Behavioral Parenting Intervention for ADHD

(PERS Trial)

Overseen By James G Waxmonsky, MD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Milton S. Hershey Medical Center

Disqualifiers: Non English speaking, Intellectual delay, Autistic traits, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 8

Duration: 12 weeks

65 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a behavioral parenting program designed to help parents manage oppositional behaviors and ADHD symptoms in their children at home. Researchers aim to determine if parents' ability to handle their own emotions affects the program's effectiveness. Specifically, they are examining whether parents who struggle with emotional management might find the training less effective in improving parenting and their child's behavior. The trial seeks parents of children aged 5-12 with ADHD who exhibit signs of oppositional defiant behavior at home. As an unphased trial, this study offers parents the opportunity to contribute to research that could enhance parenting strategies and child behavior management.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this behavioral parenting intervention is safe for children with ADHD?

Research has shown that parenting programs focused on behavior are generally safe and well-received. These programs can improve the behavior of children with ADHD and reduce parental stress. For example, an online program with eight sessions successfully improved ADHD symptoms and mental health in children. Studies have not reported any major negative effects, indicating that this approach is safe for families. While results can vary, focusing on behavior rather than medication lowers the risk of side effects. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Most treatments for ADHD, like stimulant medications and behavioral therapies, aim to reduce symptoms by managing attention and hyperactivity. However, the Behavioral Parenting Intervention is unique because it specifically focuses on training parents to address ADHD symptoms and oppositional behaviors at home. This approach empowers parents with strategies to create a supportive environment, potentially enhancing the child's long-term behavioral management. Researchers are excited about this treatment because it could offer a non-pharmacological option that not only addresses immediate symptoms but also strengthens family dynamics and improves overall outcomes for children with ADHD.

What evidence suggests that this behavioral parenting intervention is effective for ADHD?

Research shows that teaching parents specific strategies can help reduce ADHD symptoms and behavior issues in children. Studies have found that these strategies lead to lasting improvements in children's behavior and ADHD symptoms, with benefits continuing for at least six months. Specifically, training parents has successfully reduced symptoms of ADHD and oppositional defiant disorder (ODD). Parents and teachers have reported that these behavioral treatments are effective. Overall, research-based parenting programs can greatly enhance the daily lives of children with ADHD. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for parents of children aged 5-12 with ADHD and mild Oppositional Defiant Disorder symptoms. Parents must speak English, have a smartphone or tablet, live with the child most of the time, and not have another child in the study.

Inclusion Criteria

You are a parent of a child who is between 5 to 12 years old and has been diagnosed with ADHD.

Parent must report that the child has at least a mild level of symptoms at home of Oppositional Defiant Disorder (ODD) on the Disruptive Behavior Disorder Rating Scale (DBDRS).

Exclusion Criteria

Non English Speaking

Another child in the same family participating in this study already

Parent does not have a smartphone or tablet device to complete EMA ratings or does not reside with child for the majority of the time.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo 8 sessions of an evidence-based parenting program to address oppositional behaviors and ADHD symptoms at home

12 weeks

8 sessions (in-person)

Follow-up

Participants are monitored for changes in parenting behaviors and child symptoms after the intervention

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Behavioral Parenting Intervention

Trial Overview The study tests if how well parents manage their emotions affects the success of behavioral training aimed at improving parenting skills and reducing behavior problems in kids with ADHD.

How Is the Trial Designed?

Group I: Behavior Therapy Experimental Treatment 1 Intervention

8 sessions of an evidence based parenting program to address oppositional behaviors and ADHD symptoms at home. All participants are in this arm.

Who Is Running the Clinical Trial?

Milton S. Hershey Medical Center

Lead Sponsor

Trials

515

Recruited

2,873,000+

Published Research Related to This Trial

Behavioral parent training (BPT) significantly reduced the frequency and severity of problematic behaviors in children with ADHD, particularly in areas like chores, homework, and peer interactions, based on data from 304 parents.

Parents reported a notable decrease in stress related to parenting their child with ADHD after participating in BPT, indicating that this intervention not only helps children but also supports parental well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioral Parent Training for ADHD Reduces Situational Severity of Child Noncompliance and Related Parental Stress. Ciesielski, HA., Loren, REA., Tamm, L.[2021]

Behavioral parent training interventions are effective nonpharmacologic treatments for ADHD, showing positive impacts on child compliance, ADHD symptoms, and parent-child interactions based on numerous clinical trials and meta-analyses.

These interventions are categorized as well-established, evidence-based treatments for ADHD, highlighting their importance in managing the disorder in school-age children within the home setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavior management for school-aged children with ADHD. Pfiffner, LJ., Haack, LM.[2021]

A meta-analysis of 27 studies involving behavioral parent training for children with ADHD showed that the intervention leads to sustained improvements in ADHD symptoms, behavioral problems, and positive parenting behaviors, with follow-up assessments averaging 5.3 months post-intervention.

