Review of school-based interventions for children with ADHD

A systematic review published in Review of Education looks at the evidence from randomised controlled trials of the effectiveness of interventions for children with attention-deficit hyperactivity disorder (ADHD) in school settings.

Twenty-eight studies were included in the review and were sorted into eight categories of school-based intervention for ADHD. They were analysed for effectiveness according to a range of different ADHD symptoms, difficulties and school outcomes. The eight categories of intervention were: combined/multiple component; cognitive training; daily report card; neuro-feedback; relaxation; self-monitoring; study and organisation skills training; and task modification.

The strongest evidence of beneficial effects was found for interventions that combine multiple components. There was a large effect size (+0.79) for improved ADHD symptoms rated by teachers and parents, and a small effect size (+0.30) for parent- and teacher-rated academic outcomes.

Interventions involving daily report cards also showed some promise for academic outcomes (effect size = +0.68). There was a beneficial effect on academic outcomes for neuro-feedback interventions, and mixed findings for relaxation and self-monitoring interventions.

Source: School‐based interventions for attention‐deficit/hyperactivity disorder: A systematic review with multiple synthesis methods (October 2018), Review of Education Volume 6, Issue 3

Are the youngest in class more likely to be diagnosed with ADHD?

Findings from a study published in the Journal of Child Psychology and Psychiatry suggest that children who are the youngest in their classroom are more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD) than their older classmates.

Martin Whitely and colleagues conducted a systematic review of 22 studies that examined the relationship between a child’s age relative to their classmates and their chances of being diagnosed with, or medicated for, ADHD. Seventeen studies (with a total of more than 14 million children) found that it was more common for the youngest children in a school year to be diagnosed as ADHD than their older classmates. This effect was found for both countries that have a high diagnosis rate, like the US, Canada and Iceland, and countries where diagnosis is less common, like Finland and Sweden.

The researchers suggest that some teachers may be mistaking normal age-related immaturity of the youngest children in their class for ADHD, and that these findings highlight the importance of being aware of the impact of relative age and give the youngest children in class the extra time they may need to mature.

Source: Attention deficit hyperactivity disorder late birthdate effect common in both high and low prescribing international jurisdictions: systematic review (October 2018), The Journal of Child Psychology and Psychiatry doi:10.1111/jcpp.12991

Children with ADHD more likely to have language problems

Children with Attention-Deficient Hyperactivity Disorder (ADHD) can have trouble with hyperactivity, impulsivity, inattention and distractibility, all of which can affect language and communication and can lead to low academic performance and antisocial behavior. A systematic review published in the Journal of Child Psychology and Psychiatry seeks to establish the types of language problems children with ADHD experience in order to inform future research into how these language problems contribute to long-term outcomes for children with ADHD.

Hannah Korrel and colleagues examined the last 35 years of ADHD research and identified 21 studies using 17 language measures, which included more than 2,000 participants (ADHD children = 1,209; non-ADHD children  = 1,101) for inclusion in the systematic review.

The study found that children with ADHD had poorer performance than non-ADHD children on 11 of the 12 measures of overall language (effect size = 1.09). Children with ADHD also had poorer performance on measures of expressive, receptive and pragmatic language compared with non-ADHD children.

Source: Research Review: Language problems in children with Attention-Deficit Hyperactivity Disorder – a systematic meta-analytic review (2017), Journal of Child Psychology and Psychiatry Volume 58, Issue 6

The effects of parenting programmes

A new policy brief from The Campbell Collaboration summarises evidence from six Campbell systematic reviews of parenting programmes.

These programmes are designed to enhance parents’ knowledge, skills, and understanding, and to improve both child and parent behavioural and psychological outcomes. Programmes are typically offered to parents over the course of 8 to 12 weeks, for one or two hours each week. The programmes can be delivered on a one-to-one basis or to groups, and be provided in a range of settings, including hospitals, social work clinics, schools, and churches.

The six systematic reviews that have been published by The Campbell Collaboration have evaluated the effectiveness of a range of parenting programmes, including those aimed at addressing early onset conduct disorder and improving outcomes for children with ADHD. The reviews provide unequivocal evidence that parenting programmes are effective in improving aspects of parents’ psychosocial functioning (eg, depression, anxiety, confidence, and satisfaction with the partner relationship) in the short-term. Behavioural and cognitive-behavioural group-based parenting interventions have also been found to be effective at improving child conduct problems, parental mental health, and parenting skills in the short term for parents of children aged 3-12. However, the evidence of effectiveness for parents of younger children is less comprehensive.

Source: Effects of Parenting Programmes: A Review of Six Campbell Systematic Reviews (2016), The Campbell Collaboration.