Watson Silvana Maria Russo, Richels Corrin, Michalek Anne Perrotti, Raymer Anastasia
Old Dominion University, Norfolk, VA, USA
Old Dominion University, Norfolk, VA, USA.
J Atten Disord. 2015 Jan;19(1):3-10. doi: 10.1177/1087054712447857. Epub 2012 May 30.
Children with learning disabilities often experience comorbid ADHD, impacting on the effectiveness of interventions for those children. In addition to pharmacologic intervention, clinicians and educators employ a variety of psychosocial methods to address the behavioral and social issues that arise in children with ADHD, including those with co-occurring learning disabilities. Numerous systematic reviews and meta-analyses have been conducted examining treatment studies using psychosocial interventions for children with ADHD. Because of the importance of such reviews to evidence based clinical and educational practice, it is essential that reviews be conducted with rigorous methodologies to avoid bias in conclusions (Schlosser, Wendt, & Sigafoos, 2007). The purpose of this study was to evaluate the quality of systematic reviews and meta-analyses conducted for psychosocial treatments of ADHD in children.
Electronic databases were searched for peer-reviewed, English language studies of psychosocial treatments for ADHD in children up to 18-years-old from 1998 to 2010. Twenty-one studies were identified that met inclusion criteria (13 systematic reviews, 8 meta-analyses). Independent examiners used the quality rating scale proposed by Auperin, Pignon, and Pynard (1997) to rate the characteristics of good systematic reviews and meta-analyses.
Results indicated that certain methodological characteristics were common across trials reviewed, yet shortcomings were common among most reviews, including inadequate descriptions of data extraction methods and lack of quality ratings for trials included in the reviews.
Synthesis of findings from the five top-rated reviews and the literature on ADHD suggest that psychosocial treatments contribute to improvements on behavioral and social outcomes. How ADHD and LD interplay in treatment outcomes is largely unexplored.
学习障碍儿童常合并注意力缺陷多动障碍（ADHD），这会影响针对这些儿童的干预措施的效果。除药物干预外，临床医生和教育工作者还采用多种心理社会方法来解决ADHD儿童出现的行为和社会问题，包括那些同时患有学习障碍的儿童。已经进行了大量系统评价和荟萃分析，以研究使用心理社会干预措施治疗ADHD儿童的研究。由于此类评价对循证临床和教育实践很重要，因此必须采用严谨的方法进行评价，以避免结论出现偏差（施洛瑟、温特和西加福斯，2007年）。本研究的目的是评估针对ADHD儿童心理社会治疗所进行的系统评价和荟萃分析的质量。
检索电子数据库，查找1998年至2010年间针对18岁及以下ADHD儿童心理社会治疗的同行评审英文研究。确定了21项符合纳入标准的研究（13项系统评价，8项荟萃分析）。独立审查员使用奥珀兰、皮尼翁和皮纳尔（1997年）提出的质量评定量表对良好系统评价和荟萃分析的特征进行评分。
结果表明，在所审查的试验中某些方法学特征很常见，但大多数评价都存在缺陷，包括数据提取方法描述不充分以及所纳入试验缺乏质量评级。
对五项评分最高的评价结果和关于ADHD的文献进行综合分析表明，心理社会治疗有助于改善行为和社会结局。ADHD和学习障碍在治疗结局中的相互作用在很大程度上尚未得到探讨。
