协同家校干预对注意缺陷/多动障碍症状和损害的持续影响。
Sustained Effects of Collaborative School-Home Intervention for Attention-Deficit/Hyperactivity Disorder Symptoms and Impairment.
机构信息
University of California, San Francisco.
University of California, San Francisco.
出版信息
J Am Acad Child Adolesc Psychiatry. 2018 Apr;57(4):245-251. doi: 10.1016/j.jaac.2018.01.016. Epub 2018 Feb 8.
OBJECTIVES
The Collaborative Life Skills (CLS) program is a school-home intervention for students with attention-deficit/hyperactivity disorder (ADHD) symptoms and impairment. CLS integrates school, parent, and student treatments followed by booster sessions during a maintenance period into the subsequent school year. The program is delivered by school-based mental health providers. Beneficial post-treatment effects have been documented. This study evaluated the effects of CLS after the maintenance period in the subsequent school year.
METHOD
Using a cluster randomized design, schools within a large urban public school district were randomly assigned to CLS (12 schools) or usual services (11 schools). Approximately 6 students participated at each school (N = 135, grade range = 2-5). Measures were completed at baseline, after treatment, and follow-up during the next school year.
RESULTS
Students from schools assigned to CLS compared with those assigned to usual services showed significantly greater improvement at follow-up on parent, but not teacher, ratings of ADHD and oppositional defiant disorder symptom severity, organizational skills, and global impairment. Within-group analyses indicated that parent- and teacher-reported post-treatment gains for CLS in ADHD and oppositional defiant disorder symptoms, organizational skills, and academic competence were maintained into the next school year.
CONCLUSIONS
These results extend support for CLS to the following school year by demonstrating sustained benefits on parent-reported ADHD and oppositional defiant disorder symptoms and functional impairment. The lack of significant teacher-reported differences between CLS and usual services highlights the need for further study of booster treatments for improving outcomes with new teachers across school years.
CLINICAL TRIAL REGISTRATION INFORMATION
Study of the Collaborative Life Skills Program; http://clinicaltrials.gov; NCT01686724.
目的
协作生活技能（CLS）计划是一种针对注意力缺陷/多动障碍（ADHD）症状和损害学生的家校干预措施。CLS 将学校、家长和学生治疗与随后的维持期内的强化课程相结合，纳入后续学年。该计划由学校心理健康服务提供者提供。已经记录了有益的治疗后效果。本研究评估了随后学年维持期后的 CLS 效果。
方法
使用集群随机设计，将大型城市公立学区内的学校随机分配到 CLS（12 所学校）或常规服务（11 所学校）。每所学校约有 6 名学生参加（N=135，年级范围为 2-5 年级）。在基线、治疗后和下一个学年的随访期间完成了测量。
结果
与常规服务组相比，被分配到 CLS 的学校的学生在随访时，家长报告的 ADHD 和对立违抗性障碍症状严重程度、组织技能和整体损伤的评分显著改善，而教师报告的则没有。组内分析表明，CLS 治疗后 ADHD 和对立违抗性障碍症状、组织技能和学业能力的家长和教师报告的改善在接下来的学年中得到了维持。
结论
这些结果通过证明对 ADHD 和对立违抗性障碍症状以及功能障碍的持续改善，为 CLS 在下一个学年提供了支持。CLS 和常规服务之间缺乏显著的教师报告差异，突出了需要进一步研究强化治疗，以改善跨学年新教师的治疗效果。
临床试验注册信息
协作生活技能计划研究；http://clinicaltrials.gov；NCT01686724。
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