Randomised social-skills training and parental training plus standard treatment versus standard treatment of children with attention deficit hyperactivity disorder - The SOSTRA trial protocol Social-Skills and Parental Training plus Standard Treatment versus Standard Treatment for Children with ADHD – The Randomised SOSTRA Trial Social Skills Training in Children With Attention Deficit Hyperactivity Disorder: A Randomized-Controlled Clinical Trial Parent-assisted transfer of children's social skills training: effects on children with and without attention-deficit hyperactivity disorder. Social functioning in children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. Parental Influence on Children with Attention-Deficit/Hyperactivity Disorder: II. Results of a Pilot Intervention Training Parents as Friendship Coaches for Children The Link between Peer Relations, Prosocial Behavior, and ODD/ADHD Symptoms in 7–9-Year-Old Children Sports therapy for attention, cognitions and sociality. Combining Parent and Child Training for Young Children with ADHD [The prevalence of attention-deficit/hyperactivity disorder (ADHD) among children and adolescents in Germany. Initial results from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder: the Multimodal Treatment Study of children with Attention-deficit/hyperactivity disorder. In a randomized case–control trial with 10-years olds suffering from attention deficit/hyperactivity disorder (ADHD) sleep and psychological functioning improved during a 12-week sleep-training program A study on the effectiveness of videoconferencing on teaching parent training skills to parents of children with ADHD. Enhancing Behavioral and Social Skill Functioning in Children Newly Diagnosed with Attention-Deficit Hyperactivity Disorder in a Pediatric Setting A double‐blind, parallel, multicenter comparison of L‐acetylcarnitine with placebo on the attention deficit hyperactivity disorder in fragile X syndrome boys A randomized, controlled trial of integrated home-school behavioral treatment for ADHD, predominantly inattentive type. Parenting as a Mechanism of Change in Psychosocial Treatment for Youth with ADHD, Predominantly Inattentive Presentation Social skills and problem-solving training for children with early-onset conduct problems: who benefits? A two-site randomized clinical trial of integrated psychosocial treatment for ADHD-inattentive type. Effects and noneffects of methylphenidate in children with mental retardation and ADHD. Symptomatic improvement in children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. Effects of atomoxetine with and without behavior therapy on the school and home functioning of children with attention-deficit/hyperactivity disorder. The effectiveness of methylphenidate in the management of Attention Deficit Hyperactivity Disorder (ADHD) in people with intellectual disabilities: A systematic review. The effects of a stress-management program on self-concept, locus of control, and the acquisition of coping skills in school-age children diagnosed with attention deficit hyperactivity disorder. Academic achievement and emotional status of children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. Does brief, clinically based, intensive multimodal behavior therapy enhance the effects of methylphenidate in children with ADHD? Family Processes and Treatment Outcome in the MTA: Negative/Ineffective Parenting Practices in Relation to Multimodal Treatment Children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment: impact on parental practices. Atomoxetine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled, dose-response study. A randomized controlled trial of a parent training and emotion socialization program for families of hyperactive preschool-aged children. Design and rationale of controlled study of long-term methylphenidate and multimodal psychosocial treatment in children with ADHD. Effects of mindfulness-based cognitive therapy on neurophysiological correlates of performance monitoring in adult attention-deficit/hyperactivity disorder A longitudinal study of risk and protective factors associated with successful transition to secondary school in youth with ADHD: prospective cohort study protocol Predictors of persistence and remission of ADHD into adolescence: results from a four-year prospective follow-up study. The 4-year course of tic disorders in boys with attention-deficit/hyperactivity disorder. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. A comparison of behavioral parent training programs for fathers of children with attention-deficit/hyperactivity disorder. Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial. Efficacy of the Incredible Years Basic parent training programme as an early intervention for children with conduct problems and ADHD. Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later. A small-scale randomized controlled trial of the self-help version of the New Forest Parent Training Programme for children with ADHD symptoms Remediating organizational functioning in children with ADHD: immediate and long-term effects from a randomized controlled trial. Multimodal Therapy Involving High-Intensity Interval Training Improves the Physical Fitness, Motor Skills, Social Behavior, and Quality of Life of Boys With ADHD: A Randomized Controlled Study A randomized clinical trial of Cogmed Working Memory Training in school-age children with ADHD: a replication in a diverse sample using a control condition. Stimulant medication effects in a summer treatment program among young children with attention-deficit/hyperactivity disorder. Efficacy of Methylphenidate Among Children with Autism and Symptoms of Attention-Deficit Hyperactivity Disorder Worse Quality of Life for Children With Newly Diagnosed Attention-Deficit/Hyperactivity Disorder, Compared With Asthmatic and Healthy Children Behavioral Outcome Effects of Serious Gaming as an Adjunct to Treatment for Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial Effectiveness of a School-Based Multicomponent Program for the Treatment of Children with ADHD An efficacy study of a combined parent and teacher management training programme for children with ADHD The effects of magnesium physiological supplementation on hyperactivity in children with attention deficit hyperactivity disorder (ADHD). Positive response to magnesium oral loading test. Classroom seating for children with attention deficit hyperactivity disorder: therapy balls versus chairs. Computer-Based Attention Training in the Schools for Children With Attention Deficit/Hyperactivity Disorder: A Preliminary Trial Nine Months of Multicomponent Behavioral Treatment for ADHD and Effectiveness of MTA Fading Procedures
Background Children with attention deficit hyperactivity disorder ( ADHD ) are hyperactive and impulsive , can not maintain attention , and have difficulties with social interactions . Medical treatment may alleviate symptoms of ADHD , but seldom solves difficulties with social interactions . Social-skills training may benefit ADHD children in their social interactions . We want to examine the effects of social-skills training on difficulties related to the children 's ADHD symptoms and social interactions . Methods / Design The design is r and omised two-armed , parallel group , assessor-blinded trial . Children aged 8 - 12 years with a diagnosis of ADHD are r and omised to social-skills training and parental training plus st and ard treatment versus st and ard treatment alone . A sample size calculation estimated that at least 52 children must be included to show a 4-point difference in the primary outcome on the Conners 3rd Edition subscale for ' hyperactivity-impulsivity ' between the intervention group and the control group . The outcomes will be assessed 3 and 6 months after r and omisation . The primary outcome measure is ADHD symptoms . The secondary outcome is social skills . Tertiary outcomes include the relationship between social skills and symptoms of ADHD , the ability to form attachment , and parents ' ADHD symptoms . Discussion We hope that the results from this trial will show that the social-skills training together with medication may have a greater general effect on ADHD symptoms and social and emotional competencies than medication alone . Trial registration Clinical Trials ( NCT ) : Objective To investigate the effects of social-skills training and parental training programme for children with attention deficit hyperactivity disorder ( ADHD ) .  Methods We conducted a r and omized two-armed , parallel group , assessor-blinded superiority trial consisting of social-skills training plus parental training and st and ard treatment versus st and ard treatment alone . A sample size calculation showed at least 52 children should be included for the trial with follow up three and six months after r and omization . The primary outcome measure was ADHD symptoms and secondary outcomes were social skills and emotional competences . Results 56 children ( 39 boys , 17 girls , mean age 10.4 years , SD 1.31 ) with ADHD were r and omized , 28 to the experimental group and 27 to the control group . Mixed-model analyses with repeated measures showed that the time course ( y = a + bt + ct2 ) of ADHD symptoms ( p = 0.40 ) , social skills ( p = 0.80 ) , and emotional competences ( p = 0.14 ) were not significantly influenced by the intervention . Conclusions Social skills training plus parental training did not show any significant benefit for children with attention deficit hyperactivity disorder when compared with st and ard treatment . More and larger r and omized trials are needed . Trial Registration Clinical Trials.gov Evaluated efficacy of social skills training ( SST ) on children with 2 subtypes of attention deficit hyperactivity disorder ( ADHD ) . Participants were 120 children ( 30 girls , 90 boys ) , ages 8 to 12 with ADHD-Inattentive type ( ADHD-I ; n = 59 ) or Combined type ( ADHD-C ; n = 61 ) . The children were r and omly assigned within diagnosis subtype to the treatment condition ( 8 weeks of SST ) or the no-intervention control condition . SST led to greater improvements in both parent- and child-perceived assertion skills in the children with ADHD , yet did not affect the other domains of social competence . Diagnostically heterogeneous groups led to greater improvements on parent-report of their child 's cooperation and assertion abilities as well as children 's report of their own empathy skills . Diagnostically homogeneous groups led to greater decreases in externalizing behaviors at posttreatment but not at follow-up . Children with comorbid oppositional defiant disorder ( ODD ) did not benefit as much from the intervention . Children with ADHD-I improved in assertion skills more than children with ADHD-C , yet the 2 diagnostic entities did not differ in improvement levels across all other social skills OBJECTIVE Previous research has demonstrated that peer rejection is a significant part of the clinical presentation of many children with attention-deficit hyperactivity disorder ( ADHD ) . Outcome studies of treatment interventions have typically failed to show generalization of treatment gains to the home and classroom . This has been especially true for children who have comorbid oppositional defiant disorder ( ODD ) . The present study was intended to demonstrate generalization of an outpatient social skills training program when parents were trained in skills relevant to their child 's social adjustment . METHOD Thirty-five children with ADHD and 14 children without ADHD were given  12 sessions of treatment ( treatment group ) . Outcome was compared with 12 children with ADHD and 12 children without ADHD who were on a waitlist for treatment ( waitlist group ) .  