INTERVENTIONS FOR PRESCHOOL ADHD
1
SUPPLEMENTAL MATERIAL TO BE POSTED FOR ONLINE REFERENCE
Non-pharmacological Intervention for Preschool-Aged Children with ADHD
Authors
Sample
Intervention
Parent Training Interventions
Design
Results
Bor et al.,
2002
N = 87
Criteria:
DSM-IV
ADHD
10-sessions
for standard
BPT, 12 for
enhanced
BPT
3 groups:
Standard
BPT,
Enhanced
BPT, WLC
Danforth,
1999
N=2
Criteria:
DSM-IV
ADHD and
ODD
8-weekly
sessions
Case study
10-weeks: 6sessions with
parent, 4weeks with PC dyad
Case study
SBPT & EBPT
(compared to WL)
†↓Disruptive behavior,
dysfunctional parenting
†↑Parental competence,
Maintenance at 1- year
SBPT (compared to WL)
†↓ ODD, intensity of
disruptive behavior,
conflict, (at 1-year follow
up)
EBPT(compare to WL):
†↓Observed negative
behavior, inattentive
behavior (at 1-year follow
up)
*↓Hyperactivity
*↑Compliance
*↓Externalizing
*↓Aggression
*↓Maternal Stress
*↑Parenting Behavior
(observation) Maintenance
at 6-month
*↓Hyperactivity, tantrums,
aggression
*↑Compliance, social
functioning
*↑Parental confidence,
parent-child interactions
2 groups:
BPT, WLC
BPT:
†↓ADHD sxs, †↓CD sxs
Maintenance up to18months
2 groups: IT,
DT
IT: †↑Compliance,
positive P-C interaction,
Erhardt et
al., 1990
Jones et al.,
2007, 2008
Pisterman
et al., 1989
N=2
Criteria:
ADHD
diagnosis by
pediatrician
N = 79
Criteria:
Cutoff on
dimensional
scale
N = 46
Criteria:
DSM-III
12-weeks
12-weeks:
10-sessions
BPT, 2-
INTERVENTIONS FOR PRESCHOOL ADHD
ADDH
Pisterman
et al., 1992
N = 57
Criteria:
Same as
above
2
sessions with
P-C dyad
Same as
above
parenting skills
Maintenance at 3- months
Same as above
Same as
above
SonugaBarke et
al., 2001
N = 78
Criteria:
Cutoff on
dimensional
scale
8-weekly
sessions
3 groups:
BPT, PC&S,
WLC
SonugaBarke et
al., 2004
N = 89
Criteria:
Same as
above
Same as
above
2 groups:
BPT, WLC
N = 41
Criteria:
Cutoff on
Thompson dimensional 8-weekly
et al., 2009 scale
sessions
Teacher Training Interventions
N=1
Criteria:
Teacher
complaint
Allen et al., and observed
1967
hyperactivity 47-sessions
McCain et
al., 1993
N=1
Criteria:
ADHD dx
4-weeks
McGoey et
al., 2000
N = 4,
Criteria:
DSM-IV
ADHD
36-40
sessions
2 groups:
BPT, TAU
Case study,
ABAB
Case study,
ABAB
Single-subject,
reversal design
comparing TR
and RC
counterbalance
d between
participants,
matched
BPT:
†↓ADHD sxs (reported
and observed )
†↓Conduct problems
†↑Maternal sense of wellbeing & adjustment
Maintenance at 15-weeks
BPT:
No effect on ADHD sxs
*↓Parenting efficacy
*↑ Parental distress
*↓Maternal well-being
↓Observed activity
BPT:
†↓ADHD sxs (reported
and observed), Social and
behavioral problems
Maintenance of effects at
8-weeks
*↓Number of activity
changes
*↑Attentiveness and ontask behavior
*↓Disruptive behavior
*↓Number of activity
changes
INTERVENTIONS FOR PRESCHOOL ADHD
Child Training Interventions
N=4
Criteria:
Teacher
complaint
and
observation
ADHD and
Billings et
disruptive
al., 1985
behaviors
4-weeks
N=3
Criteria:
Teacher
complaint of
ADHD and
Bornstein
disruptive
et al., 1976 behaviors
10-weeks
Bryant et
al., 1982
Bateman et
al., 2004
Kaplan et
al., 1989
N = 277
Criteria:
Cutoff on
dimensional
scale
N = 24
Criteria:
control peer in
classroom
TR & RC:
*↓Hyperactivity
*↓Disruptive behavior
Maintained at 2-weeks
Case series,
multiple
baseline across
subjects, one
child served as
control
*↑Attending behavior
No maintenance of
attending behavior at 2weeks
Case series,
blind, multiple
baseline
Case series,
multiple
baseline,
sequential
administration
SIT and CR
*↑On-task behavior
Maintained at 22.5-week
SIT & CR:
*↑On-task behavior
SIT:
†↑Work accuracy
CR: †↑Rate of work
completion
3-months, 20
bi-weekly
sessions
4 groups:
CBM, MPH,
CBM+MPH,
NCG
No effect of treatment
4-weeks
10-weeks: 3week baseline
Withinsubjects,
double-blind,
crossover with
active periods
of dietary
challenge and
placebo
mixture.
