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Research on Child and Adolescent Psychopathology

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29-06-2023

Single and Combined Effects of Multiple Intensities of Behavioral Modification and Methylphenidate for Children with ADHD in the Home Setting

Auteurs: Brittany M. Merrill, Fiona L. Macphee, Lisa Burrows-MacLean, Erika K. Coles, Brian T. Wymbs, Anil Chacko, Kathryn Walker, Frances Wymbs, Allison Garefino, Jessica Robb Mazzant, Elizabeth M. Gnagy, James G. Waxmonsky, Greta M. Massetti, Daniel A. Waschbusch, Gregory A. Fabiano, William E. Pelham Jr.

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 10/2023

Abstract

Behavioral treatment, stimulants, and their combination are the recommended treatments for childhood attention-deficit/hyperactivity disorder (ADHD). The current study utilizes within-subjects manipulations of multiple doses of methylphenidate (placebo, 0.15, 0.30, and 0.60 mg/kg/dose t.i.d.) and intensities of behavioral modification (no, low, and high intensity) in the summer treatment program (STP) and home settings. Outcomes are evaluated in the home setting. Participants were 153 children (ages 5–12) diagnosed with ADHD. In alignment with experimental conditions implemented during the STP day, parents implemented behavioral modification levels in three-week intervals, child medication status varied daily, and the orders were randomized. Parents provided daily reports of child behavior, impairment, and symptoms and self-reported parenting stress and self-efficacy. At the end of the study, parents reported treatment preferences. Stimulant medication led to significant improvements across all outcome variables with higher doses resulting in greater improvement. Behavioral treatment significantly improved child individualized goal attainment, symptoms, and impairment in the home setting and parenting stress and self-efficacy. Effect sizes indicate that behavioral treatment combined with a low-medium dose (0.15 or 0.30 mg/kg/dose) of medication results in equivalent or superior outcomes compared to a higher dose (0.60 mg/kg/dose) of medication alone. This pattern was seen across outcomes. Parents overwhelmingly reported preferring treatment with a behavioral component as a first-choice treatment (99%). Results underscore the need to consider dosing as well as parent preference when utilizing combined treatment approaches. This study provides further evidence that combining behavioral treatment and stimulant medication may reduce the stimulant dose needed for beneficial effects.

vorige artikel Child Neuropsychological Functioning and Interpersonal Callousness as Predictors of Externalising Behaviour in Early Adolescence: A Prospective Population-based Study

volgende artikel Preferential Choice to Exert Cognitive Effort in Children with ADHD: a Diffusion Modelling Account

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Titel: Single and Combined Effects of Multiple Intensities of Behavioral Modification and Methylphenidate for Children with ADHD in the Home Setting
Auteurs: Brittany M. Merrill
Fiona L. Macphee
Lisa Burrows-MacLean
Erika K. Coles
Brian T. Wymbs
Anil Chacko
Kathryn Walker
Frances Wymbs
Allison Garefino
Jessica Robb Mazzant
Elizabeth M. Gnagy
James G. Waxmonsky
Greta M. Massetti
Daniel A. Waschbusch
Gregory A. Fabiano
William E. Pelham Jr.
Publicatiedatum: 29-06-2023
Uitgeverij: Springer US
Gepubliceerd in: Research on Child and Adolescent Psychopathology / Uitgave 10/2023
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI: https://doi.org/10.1007/s10802-023-01093-6

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