Nineteen children with ODD were in the treatment group and five in the waitlist . Stimulant medication was prescribed for all children with ADHD . RESULTS Subjects with ADHD showed improvement comparable with that of subjects without ADHD on all teacher- and parent-reported measures of peer adjustment and social skills , except teacher-reported withdrawal . Children with ODD had outcome comparable with that of children without ODD . Effect sized ranged from 0.93 to 1.34 indicating that the average treatment group subject was better off than 83.4 % of waitlist subjects on outcome measures . CONCLUSIONS The present results suggest that children with ADHD are best heiped by a combination of social skills training for themselves , collateral training for their parents and stimulant medication OBJECTIVE To test that methylpheni date combined with intensive multimodal psychosocial intervention , which includes social skills training , significantly enhances social functioning in children with attention-deficit/hyperactivity disorder ( ADHD ) compared with methylpheni date alone and methylpheni date plus nonspecific psychosocial treatment ( attention control ) . METHOD One hundred three children with ADHD ( ages 7 - 9 ) , free of conduct and learning disorders , who responded to short-term methylpheni date were r and omized for 2 years to receive ( 1 ) methylpheni date alone , ( 2 ) methylpheni date plus multimodal psychosocial treatment that included social skills training , or ( 3 ) methylpheni date plus attention control treatment . Assessment s included parent , child , and teacher ratings of social function and direct school observations in gym . RESULTS No advantage was found on any measure of social functioning for the combination treatment over methylpheni date alone or methylpheni date plus attention control . Significant improvement occurred across all treatments and continued over 2 years . CONCLUSIONS In young children with ADHD , there is no support for clinic-based social skills training as part of a long-term psychosocial intervention to improve social behavior . Significant benefits from methylpheni date were stable over 2 years We report findings from a pilot intervention that trained parents to be “ friendship coaches ” for their children with Attention-Deficit/Hyperactivity Disorder ( ADHD ) . Parents of 62 children with ADHD ( ages 6–10 ; 68 % male ) were r and omly assigned to receive the parental friendship coaching ( PFC ) intervention , or to be in a no-treatment control group .  Families of 62 children without ADHD were included as normative comparisons . PFC was administered in eight , 90-minute sessions to parents ; there was no child treatment component . Parents were taught to arrange a social context in which their children were optimally likely to develop good peer relationships . Receipt of PFC predicted improvements in children ’s social skills and friendship quality on play date s as reported by parents , and peer acceptance and rejection as reported by teachers unaware of treatment status . PFC also predicted increases in observed parental facilitation and corrective feedback , and reductions in criticism during the child ’s peer interaction , which mediated the improvements in children ’s peer relationships . However , no effects for PFC were found on the number of play date s hosted or on teacher report of child social skills . Findings lend initial support to a treatment model that targets parental behaviors to address children ’s peer problems Oppositional defiant disorder ( ODD ) and attention-deficit/hyperactivity disorder ( ADHD ) are characterized by symptoms that hinder successful positive interaction with peers . The main goal of this study was to examine if the presence of symptoms of ODD and ADHD affects the relationship between positive social behavior and peer status found in 7–9-year-old children who show symptoms typical of ADHD and /or ODD . Furthermore , the possible interaction with sex was investigated . We used data collected in the first wave of The Bergen Child Study of mental health ( BCS ) , a prospect i ve longitudinal total population study of children 's developmental and mental health . The target population consisted of children in the second to the fourth , in all public , private , and special schools in Bergen , Norway , in the fall of 2002 ( N = 9430 ) . All 79 primary schools in Bergen participated in the study . Both teacher ( 8809 complete cases ) and parent ( 6253 complete cases ) report were used in the analyses . ADHD and ODD scores were estimated using the Swanson Nol and and Pelham rating scale version IV ( SNAP-IV ) , and peer problems and prosocial behavior were assessed using the Strengths and Difficulties Question naire ( SDQ ) . We replicated the relationship between peer problems and prosocial behavior found previously in typically developing children . Our results showed that the relationship between peer problems and prosocial behavior became weaker as the ODD symptoms increased in number and severity . For ADHD this effect was only found in the teacher report of the children . A sex effect for ODD symptoms was found only using the parent report : boys with ODD symptoms showed less prosocial behavior than girls with similar levels of ODD symptoms . Since this effect was not found using the teacher data , it may imply a situational effect ( school/home ) for girls with high levels of ODD . The moderator effect of ODD/ADHD was comparable for boys and girls . Our findings suggest that even if children with ADHD/ODD symptoms have the opportunity to practice their social skills in peer relationships , this is not necessarily accompanied by an increase in prosocial behavior The aim of the present study was to underst and if sport improves attention symptoms , social competency , and cognitive functions in children with attention deficit and hyperactivity disorder ( ADHD ) . The present study was design ed as a 6-week , prospect i ve trial , including 12 sessions of education/sports therapy .  13 ADHD children participated in a  90-min athletic activity ( sports-cADHD ) twice a week , while 15 ADHD children received education on behavior control ( edu-cADHD ) . During the 6-week treatment period , the sports-cADHD group showed greater improvements in DuPaul 's ADHD Rating Scale scores , parent and teacher version ( K-ARS-PT ) , compared to those of the edu-sADHD group . The cognitive functions assessed with the digit symbol and Trail-Making Test part B ( TMT B ) were improved in the sports-cADHD group , while the cognitive functions observed in the edu-sADHD group were not significantly changed . The cooperativeness scores in the sports-cADHD group were greatly increased compared to those of the edu-sADHD group . The results demonstrated a positive correlation with sports and improvement in attention symptoms , cognitive symptoms and social skills . The results of the present study suggest that therapy in the form of athletic activity may increase social competency in children with ADHD , as demonstrated by improved cognitive functions The efficacy of the Incredible Years parent and child training programs is established in children diagnosed with oppositional defiant disorder but not among young children whose primary diagnosis is attention-deficit/hyperactivity disorder ( ADHD ) . We conducted a r and omized control trial evaluating the combined parent and child program interventions among 99 children diagnosed with ADHD ( ages 4–6 ) . Mother reported significant treatment effects for appropriate and harsh discipline , use of physical punishment , and monitoring , whereas fathers reported no significant parenting changes . Independent observations revealed treatment effects for mothers ' praise and coaching , mothers ' critical statements , and child total deviant behaviors . Both mothers and fathers reported treatment effects for children 's externalizing , hyperactivity , inattentive and oppositional behaviors , and emotion regulation and social competence . There were also significant treatment effects for children 's emotion vocabulary and problem-solving ability . At school teachers reported treatment effects for externalizing behaviors and peer observations indicated improvements in treated children 's social competence The cardinal symptoms of attention-deficit/hyperactivity disorder ( ADHD ) are inattention , hyperactivity and impulsivity . Etiologically , ADHD is mainly put down to genetic causes ; it entails a considerable range of psychosocial problems for those affected and their social environment . The parents of a total of 7,569 boys ( B ) and 7,267 girls ( G ) aged 3 - 17 who took part in the German Health Interview and Examination Survey for Children and Adolescents ( KiGGS ) answered a self-administered question naire including an ADHD diagnosis question and the  Strengths and Difficulties Question naire ( SDQ )  . In addition behavioural observations of 7,919 children ( aged 3 - 11 ) were carried out during the medical and physical tests . Participants whose parents reported that they had ever been given an ADHD diagnosis by a doctor or psychologist were classified as ADHD cases . Participants were classified as suspected cases of