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Behavioral Interventions Effective for Preschoolers with ADHD

Science Update

Two types of early interventions designed to reduce symptoms of attention deficit-hyperactivity disorder (ADHD) in preschoolers may be effective alternatives or additions to medication treatment, according to a recent NIMH-funded study. The study was published in the most recent quarterly edition of the journal School Psychology Review.

Lee Kern, PhD, and George DuPaul, PhD, of Lehigh University and colleagues compared a multicomponent intervention (MCI) with a parent education (PE) program using a group of 135 preschoolers (ages 3 to 5) diagnosed with ADHD and their parents. Participants who were randomly assigned to MCI received parent education classes that focused on parenting skills, understanding the child's behavior and development, and ensuring child safety. They also received individualized interventions in the home and at preschool or day care. Participants assigned to PE only received training in parenting skills in a group setting. Both programs lasted for one year and child progress was evaluated every six months.

Both groups showed significant improvement after one year. Problem behavior among the children decreased, and their social skills improved. Although the researchers expected to see more improvement among those receiving MCI compared to those receiving only PE, they found no significant differences in improvement rates between the two groups.

The researchers pose several explanations for the apparent lack of differences in outcomes between the two interventions. For example, more distinct differences between the two interventions may not be evident after only one year, but could emerge after a longer period of time. Another possibility may be that parent education classes may be sufficient for some, and more intensive interventions like MCI may not be necessary, at the very early stages of the disorder before problem behavior has become ingrained. Regardless of the reasons for the lack of differences, the results indicate that behavioral interventions for preschoolers with ADHD can be effective, and further study will help identify the best approaches.

Kern L, DePaul G, Volpe R, Sokol N, Lutz G, Arbolino L, Pipan M, VanBrakle J. Multisetting assessment-based intervention for young children at risk for attention deficit hyperactivity disorder: Initial effects on academic and behavioral functioning. School Psychology Review, 2007; 36(2): 237-255.