Evaluation of a Family-School Intervention for ADHD

多动症家庭学校干预的评估

• 批准号: 6870779
• 负责人: THOMAS J POWER
• 金额: $ 72.09万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-15 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6870779
• 关键词: academic achievement; anxiety disorders; attention deficit disorder; behavior modification; behavioral /social science research tag; central nervous system stimulants; clinical depression; clinical research; comorbidity; counseling; gender difference; health services research tag; human subject; human therapy evaluation; learning disorders; longitudinal human study; mental disorder chemotherapy; middle childhood (6-11); oppositional defiant disorder; outcomes research; parent offspring interaction; patient oriented research; problem solving; psychological models; socioeconomics; teacher

DESCRIPTION (provided by applicant): This 5-year study is designed to investigate the effectiveness of a novel psychosocial intervention for children with ADHD, Family-School Success (FSS), that promotes collaborative problem solving between parents and teachers. The primary aim is to evaluate FSS in relation to a comparison group controlling for non-specific treatment factors (COMP) to determine its effects on educational and family functioning among children who are medicated as well as those who are unmedicated. Additional aims are to evaluate the intervention acceptability of FSS, and to explore the effects of potential moderators (e.g., comorbid internalizing disorder, ADHD subtype, gender, comorbid oppositional defiant disorder, learning disabilities, socioeconomic status) on treatment response. The sample will consist of 198 children in grades 2 through 6 who meet criteria for ADHD Combined and Inattentive Types. Participants will be randomly assigned to FSS or COMP. Families will be given a choice about whether their children will be on medication during the study; it is expected that 60% of the children will be medicated. The groups will be stratified according to medication status, comorbid internalizing disorders, oppositional defiant disorder, learning disabilities, ADHD subtype, and gender. Children whose families elect medication will receive open trials using a standardized protocol that prioritizes the use of long-acting stimulants. The experimental intervention (FSS) consists of three major components: (a) family-school behavioral consultation, (b) daily report cards with home-based reinforcement, and (c) targeted homework interventions using goal setting and contingency management strategies. Outcomes will be assessed at mid-treatment, post-treatment, and 6-month follow-up across four primary domains: homework performance, home behavior and parent-child interaction, school performance and behavior, and family involvement in education. Main effects (FSS versus COMP) and interaction effects (treatment group by medication status) will be evaluated using longitudinal, mixed effects models applied to the targeted outcome variables. Moderator and mediator effects will be evaluated using criteria outlined by Baron and Kenny. Mixed effects models will also be used to estimate the degree of treatment effect at the level of the individual child and family.

描述（由申请人提供）：这项为期 5 年的研究旨在调查针对多动症儿童的新型心理社会干预措施——家庭学校成功 (FSS) 的有效性，该干预措施促进家长和教师之间的协作解决问题。主要目的是评估 FSS 与控制非特异性治疗因素 (COMP) 的对照组的关系，以确定其对接受药物治疗和未接受药物治疗的儿童的教育和家庭功能的影响。其他目的是评估 FSS 干预的可接受性，并探讨潜在调节因素（例如，共病内化障碍、ADHD 亚型、性别、共病对立违抗障碍、学习障碍、社会经济地位）对治疗反应的影响。样本将包括 198 名 2 至 6 年级的儿童，他们符合 ADHD 综合型和注意力不集中型的标准。参与者将被随机分配到 FSS 或 COMP。家庭可以选择他们的孩子是否在研究期间接受药物治疗；预计60%的儿童将接受药物治疗。这些组将根据药物状况、共病内化障碍、对立违抗障碍、学习障碍、多动症亚型和性别进行分层。家庭选择药物治疗的儿童将接受使用标准化方案的公开试验，该方案优先使用长效兴奋剂。实验干预（FSS）由三个主要部分组成：（a）家庭-学校行为咨询，（b）基于家庭强化的每日报告卡，以及（c）使用目标设定和应急管理策略的有针对性的家庭作业干预。将在治疗中期、治疗后和 6 个月的随访中对四个主要领域的结果进行评估：家庭作业表现、家庭行为和亲子互动、学校表现和行为以及家庭教育参与。将使用应用于目标结果变量的纵向混合效应模型来评估主效应（FSS 与 COMP）和相互作用效应（按药物状态划分的治疗组）。将使用巴伦和肯尼概述的标准来评估调节者和中介效应。混合效应模型还将用于估计个体儿童和家庭层面的治疗效果程度。