ADHD if they had a value of > or = 7 on the SDQ inattention/hyperactivity scale . ADHD had ever been diagnosed in 4.8 % of the children and adolescents altogether ( B : 7.7 % , G : 1.8 % ) . Another 4.9 % of the participants can be considered as suspected cases . Already 1.8 % of the preschoolers had been given an ADHD diagnosis . At primary school age ( 7 - 10 years old ) the frequency of diagnosis rises sharply . At age 11 - 17 , ADHD had ever been diagnosed in 1 in 10 boys and 1 in 43 girls . ADHD had been diagnosed significantly more frequently among participants of low socio-economic status ( SES ) than among participants of high SES . A diagnosis of ADHD is reported less often for migrants , they rank more frequently among the suspected cases . The discrepancy between confirmed and suspected cases of ADHD among migrants may point to lower diagnosis rates or lower utilization of medical services . The short- and long-term medical , social and health-economic effects of ADHD illustrate the major public health relevance of the disorder . As for prevention , the high share of genetic factors in ADHD etiology primarily suggests secondary prevention ( early support and early diagnosis ) and tertiary prevention measures . Further analysis of the KiGGS data could prospect ively identify risk groups more precisely and refine preventional approaches BACKGROUND Intent-to-treat analyses of the study revealed that medication management , alone or combined with intensive behavioral treatment , was superior to behavioral treatment and community care in reducing attention-deficit/hyperactivity disorder ( ADHD ) symptoms ; but only combined treatment showed consistently greater benefit than community care across other outcome domains ( disruptive and internalizing symptoms , achievement , parent-child relations , and social skills ) . We examine response patterns in subgroups defined by baseline variables ( moderators ) or variables related to treatment implementation ( mediators ) . METHODS We reconducted r and om-effects regression ( RR ) analyses , adding factors defined by moderators ( sex ,  prior medication use  ,  comorbid disruptive or anxiety disorder  , and public assistance ) and a mediator ( treatment acceptance/attendance ) . RESULTS Study outcomes ( N = 579 ) were upheld in most moderator subgroups ( boys and girls , children with and without prior medication , children with and without comorbid disruptive disorders ) . Comorbid anxiety disorder did moderate outcome ; in participants without anxiety , results paralleled intent-to-treat findings . For those with anxiety disorders , however , behavioral treatment yielded significantly better outcomes than community care ( and was no longer statistically different from medication management and combined treatment ) regarding ADHD-related and internalizing symptoms . In families receiving public assistance , medication management yielded decreased closeness in parent-child interactions , and combined treatment yielded relatively greater benefits for teacher-reported social skills . In families with high treatment acceptance/attendance , intent-to-treat results were upheld . Acceptance/attendance was particularly important for medication treatments . Finally , two thirds of children given community care received stimulants . Behavioral treatment did not significantly differ from , but medication management was superior to , this subgroup . CONCLUSIONS Exploratory analyses revealed that our study ( the Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder [ MTA ] ) results were confirmed across most baseline variables and treatment acceptance/attendance . In children with ADHD plus anxiety , behavioral treatment surpassed community care and approached medication-based treatments regarding parent-reported ADHD symptoms Abstract Objectives . We tested the hypothesis that sleep training would improve emotional , social and behavioural functioning in children with attention-deficit/hyperactivity disorder ( ADHD ) compared to children with ADHD without such intervention and to healthy controls . Methods . Forty children with ADHD were r and omly assigned to intervention and control conditions . Parents of 20 children with ADHD were instructed and thoroughly supervised in improving their children 's sleep schedules and sleep behaviour .  Parents of the other 20 children with ADHD and parents of 20 healthy children  received general information about sleep hygiene . At baseline and 12 weeks later , parents and children completed question naires related to children 's sleep and psychological functioning . Results . Relative to the control groups , children in the intervention group improved sleep quantitatively and qualitatively ( F values < 3.33 , P values < 0.05 ) . The intervention group children reported improvements in mood , emotions , and relationships ( F values < 2.99 , P values < 0.05 ) . Parents reported that their children improved in physical and psychological wellbeing , mood , emotions , relationships , and social acceptance ( F values < 3.02 , P values < 0.05 ) . Conclusions . Training and monitoring parents of children with ADHD in regulating and supervising children 's sleep schedules leads to positive changes in the emotions , behaviour and social lives of these children OBJECTIVE Many geographic locations are without services and staff available to provide treatment for children with attention deficit hyperactivity disorder ( ADHD ) . This is a r and omized controlled trial to evaluate the effectiveness of group parent training on ADHD treatment delivered via videoconferencing . SUBJECTS AND METHODS Twenty-two subjects were enrolled in the study , with 9 subjects in the videoconference session ( treatment group ) and 13 in the face-to-face session ( control group ) . The parent child relationship question naire for child and adolescents ( PCQ-CA ) , V and erbilt assessment scales ( parent and teacher versions ) , children global assessment scale , clinical global impression-severity score , clinical global impression-improvement score , and social skills rating system assessed the effectiveness of the treatment . A Likert scale evaluated parents ' acceptance of the training modality . Our results showed that the parent training program significantly improved parents ' disciplinary practice s based on the PRQ-CA , parent ratings of ADHD , oppositional defiant disorder , and conduct disorder symptoms , and the children 's global functioning . RESULTS The treatment effects did not differ between the videoconference and face-to-face groups ; however , the videoconference group evidence d statistically greater improvement on the hyperactive symptoms of V and erbilt assessment scales . Our findings suggest that parent training through a videoconferencing modality may be as effective as face-to-face training and is well accepted by parents . CONCLUSIONS Parent training via videoconferencing may be an important tool for addressing ADHD in geographic locations that do not have access to appropriate treatment providers ABSTRACT . The objective of this study was to evaluate the effectiveness of an 8-week behavioral and social skill ( BSS ) class for children newly diagnosed with attention-deficit hyperactivity disorder ( ADHD ) and their parents , initiating stimulant treatment in primary care . The subjects were 100 children , aged 5 to 12 years , recently diagnosed with ADHD and treated with stimulant medication , and their parents or guardians . Eligible families were r and omly assigned to an intervention group ( IG : n = 59 ) or control group ( CG : n = 41 ) . The BSS function of each child was assessed using DuPaul ’s ADHD Parent Rating Scale ( 18-item ) and Child Attention Profile ( 12-item ) during blinded baseline and follow-up interviews . Parent discipline practice was assessed using a five-item inventory based on Likert-scale ratings during identical periods . Computerized pharmacy records were used to track psychostimulant use over time . IG children exhibited significantly lower parent-rated ADHD symptoms , whereas IG parents reported significantly better and more consistent discipline practice s compared with CG parents across time . No significant differences were found between groups in Child Attention Profile scores across time . Psychostimulant use did not significantly differ between groups across time .  BSS training  was well accepted and seemed to significantly improve BSS functioning among IG children in the home setting only Attention deficit hyperactivity disorder ( ADHD ) is a frequent behavioral problem in young boys with fragile X syndrome ( FXS ) , and its treatment is critical for improving social ability . The short‐term efficacy of stimulant medications like methylpheni date ( MPH ) is well established in children with ADHD . FXS boys treated with MPH have improved attention span and socialization skills ; however their mood becomes unstable at higher doses . Therefore , alternative pharmacological treatment of ADHD symptoms is desirable . A recent study showed that carnitine has a beneficial effect on the hyperactive – impulsive behavior in boys with ADHD without side effects . Our previous placebo‐controlled trial indicated that L‐acetylcarnitine ( LAC ) reduces hyperactivity in FXS boys . The objective of this study was to determine the efficacy of LAC in a larger sample of FXS boys with ADHD . The study design was r and omized , double blind placebo controlled , parallel , and multicenter ( with eight centers involved in Italy , France , and Spain ) . Sixty‐three FXS males with ADHD ( aged 6–13 years ) were enrolled ; 7 patients dropped out , 56 completed the one‐year treatment , and 51 were included in the statistical analysis . Both groups improved their behavior , showing that psychosocial intervention has a significant therapeutic effect . However , we observed a stronger reduction of hyperactivity and improvement of social behavior in patients treated with LAC , compared with the placebo group , as determined by the Conners ' Global Index Parents and the Vinel and Adaptive Behavior Scale . Our results show that LAC ( 20–50 mg/kg/day ) represents a safe alternative to the use of stimulant drugs for the treatment of ADHD in FXS children . © 2008 Wiley‐Liss , OBJECTIVE To evaluate the efficacy of a behavioral psychosocial treatment integrated across home and school ( Child Life and Attention Skills Program ) with attention-deficit/hyperactivity disorder ( ADHD ) predominantly inattentive type ( ADHD-I ) . METHOD Sixty-nine children ages 7 to 11 years were r and omized to the Child Life and Attention Skills Program or a control group who did not receive the intervention .  