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家庭-学校干预 ADHD 患儿:一项随机临床试验结果。

A family-school intervention for children with ADHD: results of a randomized clinical trial.

机构信息

Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, and The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

出版信息

J Consult Clin Psychol. 2012 Aug;80(4):611-23. doi: 10.1037/a0028188. Epub 2012 Apr 16.

Abstract

OBJECTIVE

Accumulating evidence highlights the importance of using psychosocial approaches to intervention for children with attention-deficit/hyperactivity disorder (ADHD) that target the family and school, as well as the intersection of family and school. This study evaluated the effectiveness of a family-school intervention, Family-School Success (FSS), designed to improve the family and educational functioning of students in Grades 2-6 who meet criteria for ADHD combined and inattentive types. Key components of FSS were conjoint behavioral consultation, daily report cards, and behavioral homework interventions.

METHOD

FSS was provided over 12 weekly sessions, which included 6 group sessions, 4 individualized family sessions, and 2 school-based consultations. Participating families were given the choice of placing their children on medication; 43% of children were on medication at the time of random assignment. Children (n = 199) were randomly assigned to FSS or a comparison group controlling for non-specific treatment effects (Coping With ADHD Through Relationships and Education [CARE]). Outcomes were assessed at post-intervention and 3-month follow-up. The analyses controlled for child medication status.

RESULTS

FSS had a significant effect on the quality of the family-school relationship, homework performance, and parenting behavior.

CONCLUSIONS

The superiority of FSS was demonstrated even though about 40% of the participants in FSS and CARE were on an optimal dose of medication and there were significant time effects on each measure. This relatively brief intervention produced effect sizes comparable to those of the more intensive Multimodal Treatment Study of Children With ADHD (MTA) behavioral intervention.

摘要

目的

越来越多的证据强调了采用心理社会方法干预注意缺陷多动障碍(ADHD)儿童的重要性,这些方法针对家庭和学校,以及家庭和学校的交叉点。本研究评估了一种名为“家庭-学校成功”(FSS)的家庭-学校干预措施的有效性,该措施旨在改善符合 ADHD 混合和注意力不集中类型标准的 2-6 年级学生的家庭和教育功能。FSS 的主要组成部分是联合行为咨询、每日报告卡和行为家庭作业干预。

方法

FSS 在 12 周的时间内提供,包括 6 个小组会议、4 个个体化家庭会议和 2 个基于学校的咨询。参与家庭可以选择让孩子服用药物;在随机分组时,有 43%的孩子正在服用药物。将 199 名儿童随机分配到 FSS 或对照组,以控制非特定治疗效果(通过关系和教育应对 ADHD [CARE])。结果在干预后和 3 个月随访时进行评估。分析控制了儿童用药状况。

结果

FSS 对家庭-学校关系、家庭作业表现和养育行为有显著影响。

结论

即使 FSS 和 CARE 组约 40%的参与者正在服用最佳剂量的药物,并且每项措施都有显著的时间效应,但 FSS 的优越性仍然得到了证明。这种相对简短的干预产生了与 ADHD 更密集的多模式治疗研究(MTA)行为干预相当的效果大小。

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