ABSTRACT

Objective

Behavioral parent training (BPT) is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but little is known about the effects of separate techniques parents learn in BPT.

Method

In a three-armed randomized controlled microtrial including parents of 92 children (4–12 years) with ADHD, we examined the efficacy of two sessions parent training involving either stimulus control techniques (antecedent-based condition (AC)) or contingency management techniques (consequent-based condition (CC)), compared to a waitlist. Primary outcome was daily parent-rated problem behaviors, secondary outcomes were parent-rated symptoms of ADHD and oppositional defiant disorder (ODD), and mental health-care consumption. Measures were completed at baseline (T0), immediately after the training (T1), at two weeks (T2) and three months (T3) follow-up. We also explored whether child and parent characteristics moderated treatment effects.

Results

Compared to the waitlist, in the AC, daily rated problem behaviors improved at T1 (d= .56) and T2 (d= .65); in the CC, these behaviors only improved at T2 (d= .53). Daily rated problem behaviors within both conditions remained stable between T2 and T3. In the AC compared to the other conditions, inattention symptoms decreased at T1 and T2. For both active conditions compared to waitlist, hyperactivity-impulsivity symptoms decreased only at T2 and ODD symptoms did not decrease. No moderators were identified. Mental health-care consumption after training was low and did not differ between the active conditions.

Conclusions

Brief training of parents in antecedent- or consequent-based techniques improves problem behaviors of children with ADHD. Antecedent-based techniques appear to be especially important to target inattention.

中文翻译：

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哪些技术适用于多动症儿童的行为父母培训？随机对照微型试验

摘要

客观的

行为父母培训 (BPT) 是一种针对注意力缺陷/多动障碍 (ADHD) 儿童的循证干预措施，但对于父母在 BPT 中学习的不同技术的影响知之甚少。

方法

在一项包括 92 名患有 ADHD 的儿童（4-12 岁）的父母的三臂随机对照微型试验中，我们检查了涉及刺激控制技术（基于前因的条件 (AC)）或应急管理技术的两次家长培训的效果。基于结果的条件 (CC))，与候补名单相比。主要结果是父母评估的日常问题行为，次要结果是父母评估的多动症和对立违抗障碍（ODD）症状，以及心理保健消费。在基线 (T0)、培训后 (T1)、两周 (T2) 和三个月 (T3) 随访时完成测量。我们还探讨了儿童和父母的特征是否会调节治疗效果。

结果

与候补名单相比，在 AC 中，每日评级问题行为在 T1 ( d = .56) 和 T2 ( d = .65) 有所改善；在 CC 中，这些行为仅在 T2 ( d = .53) 时有所改善。两种情况下的每日评级问题行为在 T2 和 T3 之间保持稳定。与其他条件相比，在 AC 中，注意力不集中症状在 T1 和 T2 有所减少。与候补名单相比，两种活跃状态下，多动冲动症状仅在 T2 时减少，而 ODD 症状没有减少。没有确定主持人。训练后的心理保健消费较低，并且在不同的活动条件下没有差异。

结论

对父母进行基于前因或后因技术的简短培训可以改善多动症儿童的问题行为。基于前因的技术似乎对针对注意力不集中特别重要。