We compared groups posttreatment and at 3- to 5-month follow-up on parent and teacher ratings of inattention , sluggish cognitive tempo , and functional impairment . RESULTS Children r and omized to the Child Life and Attention Skills Program were reported to have significantly fewer inattention and sluggish cognitive tempo symptoms , and significantly improved social and organizational skills , relative to the control group . Gains were maintained at follow-up . CONCLUSIONS Behavioral psychosocial treatment , when specifically adapted for ADHD-I and coordinated among parents , teachers , and children , appears efficacious in reducing symptoms and impairment associated with We investigated whether parenting and child behavior improve following psychosocial treatment for Attention-Deficit/Hyperactivity Disorder , Predominantly Inattentive Presentation ( ADHD-I ) and whether parenting improvements mediate child outcomes . We analyzed data from a r and omized clinical trial investigating the efficacy of a multicomponent psychosocial intervention ( Child Life and Attention Skills , CLAS , n = 74 ) in comparison to Parent-Focused Treatment ( PFT , n = 74 ) and treatment as usual ( TAU , n = 51 ) for youth with ADHD-I ( average child age = 8.6 years , range 7–11 years , 58 % boys ) . Child and parent/family functioning were assessed prior to treatment , immediately following treatment , and at follow-up into the subsequent school year using parent and teacher reports of inattention , organization , social skills , academic competency ( teachers only ) , parenting daily hassles , and positive and negative parenting behaviors ( parents only ) . Both treatment groups improved on negative parenting and home impairment , but only CLAS families also improved on positive parenting as well as academic impairment . Improvements in positive and negative parenting mediated treatment effects on child impairment independent of improvements in child inattention , implicating parenting as an important mechanism of change in psychosocial treatment for ADHD-I. Further , whereas parent-focused training produces improvements in negative parenting and impairment at home for children with ADHD-I , a multicomponent approach ( incorporating child skills training and teacher consultation ) more consistently produces improvements at school and in positive parenting , which may contribute to improvements in social skills into the next school year Families of 99 children with early-onset conduct problems , aged 4 - 8 years , were r and omly assigned to a  child training treatment group ( CT ) utilizing the Incredible Years Dinosaur Social Skills and Problem Solving Curriculum or a waiting-list control group ( CON ) . Post-treatment CT children had significantly fewer externalizing problems at home , less aggression at school , more prosocial behavior with peers , and more positive conflict management strategies than CON children . Significantly more CT than CON children showed clinical ly significantly improvements on reports and independent observations of aggressive and noncompliant behavior . The differential treatment response was evaluated according to child comorbidity with attention deficit hyperactivity disorder ( ADHD ) , parenting discipline practice s. and family risk factors . The only risk factor related to failure to make improvements in child conduct problems after treatment was negative parenting ( i.e. , maternal critical statements and physical force ) . The long-term follow-up 1 year later indicated that most of the significant post-treatment changes were maintained OBJECTIVE This study evaluated the efficacy of the Child Life and Attention Skills ( CLAS ) program , a behavioral psychosocial treatment integrated across home and school , for youth with attention-deficit/hyperactivity disorder-inattentive type ( ADHD-I ) . METHOD In a 2-site r and omized controlled trial , 199 children ( ages 7 - 11 years ) were r and omized to  CLAS ( N = 74 ) , parent-focused treatment ( PFT , N = 74 ) , or treatment as usual ( TAU , N = 51 ) . We compared groups on parent and teacher ratings of inattention symptoms , organizational skills , social skills , and global improvement at posttreatment and also at follow-up during the subsequent school year . RESULTS CLAS result ed in greater improvements in teacher-reported inattention , organizational skills , social skills , and global functioning relative to both PFT and TAU at posttreatment . Parents of children in CLAS reported greater improvement in organizational skills than PFT and greater improvements on all outcomes relative to TAU at posttreatment . Differences between CLAS and TAU were maintained at follow-up for most parent-reported measures but were not significant for teacher-reported outcomes . CONCLUSIONS These findings extend support for CLAS across 2 study sites , revealing that integrating parent , teacher , and child treatment components , specifically adapted for ADHD-I , is superior to parent training alone and to usual care . Direct involvement of teachers and children in CLAS appears to amplify effects at school and home and underscores the importance of coordinating parent , teacher , and child treatment components for cross- setting effects on symptoms and impairment associated with Stimulant medication efficacy was evaluated in 14 children with attention-deficit hyperactivity disorder and IQs of 48 to 74 in a double-blind crossover study of two methylpheni date doses and placebo . Dependent measures included behavioral ratings , work output , measures of learning , attention and impulsivity , and direct observation of peer social interactions . Nine children ( 64 % ) were methylpheni date -responders , based upon the Conners Hyperactivity Index . Significant gains in on-task behavior and attentional skills were noted with methylpheni date in comparison to placebo . No improvement on measures of learning or social interactions were observed . Results extend and replicate previous research conducted by the authors OBJECTIVE To test the hypotheses that in children with attention-deficit/hyperactivity disorder ( ADHD ) ( 1 ) symptoms of ADHD , oppositional defiant disorder , and overall functioning are significantly improved by methylpheni date combined with intensive multimodal psychosocial treatment compared with methylpheni date alone and with methylpheni date plus attention control and ( 2 ) more children receiving combined treatment can be taken off methylpheni date . METHOD One hundred three children with ADHD ( ages 7 - 9 ) , free of conduct and learning disorders , who responded to short-term methylpheni date were r and omized for 2 years to ( 1 ) methylpheni date alone ; ( 2 ) methylpheni date plus psychosocial treatment that included parent training and counseling , social skills training , psychotherapy , and academic assistance , or ( 3 ) methylpheni date plus attention psychosocial control treatment . Assessment s included parent , teacher , and psychiatrist ratings , and observations in academic and gym classes . RESULTS Combination treatment did not lead to superior functioning and did not facilitate methylpheni date discontinuation . Significant improvement occurred across all treatments and continued over 2 years . CONCLUSIONS In stimulant-responsive children with ADHD , there is no support for adding ambitious long-term psychosocial intervention to improve ADHD and oppositional defiant disorder symptoms . Significant benefits from methylpheni date were stable over 2 years OBJECTIVE To evaluate the effects of atomoxetine alone and in combination with behavior therapy on the school functioning of children with attention-deficit/hyperactivity disorder ( ADHD ) . Most atomoxetine studies have not assessed school functioning other than by measuring the change in ADHD symptoms . Combining behavior therapy with atomoxetine may be particularly beneficial for the academic domain as medication has not been found to produce sustained benefits in this realm . However , there is little research examining the effects of combining atomoxetine and behavior therapy . METHOD In an 8-week open-label trial , 56 children aged 6 - 12 years with ADHD diagnosed according to DSM-IV-TR were r and omly assigned to receive  atomoxetine and behavior therapy or atomoxetine alone . Behavior therapy consisted of an 8-week parenting course , a child social skills course , and a teacher-implemented daily report card of classroom behavior . The primary outcome was direct observation of the subject 's classroom behavior . Secondary outcomes included change in ADHD symptoms and functioning at home and school . All data were collected between March 2007 and May 2008 . RESULTS Classroom observations showed that atomoxetine decreased rule violations ( P < .0001 ) . Moreover , atomoxetine was associated with significant improvements in ADHD and oppositional defiant disorder symptoms at home and school and enhanced functioning in both domains ( Impairment Rating Scale : all P < .001 ) . Combined treatment led to greater improvements in parent-rated symptoms of inattention ( P < .01 ) , problem behaviors ( P < .001 ) , and academic impairment ( P < .05 ) . However , teachers did not report significant group differences . CONCLUSIONS Atomoxetine improved ADHD symptoms and classroom functioning as measured by parents , teachers , and direct observation . The addition of behavior therapy led to further improvements at home but not at school . