Schoenfelder Erin N, Sasser Tyler
Pediatr Ann. 2016 Oct 1;45(10):e367-e372. doi: 10.3928/19382359-20160920-04.
Although side effects and family concerns are common and long-term medication adherence is low, stimulant medications are a front-line treatment for attention-deficit/hyperactivity disorder (ADHD). Psychosocial treatments include classroom, family, and child-focused interventions that teach caregivers and teachers how to implement contingencies to shape behavior and provide children with skills to compensate for ADHD deficits. Such programs have a growing evidence-base and can be implemented alone or in conjunction with pharmacological treatments. The most efficacious psychosocial treatments for children with ADHD include Behavioral Parent Training, Behavioral Classroom Management, and Behavioral Peer Interventions, which all focus on contingency management by adults. Training interventions are increasingly used to teach organizational and interpersonal skills to children and adolescents. These treatments are found to improve functional outcomes associated with ADHD, including on-task behavior, compliance, academic performance, social relationships, and family functioning. Clinicians play an important role in educating families about psychosocial treatments for ADHD, increasing family motivation and engagement, and including these interventions in multimodal treatment plans for youth with ADHD across development. [Pediatr Ann. 2016;45(10):e367-e372.].
尽管副作用和家庭担忧很常见，且长期药物依从性较低，但兴奋剂药物仍是注意力缺陷多动障碍（ADHD）的一线治疗方法。心理社会治疗包括针对课堂、家庭和儿童的干预措施，这些措施教导照顾者和教师如何实施应急措施来塑造行为，并为儿童提供弥补ADHD缺陷的技能。此类项目的证据基础日益增多，可以单独实施，也可与药物治疗联合使用。对ADHD儿童最有效的心理社会治疗包括行为家长培训、行为课堂管理和行为同伴干预，这些都侧重于成人的应急管理。培训干预越来越多地用于向儿童和青少年传授组织和人际交往技能。这些治疗方法被发现可改善与ADHD相关的功能结果，包括任务执行行为、顺从性、学业成绩、社会关系和家庭功能。临床医生在向家庭宣传ADHD的心理社会治疗方法、提高家庭积极性和参与度以及将这些干预措施纳入不同发育阶段ADHD青少年的多模式治疗计划中发挥着重要作用。[《儿科年鉴》。2016年；45(10):e367 - e372。]
