Child Study Center, Yale School of Medicine, 230 South Frontage Road, 06511 New Haven, Yale University, USA; Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19, Odense, Denmark.
Child Study Center, Yale School of Medicine, 230 South Frontage Road, 06511 New Haven, Yale University, USA; Anita Zucker Center for Excellence in Early Childhood Studies, University of Florida, 1345 Norman Hall 618 SW 12th Street, Gainesville, USA.
Clin Psychol Rev. 2017 Mar;52:108-123. doi: 10.1016/j.cpr.2016.12.004. Epub 2016 Dec 29.
In addition to problems with attention and hyperactivity, children with ADHD present with poor organizational skills required for managing time and materials in academic projects. Organizational skills training (OST) has been increasingly used to address these deficits. We conducted a systematic review and meta-analysis of OST in children with ADHD.
The objective of this study was to systematically review the evidence of the effects of OST for children with ADHD for organizational skills, attention, and academic performance.
We searched 3 electronic databases to locate randomized controlled trials published in English in peer-reviewed journals comparing OST with parent education, treatment-as-usual, or waitlist control conditions. Standardized mean difference effect sizes from the studies were statistically combined using a random-effects meta-analyses across six outcomes: teacher- and parent-rated organizational skills, teacher- and parent-rated inattention, teacher-rated academic performance, and Grade Point Average (GPA). Risk of bias was assessed for randomization, allocation concealment, blinding of participants and treatment personnel, blinding of outcome assessors, incomplete outcome data, and selective outcome reporting.
Twelve studies involving 1054 children (576 treatment, 478 control) were included in the meta-analyses. Weighted mean effect sizes for teacher- and parent-rated outcome measures of organizational skills were g=0.54 (95% CI 0.17 to 0.91) and g=0.83 (95% CI 0.32 to 1.34), respectively. Weighted mean effect sizes of teacher- and parent-rated symptoms of inattention were g=0.26 (95% CI 0.01 to 0.52) and g=0.56 (95% CI 0.38 to 0.74), respectively. Weighted standardized mean effect size for teacher-rated academic performance and GPA were g=0.33 (95% CI 0.14 to 0.51) and g=0.29 (95% CI 0.07 to 0.51), respectively.
OST leads to moderate improvements in organizational skills of children with ADHD as rated by teachers and large improvements as rated by parents. More modest improvements were observed on the ratings of symptoms of inattention and academic performance.
PROSPERO (CRD42015019261).
除了注意力和多动问题外，患有 ADHD 的儿童在管理学术项目的时间和材料方面也存在组织技能较差的问题。组织技能训练（OST）已越来越多地用于解决这些缺陷。我们对 ADHD 儿童的 OST 进行了系统评价和荟萃分析。
本研究旨在系统评价 OST 对 ADHD 儿童组织技能、注意力和学业成绩影响的证据。
我们检索了 3 个电子数据库，以查找在同行评议期刊上发表的比较 OST 与家长教育、常规治疗或候补对照组的英语随机对照试验。使用随机效应荟萃分析对 6 个结果的研究进行标准化均数差效应大小的统计学合并：教师和家长评定的组织技能、教师和家长评定的注意力不集中、教师评定的学业成绩和平均绩点（GPA）。对随机分组、分配隐藏、参与者和治疗人员的盲法、结果评估者的盲法、不完整的结果数据和选择性结果报告进行了偏倚风险评估。
12 项研究涉及 1054 名儿童（576 例治疗，478 例对照）被纳入荟萃分析。教师和家长评定的组织技能的加权平均效应量分别为 g=0.54（95%CI 0.17 至 0.91）和 g=0.83（95%CI 0.32 至 1.34）。教师和家长评定的注意力不集中症状的加权平均效应量分别为 g=0.26（95%CI 0.01 至 0.52）和 g=0.56（95%CI 0.38 至 0.74）。教师评定的学业成绩和 GPA 的加权标准化平均效应量分别为 g=0.33（95%CI 0.14 至 0.51）和 g=0.29（95%CI 0.07 至 0.51）。
OST 可使 ADHD 儿童的组织技能得到中等程度的提高，教师评定的技能提高明显，家长评定的技能提高显著。在注意力不集中症状和学业成绩的评定上观察到更为适度的改善。
PROSPERO（CRD42015019261）。