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00918567 BACKGROUND The effectiveness of psychostimulants , primarily methylpheni date ( MPH ) , in the treatment of Attention Deficit Hyperactivity Disorder ( ADHD ) in the general population of typically growing children and adolescents is well established through many R and omised Controlled Trials ( RCTs ) . AIMS AND METHODS We carried out a systematic review of all the RCTs in people with intellectual disabilities ( ID ) that assessed effectiveness of MPH on the core ADHD symptoms . OUTCOMES AND RESULTS We included 15 papers from 13 studies that were all on children and adolescents with ID ( 315 participants were on MPH and placebo respectively ) , 12 of which used a cross over design , and one used a parallel design . On average around 40 - 50 % responded to MPH in the ID group whereas around 70 - 80 % response rate is reported among the non-ID children . Because of the heterogeneity of the outcome data it was not possible to carry out a meta- analysis . Significant adverse events included sleep difficulties and poor appetite along with weight loss and also irritability , social withdrawal and increased motor activities including tic . CONCLUSIONS AND IMPLEMENTATION On the basis of the poor quality evidence that is available , it seems that MPH may be effective in some but not all children and adolescents with ID and ADHD PROBLEM What is the effectiveness of a stress-management program on self-concept , locus of control , and acquisition of appropriate coping strategies in children with attention deficit hyperactivity disorder ( ADHD ) ? METHODS Forty-two children with ADHD ( age range 9 - 12 ) were r and omly assigned to a control group , a therapist-led group , or a group in which the stress-management techniques were taught by the parents . The subjects were pre- and posttested on self-concept , locus of control , and acquisition of coping skills . FINDINGS Although there were no significant changes in any of the three groups for acquisition of coping skills , the children in the therapist-led group reported more appropriate coping strategies . CONCLUSIONS Involving parents in a cognitive-behavioral approach could improve  parent-child relationships and further increase the opportunities for successful academic and social functioning OBJECTIVE To test the hypothesis that intensive multimodal psychosocial intervention ( that includes academic assistance and psychotherapy ) combined with methylpheni date significantly enhances the academic performance and emotional status of children with attention-deficit/hyperactivity disorder ( ADHD ) compared with methylpheni date alone and with methylpheni date combined with nonspecific psychosocial treatment ( attention control ) . METHOD One hundred three children with ADHD ( ages 7 - 9 ) , free of conduct and learning disorders , who responded to short-term methylpheni date were r and omized for 2 years to receive one of three treatments : ( 1 ) methylpheni date alone , ( 2 ) methylpheni date plus psychosocial treatment that included academic remediation , organizational skills training , and psychotherapy as well as parent training and counseling and social skills training , or ( 3 ) methylpheni date plus attention control treatment . Children 's function was assessed through academic testing , parent ratings of homework problems , and self-ratings of depression and self-esteem . RESULTS No advantage was found on any measure of academic performance or emotional status for the combination treatment over methylpheni date alone and over methylpheni date plus attention control . Significant improvement occurred across all treatments and was maintained over 2 years . CONCLUSIONS In stimulant-responsive young children with ADHD without learning and conduct disorders , there is no support for academic assistance and psychotherapy to enhance academic achievement or emotional adjustment . Significant short-term improvements were maintained over 2 years Objective The additional value of a short-term , clinical ly based , intensive multimodal behavior therapy to optimally titrated methylpheni date in children with attention-deficit hyperactivity disorder ( ADHD ) was investigated . Method Fifty children with ADHD ( ages 8–12 ) were r and omized to treatment of methylpheni date or treatment with methylpheni date combined with 10 weeks of multimodal behavior therapy . The multimodal behavior therapy consisted of a child and parent behavioral therapy and a teacher behavioral training . Assessment s included parent , teacher and child ratings of ADHD symptoms , oppositional and conduct behavior , social skills , parenting stress , anxiety and self-worth . Results Both treatment conditions yielded significant improvements on all outcome domains . No significant differences were found between both treatments . Conclusions No evidence was found for the additive effect of multimodal behavior therapy next to optimally titrated methylpheni date . Clinical implication sThis study does not support the expectation that optimally dosed stimulant treated children with ADHD should routinely receive psychosocial treatment to further reduce ADHD- and related symptoms To eluci date processes underlying therapeutic change in a large-scale r and omized clinical trial , we examined whether alterations in self-reported parenting practice s were associated with the effects of behavioral , medication , or combination treatments on teacher-reported outcomes ( disruptive behavior , social skills , internalizing symptoms ) in children with attention-deficit hyperactivity disorder ( ADHD ) . Participants were 579 children with Combined-type ADHD , aged 7–9.9 years , in the Multimodal Treatment Study of Children with ADHD ( MTA ) . We uncovered 2 second-order factors of parenting practice s , entitled Positive Involvement and Negative/Ineffective Discipline . Although Positive Involvement was not associated with amelioration of the school-based outcome measures , reductions in Negative/Ineffective Discipline mediated improvement in children 's social skills at school . For families showing the greatest reductions in Negative/Ineffective Discipline , effects of combined medication plus behavioral treatment were pronounced in relation to regular community care . Furthermore , only in combination treatment ( and not in behavioral treatment alone ) was decreased Negative/Ineffective Discipline associated with reduction in children 's disruptive behavior at school . Here , children in families receiving combination treatment who showed the greatest reductions in Negative/Ineffective Discipline had teacher-reported disruptive behavior that was essentially normalized . Overall , the success of combination treatment for important school-related outcomes appears related to reductions in negative and ineffective parenting practice s at home ; we discuss problems in interpreting the temporal sequencing of such process- outcome linkages and the means by which multimodal treatment may be mediated by psychosocial processes related to parenting OBJECTIVE To test the hypothesis that multimodal psychosocial intervention , which includes parent training , combined with methylpheni date significantly enhances the behavior of parents of children with attention-deficit/hyperactivity disorder ( ADHD ) , compared with methylpheni date alone and compared with methylpheni date and nonspecific psychosocial treatment ( attention control ) . METHOD One hundred three children with ADHD ( ages 7 - 9 ) , free of conduct and learning disorders , who responded to short-term methylpheni date therapy were r and omized for 2 years to receive either ( 1 ) methylpheni date treatment alone ; ( 2 ) methylpheni date plus psychosocial treatment that included parent training and counseling , social skills training , academic assistance , and psychotherapy ; or ( 3 ) methylpheni date plus attention control treatment . Parents rated their knowledge of parenting principles and negative and positive parenting behavior . Children rated their parents ' behavior . RESULTS Psychosocial treatment led to significantly better knowledge of parenting principles but did not enhance parenting practice s , as rated by parents and children . Significant improvement in mothers ' negative parenting occurred across all treatments and was maintained . CONCLUSIONS In nonconduct-disordered , stimulant-treated children with ADHD , parent training does not improve self-rated parental behavior . The benefits of brief stimulant treatment for negative parental behavior are sustained with extended treatment OBJECTIVE Atomoxetine is an investigational , nonstimulant pharmacotherapy being studied as potential treatment for attention-deficit/hyperactivity disorder ( ADHD ) . It is thought to act via blockade of the presynaptic norepinephrine transporter in the brain . We assessed the efficacy of 3 doses of atomoxetine compared with placebo in children and adolescents with ADHD . METHODS A total of 297 children and adolescents who were 8 to 18 years of age and had ADHD as defined by the Diagnostic and Statistical Manual of Mental Disorders , 4th edition , were r and omized to placebo or atomoxetine dosed on a weight-adjusted basis at 0.5 mg/kg/day , 1.2 mg/kg/day , or 1.8 mg/kg/day for an 8-week period . ADHD symptoms , affective symptoms , and social and family functioning were assessed using parent and investigator rating scales . RESULTS Approximately 71 % of children enrolled were male , approximately 67 % met criteria for mixed subtype ( both inattentive and hyperactive/impulsive symptoms ) , and the only common psychiatric comorbidity was oppositional defiant disorder ( approximately 38 % of the sample ) . At baseline , symptom severity was rated as moderate to severe for most children . At endpoint , atomoxetine 1.2 mg/kg/day and 1.8 mg/kg/day were consistently associated with superior outcomes in ADHD symptoms compared with placebo and were not different from each other . The dose of 0.5 mg/kg/day was associated with intermediate efficacy between placebo and the 2 higher doses , suggesting a grade d dose-response . Social and family functioning also were improved in the atomoxetine groups compared with placebo with statistically significant improvements in measures of children 's ability to meet psychosocial role expectations and parental impact . Discontinuations as a result of adverse events were < 5 % for all groups . CONCLUSION Among children and adolescents aged 8 to 18 , atomoxetine was superior to placebo in reducing ADHD symptoms and in improving social and family functioning symptoms . Atomoxetine was associated with a grade d dose-response , and 1.2 mg/kg/day seems to be as effective as 1.8 mg/kg/day and is likely to be the appropriate initial target dose for most patients . Treatment with atomoxetine was safe and well tolerated The present study evaluated the effectiveness of a parent training and emotion socialization program design ed specifically for hyperactive preschoolers . Participants were 31 preschool-aged children whose parents were r and omly assigned to a  parent training ( PT ) or waitlist ( WL ) control group .  