, alone, did not produce positive changes in child behaviour. To lead to improvements, it must be combined with other factors, such as increasing parenting confidence or educating parents on their influence in child development.

• Short-term improvements in children’s academic performance and social skills were noted, though this needs to be further explored. Behavioural interventions also decreased conduct problems in children with ADHD.

• Overall, children and adolescents treated with behavioural interventions showed positive effects on important parts of daily functioning, such as organization or concentration


Take home message

More evidence is needed before behavioural interventions can be recommended as a primary therapy for ADHD. Nonetheless, it is known that behavioural interventions have positive effects on parenting and parents’ self-concept and functioning. Further research is also needed to confirm the effects behavioural interventions have on outcomes related to academic achievement and social skills.


Notes

The original Research Report was written by D. Daley, et. al. of the European ADHD Guidelines Group of the European Network for Hyperkinetic Disorder and published in The Journal of the American Academy of Child & Adolescent Psychiatry. 2014.