Journal of the Korean Academy of Child and Adolescent Psychiatry : eISSN 2233-9183 / pISSN 1225-729X

Table. 6.

Table. 6.

Treatment procedure of randomized clinical trial and cross-sectional study design

Domains Pfiffner et al. [31] Hart et al. [27]
Recruitment Schools, school mental health providers, learning specialists Local professionals or schools, advertisements or reports in the local media
Screening Parent/Teacher telephone interviews and assessed for demographics, school and mental status (Children who failed the initial screening requirements were further evaluated) Nil
Diagnostic Parents and teachers rated the children using:
- Child Symptom Inventory (CSI-4)
- Disability Rating Scale (IRS)
Parents and teachers rated the children using:
- Disruptive Behavior Disorder Rating Scale
- IOWA Conners Rating Scale
Children who met the evidence-based diagnostic criteria got enrolled into the Summer Treatment Program (STP)
Academic Testing Nil - Woodcock-Johnson Tests of Academic Achievement (WJ-III) (Subtests: Letter Word Identification, Reading Fluency, Work Attack, Math Calculation, and Math Fluency)
- Peabody Vocabulary Test (PPVT-III)
Targeted Measures Efficacy of Child Life and Attention Skills Treatment:
Parent component - planning, working memory, multitasking, prioritizing
Child component - independence (academic, study and organizational skills: self-care and daily living skills) and social skills (good sportsmanship, assertion, conversational skills, dealing with teasing, friendship making, play-date skills)
- On task behavior during instructional period
- On task behavior and work productivity during testing
Intervention procedure A. Child Life and Attention Skills Treatment (CLAS)
CLAS attempts to maximize the efficacy of psychosocial treatment for the Inattentive Type of ADHD.
CLAS included:
- The reliance of techniques such as scaffolding, reminders and routinization.
- Parent component (PA), child component (CA), and teacher component (TA)
Strategies included:
a. PA: rewards, praise, establishing daily routines, directions and commands, avoiding power struggles, parent stress management, organize/structure the home
b. CA: problem solving steps, self-cues, reminder lists focusing on independence and social skills
c. TA: evidence based classroom management strategies
B. Parent-Focused Treatment (PFT) Received the same number of parent group and individual family meetings as CLAS families
STP offered state-of-the-art treatment to children with ADHD and related problems
- Included Whole Group (WG) condition, Small Group (SG) condition, and Independent Seatwork (IS) condition
- Both the instructional and testing periods were present in all three conditions, with the instructional period focusing on reading comprehension and the testing period on worksheet completion.
C. Treatment as usual (TAU)—Booster session for PFT and CLAS
Families received a written diagnostic report and a list of community treatment providers
Duration of session Ten 90 min parent group meetings
Ten 90 min child group meetings
One 30 min orientation meeting
10 min each for WG, SG, and IS conditions (instructional and testing periods)
Personnel for data recording Therapists Teachers and Research assistant
Post intervention analysis -DSM-IV inattention symptoms rated on a 4-point scale
-Organization skills were rated on a 4-point rating scale by teachers and parents
-Social skills rated using Social-Skills Improvement system (SSIS) by teachers and parents
-Functional Impairment was rated using the Impairment Rating Scale (IRS)
-Global psychosocial functioning was rated on a 7 point rating scale using Global Impression Scale
Nil
Treatment/procedure integrity and fidelity Interrater reliability for the CLAS and PFT was >97% The average observation rating:
- Appropriately administered treatment components: 98.7 %
- Average percentage of appropriate commands: 89.2%
Social validity Ascertained from parents and teachers using a 5-point scale pertaining to the usefulness and appropriateness of the CLAS and PFT program.
Degree of satisfaction (CLAS): Parents: >95%; Teachers: 94%
Degree of satisfaction (PFT): Parents: 94-95%
Nil
Results Post hoc comparison between CLAS, PFT and TAU was done and the results (level of significance) are as follows:
A. Inattention symptoms:
Child Symptom Inventory (CSI)
CLAS-PFT: Parent Report (PR)-0.35
& Teacher Report (TR)-0.21
CLAS-TAU: PR-0.68 & TR -0.17
PFT-TAU:PR-0.33 & TR-0.04
B. Organizational skills:
Children’s organizational skill scale(COSS)
CLAS-PFT: PR-0.35 & TR -0.25
CLAS-TAU: PR-0.46 & TR-0.16
PFT-TAU: PR-0.12 & TR -0.09
C. Social skills:
Social skills improvement system(SSIS)
CLAS-PFT: PR-0.12 & TR-0.26
CLAS-TAU: PR-0.34 & TR-0.02
PFT-TAU: PR-0.22 & TR-0.24
D. Overall improvement:
PR: Clinical Global Impressions- Improvement(CGI-I)
TR: Clinical Global Impression- Severity (CGI-S)
CLAS-PFT: PR-0.23 & TR-0.16
CLAS-TAU: PR-0.67 & TR-0.17
PFT-TAU: PR-0.45 & TR-0.01
Post hoc comparison between Independent seatwork, small group and whole group condition
On-Task Behavior during Instructional and testing period:Instructional Period:
a) IS - F(1, 31) = 10.44, p< .001
b) SG- F(1, 32) = 20.0, p<.001
c) WG- F(1, 32) = 6.01, p = .020
Testing Period:
F(2, 31) =1.695, p =.200
Post hoc analyses were not interpreted to evaluate differences between conditions, suggests that the on-task behavior of children with ADHD does not differ between testing contexts
Work Productivity during Testing:
a) IS: F(2, 31) =7.501, p =.002
b) SG: F(1, 32) =8.845, p =.006
c) WG: F(1, )32 14.785, p =.001
J Korean Acad Child Adolesc Psychiatry 2022;33:2-15 https://doi.org/10.5765/jkacap.210021
© 2022 J Korean Acad Child Adolesc Psychiatry