PT parents took part in a 14-week parenting program that involved teaching parenting strategies for managing hyperactive and disruptive behavior as well as emotion socialization strategies for improving children 's emotion regulation . Compared to WL mothers , PT mothers reported significantly less child inattention , hyperactivity , oppositional defiance , and emotional lability ; were observed using significantly more positive and less negative parenting ; and reported significantly less maternal verbosity and unsupportive emotion socialization practice s. Results provide some support for the effectiveness of this parenting program for reducing attention-deficit hyperactivity disorder ( ADHD ) symptoms and associated problems in preschool-aged children OBJECTIVE To describe the rationale , methodology , and sample characteristics of a dual-site treatment study ( New York and Montreal ) of children with attention-deficit/hyperactivity disorder ( ADHD ) conducted between 1990 and 1995 . The hypotheses were that ( 1 ) methylpheni date combined with comprehensive multimodal psychosocial treatment was superior to methylpheni date alone in improving multiple functions and ( 2 ) the efficacy of the psychosocial intervention result ed from its specific components and not from nonspecific treatment effects . METHOD One hundred three children with ADHD ( ages 7 - 9 ) , free of conduct and learning disorders , who responded to methylpheni date , were r and omized for 2 years to ( 1 ) methylpheni date treatment alone ; ( 2 ) methylpheni date combined with multimodal psychosocial treatment that included parent training and counseling , academic assistance , psychotherapy , and social skills training ; or ( 3 ) methylpheni date plus attention control treatment that excluded specific aspects of the psychosocial intervention . Children were switched to single-blind placebo after 12 months ; methylpheni date was reinstituted when clinical ly indicated . Assessment s included ratings by parents , teachers , children , and psychiatrists ; school observations in academic and gym classes ; and academic performance tests . Almost 80 % of families completed the 2-year study . Companion papers present treatment effects . CONCLUSIONS A comprehensive 2-year psychosocial treatment was delivered successfully to children with ADHD and their families OBJECTIVE To examine whether mindfulness-based cognitive therapy ( MBCT ) would enhance attenuated amplitudes of event-related potentials ( ERPs ) indexing performance monitoring biomarkers of attention-deficit/hyperactivity disorder ( ADHD ) . METHODS Fifty adult ADHD patients took part in a r and omised controlled study investigating ERP and clinical measures pre-to-post MBCT .  Twenty-six patients were r and omly allocated to MBCT , 24 to a wait-list control . Main outcome measures included error processing ( ERN , Pe ) , conflict monitoring ( NoGo-N2 ) , and inhibitory control ( NoGo-P3 ) ERPs concomitant to a continuous performance task ( CPT-X ) . Inattention and hyperactivity-impulsivity ADHD symptoms , psychological distress and social functioning , and mindfulness skills were also assessed . RESULTS MBCT was associated with increased Pe and NoGo-P3 amplitudes , coinciding with reduced ' hyperactivity/impulsivity ' and ' inattention ' symptomatology . Specific to the MBCT ; enhanced Pe amplitudes correlated with a decrease in hyperactivity/impulsivity symptoms and increased ' act-with-awareness ' mindfulness skill , whereas , enhanced P3 correlated with amelioration in inattention symptoms . CONCLUSIONS MBCT enhanced ERP amplitudes associated with motivational saliency and error awareness , leading to improved inhibitory regulation . SIGNIFICANCE MBCT suggests having comparable modulation on performance monitoring ERP amplitudes as pharmacological treatments . Further study and development of MBCT as a treatment for ADHD is warranted , in addition to its potential scope for clinical applicability to broader defined externalising disorders and clinical problems associated with impairments of the prefrontal cortex Background Attention-Deficit/Hyperactivity Disorder ( ADHD ) has a significant impact on child and adolescent development , especially in relation to school functioning and academic outcomes . Despite the transition to high school being a potentially critical period for children with ADHD , most research in this period has focused on academic outcomes . This study aims to extend previous research by describing academic , school engagement , behaviour and social-emotional outcomes for young people with ADHD in the first and third years of high school and to identify risk and protective factors predictive of differing outcomes across these four domains . Methods and design The Moving Up study is a longitudinal , prospect i ve cohort study of children with ADHD as they transition and adjust to high school ( age 12–15 years ) . Data are collected through direct assessment and child , parent and teacher surveys . The primary outcome is academic achievement , obtained by linking to st and ardised test results . Secondary outcomes include measures of behaviour , ADHD symptoms , school engagement ( attitudes and attendance ) , and social and emotional functioning , including depressive symptoms . The mean performance of the study cohort on each outcome measure will be compared to the population mean for same aged children , using t-tests . Risk and protective factors to be examined using multiple regression include a child , family and school factors know to impact academic and school functioning . Discussion The Moving up study is the first Australian study prospect ively design ed to measure a broad range of student outcomes for children with ADHD during the high school transition period . Examining both current ( cross sectional ) and earlier childhood ( longitudinal ) factors gives us the potential to learn more about risk and protective factors associated with school functioning in young people with ADHD . The richness and depth of this information could lead to more targeted and effective interventions that may alter academic and wellbeing trajectories for young people at risk of poor outcomes .The study is approved by The Royal Children ’s Hospital Melbourne Human Research Ethics Committee ( 33206 ) . Findings will be disseminated through peer- review ed journals and conference presentations OBJECTIVE To evaluate the predictors of persistence and the timing of remission of attention-deficit hyperactivity disorder ( ADHD ) . METHOD Subjects were 6- to 17-year old Caucasian , non-Hispanic boys with and without ADHD . DSM-III-R structured diagnostic interviews and blind raters were used to examine psychiatric diagnoses , cognitive achievement , social , school , and family functioning at a 4-year follow-up assessment . RESULTS At the 4-year follow-up assessment , 85 % of children with ADHD continued to have the disorder and 15 % remitted . Of those who remitted , half did so in childhood and the other half in adolescence . Predictors of persistence were familiality of ADHD , psychosocial adversity , and comorbidity with conduct , mood , and anxiety disorders . CONCLUSIONS The findings prospect ively confirm that the majority of children with ADHD will continue to express the disorder 4 years later . For a minority of children , ADHD was a transient disorder that remits early in development . In addition , we have shown that persistence of ADHD is predictable . Familiality , adversity , and psychiatric comorbidity may be clinical ly useful predictors of which children with ADHD are at risk for a persistent disorder BACKGROUND Despite long-st and ing clinical concerns , relatively little is known about the comorbidity between attention-deficit/hyperactivity disorder ( ADHD ) and tic disorders . Therefore , we examined tic disorders in an ongoing prospect i ve follow-up study of male subjects with ADHD , a sample unselected for any comorbid disorder . METHODS One hundred twenty-eight male children and adolescents with ADHD and 110 male controls were comprehensively evaluated at baseline and 4 years later . We characterized tic disorders along with a wide range of neuropsychiatric correlates , including other comorbid disorders and indices of psychosocial function in multiple domains ( school , cognitive , social , and family ) . RESULTS Compared with controls , subjects with ADHD showed more tic disorders at baseline and more new onsets were reported at follow-up . Attention-deficit/hyperactivity disorder and tic disorders appeared to be independent in course : in contrast to low rates of ADHD remission , tic disorders mostly remitted . The age-adjusted rate of ADHD remission was 20 % and that of tic remission , 65 % . Tic disorders had little effect on the psychosocial functioning of subjects with ADHD . CONCLUSIONS These findings suggest that comorbidity with a tic disorder has a limited effect on ADHD outcome . However , because of the relatively small sample of subjects with tic disorders , our conclusions should be considered preliminary until confirmed in larger studies of medicated and unmedicated children with ADHD with and without tic disorders BACKGROUND Previous studies have demonstrated the short-term efficacy of pharmacotherapy and behavior therapy for attention-deficit/hyperactivity disorder ( ADHD ) , but no longer-term ( i.e. , > 4 months ) investigations have compared these 2 treatments or their combination . METHODS A group of 579 children with ADHD Combined Type , aged 7 to 9.9 years , were assigned to 14 months of medication management ( titration followed by monthly visits ) ; intensive behavioral treatment ( parent , school , and child components , with therapist involvement gradually reduced over time ) ; the two combined ; or st and ard community care ( treatments by community providers ) . Outcomes were assessed in multiple domains before and during treatment and at treatment end point ( with the combined treatment and medication management groups continuing medication at all assessment points ) . Data were analyzed through intent-to-treat r and om-effects regression procedures . RESULTS All 4 groups showed sizable reductions in symptoms over time , with significant differences among them in degrees of change . For most ADHD symptoms , children in the combined treatment and medication management groups showed significantly greater improvement than those given intensive behavioral treatment and community care . Combined and medication management treatments did not differ significantly on any direct comparisons , but in several instances ( oppositional/aggressive symptoms , internalizing symptoms , teacher-rated social skills , parent-child relations , and reading achievement )  combined treatment proved superior to intensive behavioral treatment and /or community care while medication management did not . Study medication strategies were superior to community care treatments , despite the fact that two thirds of community-treated subjects received medication during the study period . CONCLUSIONS For ADHD symptoms , our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication . Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms , but may have provided modest advantages for non-ADHD symptom and positive functioning outcomes Few behavioral parent training ( BPT ) treatment studies for attention-deficit/hyperactivity disorder ( ADHD ) have included and measured outcomes with fathers . In this study , fathers were r and omly assigned to attend a st and ard BPT program or the Coaching Our Acting-Out Children : Heightening Essential Skills ( COACHES ) program . The COACHES program included BPT plus sports skills training for the children and parent-child interactions in the context of a soccer game . Groups did not differ at baseline , and father ratings of treatment outcome indicated improvement at posttreatment for both groups on measures of child behavior . There was no significant difference between groups on ADHD-related measures of child outcome . However , at posttreatment , fathers who participated in the COACHES program rated children as more improved , and they were significantly more engaged in the treatment process ( e.g. , greater attendance and arrival on time at sessions , more homework completion , greater consumer satisfaction ) . The implication s for these findings and father-related treatment efforts are discussed BACKGROUND For children with attention deficit/hyperactivity disorder ( ADHD ) , a reduction of inattention , impulsivity and hyperactivity by neurofeedback ( NF ) has been reported in several studies . But so far , unspecific training effects have not been adequately controlled for and /or studies do not provide sufficient statistical power . To overcome these method ological shortcomings we evaluated the clinical efficacy of neurofeedback in children with ADHD in a multisite r and omised controlled study using a computerised attention skills training as a control condition . METHODS 102 children with ADHD , aged 8 to 12 years , participated in the study . Children performed either 36 sessions of NF training or a computerised attention skills training within two blocks of about four weeks each ( r and omised group assignment ) . The combined NF treatment consisted of one block of theta/beta training and one block of slow cortical potential ( SCP ) training . Pre-training , intermediate and post-training assessment encompassed several behaviour rating scales ( e.g. , the German ADHD rating scale , FBB-HKS ) completed by parents and teachers . Evaluation ( ' placebo ' ) scales were applied to control for parental expectations and satisfaction with the treatment . RESULTS For parent and teacher ratings , improvements in the NF group were superior to those of the control group . For the parent-rated FBB-HKS total score ( primary outcome measure ) , the effect size was .60 . Comparable effects were obtained for the two NF protocol s ( theta/beta training , SCP training ) . Parental attitude towards the treatment did not differ between NF and control group . CONCLUSIONS Superiority of the combined NF training indicates clinical efficacy of NF in children with ADHD . Future studies should further address the specificity of effects and how to optimise the benefit of NF as treatment module for ADHD BACKGROUND The efficacy of the Incredible Years ( IY ) Basic parent training ( PT ) programme for a community-based sample of families with pre-school children at risk of developing both conduct problems and attention deficit hyperactivity disorder ( ADHD ) was examined . METHODS Pre-school children displaying signs of both early-onset conduct problems and ADHD were r and omly allocated to either IY PT intervention , or to a waiting list ( WL ) control group . Child symptoms were assessed before and after the intervention . RESULTS Post intervention , the intervention group was associated with significantly lower levels of parent-reported inattention and hyperactive/impulsive difficulties , even after controlling for post-intervention changes in child deviance . In addition , 52 % of those in the intervention condition , compared with 21 % in the control condition , displayed clinical ly reliable improvements post intervention , giving an absolute risk reduction of 31 % and a number needed to treat of 3.23 . CONCLUSIONS Findings from this study indicate that the IY PT programme is a valuable intervention for many pre-school children displaying early signs of ADHD CONTEXT Prospect i ve studies of childhood attention-deficit/hyperactivity disorder ( ADHD ) have not extended beyond early adulthood . OBJECTIVE To examine whether children diagnosed as having ADHD at a mean age of 8 years ( prob and s ) have worse educational , occupational , economic , social , and marital outcomes and higher rates of ongoing ADHD , antisocial personality disorder ( ASPD ) , substance use disorders ( SUDs ) , adult-onset psychiatric disorders , psychiatric hospitalizations , and incarcerations than non-ADHD comparison participants at a mean age of 41 years . DESIGN Prospect i ve , 33-year follow-up study , with masked clinical assessment s. SETTING Research clinic . PARTICIPANTS A total of 135 white men with ADHD in childhood , free of conduct disorder , and 136 men without childhood ADHD ( 65.2 % and 76.4 % of original cohort , respectively ) . MAIN OUTCOME MEASURES Occupational , economic , and educational attainment ; marital history ; occupational and social functioning ; ongoing and lifetime psychiatric disorders ; psychiatric hospitalizations ; and incarcerations . RESULTS Prob and s had significantly worse educational , occupational , economic , and social outcomes ; more divorces ; and higher rates of ongoing ADHD ( 22.2 % vs 5.1 % , P < .001 ) , ASPD ( 16.3 % vs 0 % , P < .001 ) , and SUDs ( 14.1 % vs 5.1 % , P = .01 ) but not more mood or anxiety disorders ( P = .36 and .33 ) than did comparison participants . Ongoing ADHD was weakly related to ongoing SUDs ( ϕ = 0.19 , P = .04 ) , as well as ASPD with SUDs ( ϕ = 0.20 , P = .04 ) . During their lifetime , prob and s had significantly more ASPD and SUDs but not mood or anxiety disorders and more psychiatric hospitalizations and incarcerations than comparison participants . Relative to comparisons , psychiatric disorders with onsets at 21 years or older were not significantly elevated in prob and s. Prob and s without ongoing psychiatric disorders had worse social , but not occupational , functioning . CONCLUSIONS The multiple disadvantages predicted by childhood ADHD well into adulthood began in adolescence , without increased onsets of new disorders after 20 years of age . Findings highlight the importance of extended monitoring and treatment of children with ADHD The efficacy of a self-help parent training programme for children with attention deficit hyperactivity disorder ( ADHD ) was evaluated . The New Forest Parenting Programme Self-help ( NFPP-SH ) is a 6-week written self-help psychological intervention design ed to treat childhood ADHD . Forty-three children were r and omised to either NFPP-SH intervention or a waiting list control group . Outcomes were child ADHD symptoms measured using question naires and direct observation , self-reported parental mental health , parenting competence , and the quality of parent – child interaction . Measures of child symptoms and parental outcomes were assessed before and after the intervention . ADHD symptoms were reduced , and parental competence was increased by self-help intervention . Forty-five percent of intervention children showed clinical ly significant reductions in ADHD symptoms . Self-help intervention did not lead to improvements in parental mental health or parent – child interaction . Findings provide support for the efficacy of self-help intervention for a clinical sample of children with ADHD symptoms . Self-help may provide a potentially cost-effective method of increasing access to evidence -based interventions for clinical population OBJECTIVE The study compared the efficacy of 2 behavioral interventions to ameliorate organization , time management , and planning ( OTMP ) difficulties in 3rd- to 5th- grade children with attention-deficit/hyperactivity disorder ( ADHD ) . METHOD In a dual-site r and omized controlled trial , 158 children were assigned to  organizational skills training ( OST ; N = 64 ) ; PATHKO , a performance-based intervention that precluded skills training ( N = 61 ) ; or a wait-list control ( WL , N = 33 ) . Treatments were 20 individual clinic-based sessions over 10 - 12 weeks . OST involved skills building provided primarily to the child . PATHKO trained parents and teachers to reinforce children contingently for meeting end-point target goals . Primary outcomes were the Children 's Organizational Skills Scales ( COSS-Parent , COSS-Teacher ) . Other relevant functional outcomes were assessed . Percentage of participants no longer meeting inclusion criteria for OTMP impairments informed on clinical significance . Assessment s occurred at post-treatment , 1-month post-treatment , and twice in the following school year . RESULTS OST was superior to WL on the COSS-P ( Cohen 's d = 2.77 ; p < .0001 ) , COSS-T ( d = 1.18 ; p < .0001 ) , children 's COSS self-ratings , academic performance and proficiency , homework , and family functioning . OST was significantly better than PATHKO only on the COSS-P ( d = 0.63 ; p < .005 ) . PATHKO was superior to WL on most outcomes but not on academic proficiency . Sixty percent of OST and PATHKO participants versus 3 % of controls no longer met OTMP inclusion criteria . Significant maintenance effects were found for both treatments . CONCLUSIONS Two distinct treatments targeting OTMP problems in children with ADHD generated robust , sustained functional improvements . The interventions show promise of clinical utility in children with ADHD and organizational deficits Objective : To compare the effects of multimodal therapy including supervised high-intensity interval training ( HIIT ) with those of st and ard multimodal therapy ( TRAD ) concerning key variables