The study found that the benefits of behavioral parent training are maintained over time, with significant small-to-moderate effects on various outcomes, indicating its effectiveness as a long-term intervention for managing ADHD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sustained improvements by behavioural parent training for children with attention-deficit/hyperactivity disorder: A meta-analytic review of longer-term child and parental outcomes. Doffer, DPA., Dekkers, TJ., Hornstra, R., et al.[2023]

A meta-regression analysis of 29 studies involving 2,345 parents showed that behavioral parent training for children with ADHD has small- to medium-sized positive effects on various parental outcomes, such as parenting competence and mental health.

Techniques that focus on manipulating antecedents of behavior and reinforcing desired behaviors were particularly effective, while higher dosages of psychoeducation were found to negatively impact parental outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Meta-analysis: Which Components of Parent Training Work for Children With Attention-Deficit/Hyperactivity Disorder? Dekkers, TJ., Hornstra, R., van der Oord, S., et al.[2022]

Behavioral parent training led to significant improvements in parenting behaviors for both mothers and fathers of 20 children with ADHD, indicating its efficacy in enhancing parental functioning.

Mothers experienced notable reductions in parenting stress, and even areas without statistically significant changes showed clinically meaningful improvements, highlighting the overall positive impact of the training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parental functioning in families of children with ADHD: evidence for behavioral parent training and importance of clinically meaningful change. Gerdes, AC., Haack, LM., Schneider, BW.[2015]

Behavioral Parent Training (BPT) is an effective first-line treatment for children with ADHD under six years old and a recommended combination treatment for older children, showing significant improvements in problem behaviors like inattention and hyperactivity.

The study demonstrated that BPT significantly improved parenting practices, as evidenced by changes in Parenting Scale scores, indicating that it can reduce negative parenting behaviors and enhance outcomes for children with ADHD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does a Behavioral Parent Training Program for Parents of ADHD Children Improve Outcomes? A Pilot Project. Morgan, TC., O'Keefe, LC.[2021]

Behavioral parent training (BPT) is an effective treatment for ADHD, improving both child behavior and parenting practices, as well as reducing parenting stress and enhancing classroom behavior.

Despite its effectiveness, research on BPT for ADHD is less comprehensive than for other disorders like oppositional defiant disorder (ODD) and conduct disorder (CD), highlighting the need for further studies to understand factors affecting treatment outcomes, especially given the high comorbidity between ADHD and these disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancements to the behavioral parent training paradigm for families of children with ADHD: review and future directions. Chronis, AM., Chacko, A., Fabiano, GA., et al.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10501699/

Sustained improvements by behavioural parent training for ... We conclude that behavioural parent training has longer‐term benefits for children's ADHD symptoms and behavioural problems, and for positive ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11162428/

Improving the efficacy and effectiveness of evidence-based ... Overall, commercialized BPT and homegrown BPT have been found to be effective in improving the functioning of children with ADHD and their ...

3. bmcpediatr.biomedcentral.com bmcpediatr.biomedcentral.com/articles/10.1186/s12887-021-03046-8

Long-term effectiveness of behavioural intervention in ... Behavioural intervention can effectively improve behaviour management and relieve symptoms in children with ADHD. These effects lasted at least six months.

4. frontiersin.org frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2024.1293244/full

Parent training for disruptive behavior symptoms in ... Parent training was effective in reducing symptoms of ADHD (p = 0.030) and ODD (p = 0.026) irrespective of modality (p = 1.000).

5. sciencedirect.com sciencedirect.com/science/article/pii/S0890856721002331

An Individual Participant Data Meta-analysis: Behavioral ... Behavioral treatments are effective for reducing ADHD symptoms, behavioral problems, and impairment as reported by raters most proximal to treatment.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6544776/

Parent training interventions for Attention Deficit Hyperactivity ... Parent training may have a positive effect on the behaviour of children with ADHD. It may also reduce parental stress and enhance parental confidence. However, ...

7. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1876201825001029

Internet-based behavioural parent training intervention for ... This study evaluates the efficacy of an 8-session internet-based BPT (I-BPT) program in improving ADHD symptoms and mental health outcomes for children and ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10488593/

Factors Influencing Long-Term Behavioral Intervention ... Previous studies have demonstrated the long-term effectiveness of behavioral interventions for attention-deficit hyperactivity disorder (ADHD) in preschool ...

9. trialsjournal.biomedcentral.com trialsjournal.biomedcentral.com/articles/10.1186/s13063-024-08431-z

Efficacy of behavioural parent training on attachment security ... The effectiveness of BPT in children with ADHD has been extensively studied, yielding somewhat inconsistent results. A Cochrane review [2] found ...

10. nature.com nature.com/articles/s41398-024-02890-3

Improving the efficacy and effectiveness of evidence-based ... While there is limited data, only a significant minority of children are “normalized” following BPT [15]. Collectively, a more nuanced ...