Coates Janine, Taylor John A, Sayal Kapil
Division of Psychology, Nottingham Trent University, UK.
NIHR Collaboration for Leadership in Applied Health Research and Care Nottinghamshire, Derbyshire and Lincolnshire.
J Atten Disord. 2015 Oct;19(10):831-43. doi: 10.1177/1087054714535952. Epub 2014 Jun 10.
To evaluate the evidence base relating to the effectiveness of parent-administered behavioral interventions for ADHD.
A systematic review of randomized controlled trials or non-randomized but adequately controlled trials for children with ADHD or high levels of ADHD symptoms was carried out across multiple databases. For meta-analyses, the most proximal ratings of child symptoms were used as the primary outcome measure.
Eleven studies met inclusion criteria (603 children, age range = 33-144 months). Parenting interventions were associated with reduction in ADHD symptoms (Standardized Mean Difference [SMD] = 0.68; 95% confidence interval [CI] [0.32, 1.04]). There was no evidence of attenuation of effectiveness after excluding studies where medication was also used. Parenting interventions were also effective for comorbid conduct problems (SMD = 0.59; 95% CI [0.29, 0.90]) and parenting self-esteem (SMD = 0.93; 95% CI [0.48, 1.39]).
These findings support clinical practice guidelines and suggest that parenting interventions are effective. There is a need to ensure the availability of parenting interventions in community settings.
评估父母实施的行为干预对注意缺陷多动障碍(ADHD)有效性的证据基础。
对多个数据库中针对患有ADHD或ADHD症状水平较高儿童的随机对照试验或非随机但有充分对照的试验进行系统评价。对于荟萃分析,将儿童症状的最直接评分用作主要结局指标。
11项研究符合纳入标准(603名儿童,年龄范围 = 33 - 144个月)。育儿干预与ADHD症状减轻相关(标准化均数差[SMD] = 0.68;95%置信区间[CI][0.32, 1.04])。在排除同时使用药物的研究后,没有证据表明有效性减弱。育儿干预对共患品行问题(SMD = 0.59;95% CI[0.29, 0.90])和育儿自尊(SMD = 0.93;95% CI[0.48, 1.39])也有效。
这些发现支持临床实践指南,并表明育儿干预是有效的。有必要确保在社区环境中提供育儿干预。