Development of strategies to reduce the impact of the relative age effect on kindergarteners with ADHD

制定策略以减少相对年龄效应对患有多动症的幼儿园儿童的影响

• 批准号: 10057011
• 负责人: GREGORY A FABIANO
• 金额: $ 68.01万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10057011
• 关键词: Academic achievement; Address; Adult; Age; Aloe; Area; Attention deficit hyperactivity disorder; Attenuated; Behavior; Behavior Control; Behavioral; Characteristics; Child; Child Development; Chronic; Chronology; Clinical Trials; Coercion; Coupled; Data; Development; Diagnosis; Diagnostic; Distal; Education; Elderly; Exhibits; Family; Future; Growth; Health Benefit; Impairment; Intervention; Lifestyle-related condition; Literature; Maintenance; Measures; Modification; Neurocognitive; Outcome; Paper; Parents; Pharmaceutical Preparations; Policies; Prevention; Preventive Intervention; Process; Productivity; Public Health; Randomized; Recommendation; Risk; Schools; Stress; Symptoms; Teacher Professional Development; Testing; Time; Treatment outcome; age effect; base; career; college; comorbidity; early childhood; evidence base; executive function; expectation; experience; falls; first grade; functional disability; group intervention; improved; improved functioning; improved outcome; intervention effect; kindergarten; prevent; programs; scaffold; social; teacher; therapy development

PROJECT SUMMARY Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition, present from early childhood, which persists throughout the lifecourse. There is now clear evidence that children entering kindergarten, that are relatively young for the grade (e.g., born in the months immediately preceding the school entry cut-off) are at significantly more risk for receiving an ADHD diagnosis and being prescribed stimulant medication. These risks appear to be related solely to age of entry when other explanatory variables are controlled (Elder, 2010). This situation, termed the “Relative Age Effect” in this literature has potentially serious consequences for kindergarten children (e.g., greater likelihood of being prescribed psychoactive medication to control behavior; Elder, 2010). The present proposal aims to develop a teacher intervention to attenuate the impact of the relative age effect on young kindergarteners with elevated ADHD symptoms, and test the correspondence between the hypothesized mechanisms and treatment outcomes related to ADHD (e.g., symptoms, impairment). Following intervention development and refinement, 60 children entering kindergarten in the fall, and young for the grade, will be randomly assigned to (1) Kindergarten as Usual (KAU); (2) a Relative Age Effect prevention intervention administered immediately; or (3) a Relative Age Effect prevention intervention administered mid-year. In the intervention groups, teachers will be introduced to the relative age effect, receive information on how to anchor behavioral ratings in developmental norms, and implement a positive behavioral support to support growth in the child across the kindergarten school year. Primary aims will be to demonstrate the feasibility and acceptability of the intervention approach as well as the ability of the team to retain young children in a longitudinal trial. Further, the hypothesized mechanisms (e.g., improved neurocognitive functioning; improved teacher use of positive behavioral supports) will be measured and correspondence to hypothesized outcomes (e.g., reduced ADHD symptoms and impairment) will be evaluated. Data collected will be used to justify a larger efficacy-based trial to support the positive development of children with ADHD during this critical developmental transition.

项目概要 注意力缺陷/多动障碍 (ADHD) 是一种慢性疾病，从儿童早期就存在， 现在有明确的证据表明，进入幼儿园的儿童， 就该年级而言相对年轻（例如，出生于入学截止日期之前的几个月） 接受多动症诊断和服用兴奋剂药物的风险明显更高。 当其他解释变量受到控制时，风险似乎仅与进入年龄相关（Elder，2010）。 这种情况在本文献中被称为“相对年龄效应”，对以下人群有潜在的严重后果： 幼儿园儿童（例如，更有可能服用精神活性药物来控制行为； 埃尔德，2010）。 本提案旨在制定教师干预措施，以减轻相对年龄的影响 对 ADHD 症状加重的幼儿的影响，并测试之间的对应关系 与 ADHD 相关的阻碍机制和治疗结果（例如症状、障碍）。 干预措施的发展和完善，60名儿童在秋季进入幼儿园，以及年级的幼儿， 将被随机分配到 (1) 照常幼儿园 (KAU)；(2) 相对年龄效应预防干预 (3) 年中实施相对年龄效应预防干预措施。 干预小组中，教师将了解相对年龄效应，获得如何锚定的信息 发展规范中的行为评级，并实施积极的行为支持以支持成长 孩子整个幼儿园学年。 主要目标是证明干预方法的可行性和可接受性 作为团队在纵向试验中保留幼儿的能力。 （例如，改善神经认知功能；改善教师对积极行为支持的使用） 测量并与结果相对应（例如，减少多动症症状和损害） 将进行评估，收集的数据将用于证明更大规模的基于疗效的试验的合理性，以支持积极的结果。 多动症儿童在这个关键的发展转变期间的发展。