Withinsubjects,
*↓Hyperactivity during
dietary challenge (parent
rated)
*↓ADHD behaviors
*↓Behavioral problem
N=3
Criteria:
Teacher
complaints of
behavior
8-days
N = 24
Criteria:
Cutoff on
Cohen et
dimensional
al., 1981
scale
Dietary Restrictions
3
INTERVENTIONS FOR PRESCHOOL ADHD
DSM-III
ADDH
Nutritional Supplements
N=1
Criteria:
Konofal et DSM-IV
al., 2005
ADHD
Acupuncture
N = 180
Criteria:
Li et al.,
DSM-IV
2010
ADHD
Multimodal Interventions
Barkley et
al., 2000;
Shelton et
al., 2000
N = 158
Criteria:
Cutoff on
dimensional
scale
N = 8,
Criteria:
DSM-IV
ADHD
Chang et
al., 2004
Kern et al.,
2007;
DuPaul et
al. 2011
diet, 3-week
placebo, 4week
experimental
diet
8-months
Acupuncture
9 months
(school year)
STC, 10weekly BPT
sessions, 6monthly
booster
sessions
8-weekly
sessions:
BPT, and
joint P-C SST
sessions
BPT+ home
4
double-blind,
placebocontrolled,
crossover of
baseline and
dietary meals
*↓Sleep problems
Case study
*↓ADHD (Parent and
teacher rated)
*↑Sleep quality
*↑Peer relations
2 groups: EG,
CG
EG:
†↓ADHD sxs
Some maintenance at 6months
4 groups: BPT,
STC, BPT+
STC, CG
Uncontrolled
trial
↓Frequency of Dx
STC & BPT+STC:
†↑ Attention, social
skills (teacher rated),
adaptive function
(parent rated)
↑Self-control
†↓Behavior problem,
aggression, externalizing
(observed)
No maintenance at 2years
*↓ADHD sxs, problem
behavior at home,
impulsivity, parental
frustration
↑Emotional
expression/regulation,
Concentration,
confidence, assertion,
parental satisfaction
*↓ADHD Problems,
ODD Sxs, aggression,
conduct problems,
delinquency,
*↑Preacademic skills,
Social Skills (Parent and
INTERVENTIONS FOR PRESCHOOL ADHD
5
N = 135
DSM-IV
ADHD
and school
intervention
12-months:
20-PE
sessions
2 groups: PE,
EG
McGoey et
al., 2005
N = 57
Criteria:
DSM-IV
ADHD
12-months:
12-weekly
BPT sessions,
9-monthly
booster
sessions,
preschool
consultation,
and
medication
consultation
2 groups: EI,
TAU
WebsterStratton et
al., 2011
N = 99,
Criteria:
DSM-IV
ADHD-C or
H type
Williford et
al., 2008
N = 103
Criteria:
Cutoff on
dimensional
scale
20-weekly
BPT + SEB
sessions
BPT
Consultation
model.
4-month
classroom
consultation,
10- week BPT
2 groups: EG,
WLC
2 groups: EG,
CG
teacher rated)
Some maintenance at
12-months, lesser
maintenance at 24months
↑On-task behavior,
compliance,
*↑ self control,
*↓Problem behavior,
Negative social behavior
*↑Social Skills (teacher
rated), positive behavior
(observed), school
readiness
↓Parenting stress
*↑Positive parenting
behavior, family coping
*↓ Negative parenting
behavior, dysfunctional
parent-child interaction
EG:
†↓Hyperactivity,
inattention, opposition,
aggression, intensity and
number of conduct
problems, externalizing
(parent and teacher
report), deviant
behaviors,
†↑Emotion-regulation,
problem-solving,
emotional vocabulary,
social competence,
mother’s positive
parenting behavior,
mother’s praise and
coaching
EG:
†↓Disruptive behavior
(parent and teacher
rated)
†↑Positive parenting
↑Teaching strategies
This table only documents outcomes that demonstrated effects of time and/or treatment
INTERVENTIONS FOR PRESCHOOL ADHD
6
*= Significant effect of time, no effect of treatment condition; †= Significant effect of experimental group
by time; ↑= increase ↓= decrease ABAB= Reversal design; ADDH= Attention-Deficit Disorder with
hyperactivity; ADHD= Attention-Deficit Hyperactivity Disorder; AT=Atopy; BPT= Behavioral parent
training; CBM= Cognitive behavioral modification; CD= Conduct Disorder; CG= Control group; CR=
Contingent reinforcement; DSM= Diagnostic and Statistical Manual; DT= Delayed treatment; Dx=
Diagnosis; EG= Experimental Group; EBPT= Enhanced BPT; EI= Early intervention; HA=Hyperactivity;
IT= Immediate treatment; MCI= Multicomponent intervention; MPH= Methylphenidate; NCG= Normal
control group; ODD= Oppositional Defiant Disorder; P-C= Parent-child; PC&S= Parent counseling and
support; PE= Parent education; RC= Reinforcement contingency; SBPT= Standard BPT; SCT= Special
treatment classroom; SEB= Social emotional behavioral intervention; SIT= Self instructional training;
SST=Social Skills Training; Sxs= symptoms; TAU= Treatment as usual; TR= Token reinforcement;
WLC= Waitlist control