Psychology Department, Queens College and the Graduate Center, City University of New York, 65-30 Kissena Boulevard, Flushing, New York, 11367, USA.
NYU Child Study Center, New York, NY, USA.
J Abnorm Child Psychol. 2020 Mar;48(3):375-389. doi: 10.1007/s10802-019-00610-w.
This preliminary randomized controlled trial compared Training Executive, Attention and Motor Skills (TEAMS), a played-based intervention for preschool children with attention-deficit/hyperactivity disorder (ADHD), to an active comparison intervention consisting of parent education and support (ClinicalTrials.gov Identifier: NCT01462032). The primary aims were to gauge preliminary efficacy and assist in further development of TEAMS. Four- and 5-year-old children with ADHD were randomly assigned to receive TEAMS (N = 26) or the comparison intervention (N = 26) with blinded assessments by parents, teachers and clinicians ascertained pretreatment, post-treatment, and 1- and 3-months post-treatment. Changes in ADHD severity, impairment, parenting factors, and neuropsychological functioning over time as a function of treatment condition were assessed using the PROC MIXED procedure in SAS. Across most measures, significant main effects for Time emerged; both treatments were associated with reduced ADHD symptoms that persisted for three months post-treatment. There were no significant Treatment effects or Time x Treatment interactions on symptom and impairment measures, suggesting that the magnitude of improvement did not differ between the two interventions. However, significant correlations emerged between the magnitude of behavioral change, as assessed by parents and clinicians, and the amount of time families engaged in TEAMS-related activities during treatment. Across a wide array of parenting and neuropsychological measures, there were few significant group differences over time. TEAMS and other psychosocial interventions appear to provide similar levels of benefit. Play-based interventions like TEAMS represent a potentially viable alternative/addition to current ADHD treatments, particularly for young children, but more research and further development of techniques are necessary.
这项初步的随机对照试验比较了 Training Executive、Attention and Motor Skills（TEAMS），这是一种针对注意力缺陷/多动障碍（ADHD）学龄前儿童的基于游戏的干预措施，与由家长教育和支持组成的积极对照干预措施（ClinicalTrials.gov 标识符：NCT01462032）。主要目的是评估初步疗效并帮助进一步开发 TEAMS。将 4 岁和 5 岁的 ADHD 儿童随机分配接受 TEAMS（N=26）或比较干预（N=26），家长、教师和临床医生在治疗前、治疗后以及治疗后 1 个月和 3 个月进行盲法评估。使用 SAS 中的 PROC MIXED 过程评估随时间变化的 ADHD 严重程度、损伤、养育因素和神经心理功能变化作为治疗条件的函数。在大多数测量指标上，时间都有显著的主效应；两种治疗方法都与 ADHD 症状的减少有关，这种减少持续到治疗后 3 个月。在症状和损伤测量方面，没有治疗效果或时间与治疗的交互作用，这表明两种干预方法的改善程度没有差异。然而，家长和临床医生评估的行为变化程度与家庭在治疗期间参与 TEAMS 相关活动的时间之间存在显著的相关性。在广泛的养育和神经心理测量指标中，随着时间的推移，群体差异很少。TEAMS 和其他心理社会干预措施似乎提供了相似水平的益处。像 TEAMS 这样的基于游戏的干预措施代表了当前 ADHD 治疗的一种潜在可行的替代/补充方法，特别是对于幼儿，但需要更多的研究和进一步发展技术。
