Category: ADHD - Child
Keywords: Child | Medication | Parent Training
Presentation Type: Symposium
It is unclear how best to combine and sequence treatment in families of young children at risk for ADHD who have mothers with ADHD (Chronis et al., 2016; Stein, 2015). In this pilot sequential multiple assignment randomized trial (SMART), we examine the impact of treating mothers with ADHD with stimulant medication, behavioral parent training (BPT), or both. Mothers with ADHD and their children (ages 3-8 years) with elevated ADHD symptoms (n=35) participated in a 16-week trial with mothers first randomized to 8 weeks of stimulant medication (Med; lisdexamphetamine) or BPT, and then re-randomized to 8 weeks of the same treatment augmented (Med, n=10; BPT, n=8) or combination treatment (Med/BPT, n=16). Outcome measures included the Clinical Global Impressions-Severity scale (CGI-S) to assess child functioning; Alabama Parenting Questionnaire and Dyadic Parent-Child Interaction Coding System to assess parenting; and the CGI-S, Conners Adult ADHD Rating Scale, and Wender-Reimherr Adult Attention Deficit Disorder Scale to assess maternal functioning. The Med group showed significant pre-post improvement in parenting and maternal functioning, but not child functioning. The BPT group showed significant improvement in child functioning, parenting, and the CGI-S. The Med/BPT group showed significant gains across child functioning, parenting, and maternal functioning. In post-hoc comparisons, the Med and Med/BPT groups outperformed the BPT in maternal functioning, whereas BPT and Med/BPT groups outperformed Med in child functioning and parenting. In summary, child functioning improved only with behavior modification, whereas maternal functioning improved only with maternal medication. Combined treatment was consistently associated with more consistent improvements across outcomes. Larger studies can examine how best to sequence these treatments.
Seattle Children's Hospital
Sunday, November 19
10:15 AM – 11:45 AM
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