Sayal Kapil, Daley David, James Marilyn, Yang Min, Batty Martin J, Taylor John A, Pass Sarah, Sampson Christopher James, Sellman Edward, Valentine Althea, Hollis Chris
Division of Psychiatry, School of Community Health Sciences, University of Nottingham, Nottingham, Nottinghamshire, UK.
BMJ Open. 2012 Sep 3;2(5). doi: 10.1136/bmjopen-2012-001783. Print 2012.
Early intervention for childhood behavioural problems may help improve health and educational outcomes in affected children and reduce the likelihood of developing additional difficulties. The National Institute for Health and Clinical Excellence guidelines for attention deficit/hyperactivity disorder (ADHD), a common childhood behavioural disorder, recommend a stepped care approach for the identification and management of these problems. Parents of children with high levels of hyperactivity and inattention may benefit from intervention programmes involving behavioural management and educational approaches. Such interventions may be further enhanced by providing training and feedback to teachers about the strategies discussed with parents. In relation to children with high levels of hyperactivity, impulsiveness and inattention, we aim to test the feasibility and effectiveness of a parenting programme (with and without an accompanying teacher session) in primary schools.
This clustered (at the level of school) randomised controlled trial (RCT) focuses on children in their first four school years (ages 4-8 years) in the East Midlands area of England. Parents will complete a screening measure, the Strengths and Difficulties Questionnaire, to identify children with high levels of hyperactivity/inattention. Three approaches to reducing hyperactivity and attention problems will be compared: a group programme for parents (parent-only intervention); group programme for parents combined with feedback to teachers (combined intervention); and waiting list control (no intervention). Differences between arms on the short version of Conners' Parent and Teacher Rating Scales Revised will be compared and also used to inform the sample size required for a future definitive cluster RCT. A preliminary cost-effectiveness analysis will also be conducted.
The outcomes of this study will inform policy makers about the feasibility, acceptability and effectiveness of delivering targeted behavioural interventions within a school setting. The study has received ethical approval from the University of Nottingham Medical School Ethics Committee.
ISRCTN87634685.
对儿童行为问题进行早期干预可能有助于改善受影响儿童的健康和教育成果，并降低出现更多困难的可能性。英国国家卫生与临床优化研究所针对注意力缺陷多动障碍（ADHD，一种常见的儿童行为障碍）发布的指南建议采用逐步护理方法来识别和管理这些问题。多动和注意力不集中程度较高的儿童的家长可能会从涉及行为管理和教育方法的干预计划中受益。通过向教师提供与家长讨论的策略方面的培训和反馈，此类干预可能会得到进一步加强。针对多动、冲动和注意力不集中程度较高的儿童，我们旨在测试一项小学家长培训计划（有或没有配套教师课程）的可行性和有效性。
这项整群（学校层面）随机对照试验（RCT）聚焦于英格兰东米德兰兹地区处于前四个学年（4 - 8岁）的儿童。家长将完成一项筛查工具，即优势与困难问卷，以识别多动/注意力不集中程度较高的儿童。将比较三种减少多动和注意力问题的方法：针对家长的小组计划（仅家长干预）；针对家长的小组计划结合向教师提供反馈（联合干预）；以及等待名单对照（无干预）。将比较各组在修订版康纳斯父母与教师评定量表简版上的差异，并用于确定未来确定性整群RCT所需的样本量。还将进行初步的成本效益分析。
本研究的结果将向政策制定者通报在学校环境中提供有针对性行为干预的可行性、可接受性和有效性。该研究已获得诺丁汉大学医学院伦理委员会的伦理批准。
ISRCTN87634685