of physical fitness ( peak power and oxygen uptake ) , motor skills , social behavior , and quality of life in boys with ADHD . Method : A single-center , two-arm r and omized , controlled design was used , with 28 boys ( 8 - 13 years of age , IQ = 83 - 136 ) being r and omly assigned to multimodal HIIT  ( three sessions/week , 4 × 4-min intervals at 95 % of peak heart rate ) or TRAD . The Movement Assessment Battery for Children II evaluated motor skills and the German version of the hyperkinetic disorder question naire for external evaluation by the guardians ( FBB-HKS ) or German version of the hyperkinetic disorder question naire for self- assessment by the children ( SBB-HKS ) and the KINDL-R question naires mental health and health-related quality of life . Results : Both interventions enhanced peak power , and HIIT also reduced submaximal oxygen uptake . HIIT was more effective than TRAD  in improving the total score for motor skills ( including manual dexterity and ball skills ; p < .05 ) , self-esteem , friends , and competence ( p < .05 ) and , moreover , improved subjective ratings of attention . Conclusion : Three weeks of multimodal therapy including HIIT improved physical fitness , motor skills , certain aspects of quality of life , competence , and attention in boys with ADHD BACKGROUND Cogmed Working Memory Training ( CWMT ) has received considerable attention as a promising intervention for the treatment of Attention-Deficit/Hyperactivity Disorder ( ADHD ) in children . At the same time , method ological weaknesses in previous clinical trials call into question reported efficacy of CWMT . In particular , lack of equivalence in key aspects of CWMT ( i.e. , contingent reinforcement , time-on-task with computer training , parent-child interactions , supportive coaching ) between CWMT and placebo versions of CWMT used in previous trials may account for the beneficial outcomes favoring CWMT . METHODS Eighty-five 7- to 11-year old school-age children with ADHD ( 66 male ; 78 % ) were r and omized to either st and ard CWMT ( CWMT Active ) or a well-controlled CWMT placebo condition ( CWMT Placebo ) and evaluated before and 3 weeks after treatment . Dependent measures included parent and teacher ratings of ADHD symptoms ; objective measures of attention , activity level , and impulsivity ; and psychometric indices of working memory and academic achievement ( Clinical trial title : Combined cognitive remediation and behavioral intervention for the treatment of Attention-Deficit/Hyperactivity Disorder ; http:// clinical trials.gov/ct2/show/NCT01137318 ) . RESULTS CWMT Active participants demonstrated significantly greater improvements in verbal and nonverbal working memory storage , but evidence d no discernible gains in working memory storage plus processing/manipulation . In addition , no treatment group differences were observed for any other outcome measures . CONCLUSIONS When a more rigorous comparison condition is utilized , CWMT demonstrates effects on certain aspects of working memory in children with ADHD ; however , CWMT does not appear to foster treatment generalization to other domains of functioning . As such , CWMT should not be considered a viable treatment for children with ADHD OBJECTIVE This study examined the effectiveness of stimulant medication on multiple domains of functioning in 36 young ( 5 to 6 years old ) children diagnosed with attention-deficit/hyperactivity disorder ( ADHD ) . METHOD Five- and 6-year-old children attending a summer treatment program between 1987 and 1997 underwent a r and omized clinical assessment of the effect of two doses of methylpheni date ( 0.3 mg/kg versus 0.6 mg/kg ) and placebo on social behavior and academic performance . RESULTS Methylpheni date had an effect on all four social behaviors and improved two of the three areas of academic functioning . Dose effects were present for three of the seven dependent measures . Individual analyses indicated a therapeutic response rate between 39 % and 100 % across dependent measures . Furthermore , individual analyses of response indicated that across several important dependent measures , 39 % to 98 % of children showed little incremental improvement with the higher dose compared with the lower dose of stimulant medication . CONCLUSIONS Stimulant medication is an effective treatment for young children diagnosed with ADHD ; however , multiple domains of functioning must be assessed to determine the most effective dose for young children with ADHD Thirteen children ( ages 5.6 to 11.2 years ) with autism and symptoms of attention-deficit hyperactivity disorder ( ADHD ) participated in a double-blind , placebo-controlled crossover study of methylpheni date ( 0.3 and 0.6 mg/kg per dose ) . Eight subjects responded positively , based upon a minimum 50 % decrease on the Conners Hyperactivity Index . Ratings of stereotypy and inappropriate speech , which are often associated with autistic core features , also decreased . However , no changes were found on the Child Autism Rating Scale , a global assessment of autistic symptomotology . Significant adverse side effects occurred in some children including social withdrawal and irritability , especially at the 0.6 mg/kg dose . Results suggest that methylpheni date can be efficacious for children with autism and ADHD symptoms . However , this group of children seems to be particularly susceptible to adverse side effects Objective . To evaluate the quality of life ( QOL ) of untreated children with newly diagnosed attention-deficit/hyperactivity disorder ( ADHD ) , compared with asthmatic and healthy children . Methods . This prospect i ve , case-control study included a group of 120 children , 6 to 12 years of age , with newly diagnosed ADHD according to the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition . Subjects were matched according to age , gender , and health care area with 2 control groups , ie , 93 asthmatic children and 120 healthy children . Sociodemographic characteristics and Child Health Question naire scores were collected . Results . The QOL of children with ADHD was rated worse than that of asthmatic or healthy children for most Child Health Question naire domains . The greatest differences were found in behavior , social limitations attributable to physical problems , emotional impact on parents , and family activities . Almost every psychosocial domain was more affected in comparison with asthmatic children and both psychosocial and physical domains in comparison with healthy children . Conclusions . ADHD interferes with the daily lives of children , parents , and families even more than asthma , primarily in areas related to psychosocial functioning , although evidence of impaired physical functioning also emerged . Delays in recognition , assessment , and management of ADHD may affect negatively the QOL of those children Background The need for accessible and motivating treatment approaches within mental health has led to the development of an Internet-based serious game intervention ( called “ Plan-It Comm and er ” ) as an adjunct to treatment as usual for children with attention-deficit/hyperactivity disorder ( ADHD ) . Objective The aim was to determine the effects of Plan-It Comm and er on daily life skills of children with ADHD in a multisite r and omized controlled crossover open-label trial . Methods Participants ( N=170 ) in this 20-week trial had a diagnosis of ADHD and ranged in age from 8 to 12 years ( male : 80.6 % , 137/170 ; female : 19.4 % , 33/170 ) . They were r and omized to a serious game intervention group ( group 1 ; n=88 ) or a treatment-as-usual crossover group ( group 2 ; n=82 ) . Participants r and omized to group 1 received a serious game intervention in addition to treatment as usual for the first 10 weeks and then received treatment as usual for the next 10 weeks . Participants r and omized to group 2 received treatment as usual for the first 10 weeks and crossed over to the serious game intervention in addition to treatment as usual for the subsequent 10 weeks . Primary ( parent report ) and secondary ( parent , teacher , and child self-report ) outcome measures were administered at baseline , 10 weeks , and 10-week follow-up . Results After 10 weeks , participants in group 1 compared to group 2 achieved significantly greater improvements on the primary outcome of time management skills ( parent-reported ; P=.004 ) and on secondary outcomes of the social skill of responsibility ( parent-reported ; P=.04 ) , and working memory ( parent-reported ; P=.02 ) . Parents and teachers reported that total social skills improved over time within groups , whereas effects on total social skills and teacher-reported planning/organizing skills were nonsignificant between groups . Within group 1 , positive effects were maintained or further improved in the last 10 weeks of the study . Participants in group 2 , who played the serious game during the second period of the study ( weeks 10 to 20 ) , improved on comparable domains of daily life functioning over time . Conclusions Plan-It Comm and er offers an effective therapeutic approach as an adjunct intervention to traditional therapeutic ADHD approaches that improve functional outcomes in daily life . Trial Registration International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 62056259 ; http://www.controlled-trials.com/IS RCT N62056259 ( Archived by WebCite at http://www.webcitation.org/6eNsiTDJV ) The objective of this study was to evaluate the efficacy of a multicomponent program for treating attention-deficit/hyperactivity disorder ( ADHD ) carried out by teachers in a classroom context . Dependent measures included neuropsychological tasks , behavioral rating scales for parents and teachers , direct observation of behavior in the classroom , and academic records of children with ADHD . Fifty children with ADHD participated in the study . The teachers of 29 of the 50 students  were trained in the use of behavior modification techniques , cognitive behavior strategies , and instructional management strategies . The other 21 students formed the  control group . Parents ' and teachers'ratings detected improvements in primary symptoms ( inattention — disorganization , hyperactivity — impulsivity ) and in behavioral difficulties usually associated with ADHD ( e.g. , antisocial behavior , psychopathological disorders , anxiety ) . Furthermore , the results showed increased academic scores , enhanced classroom behavioral observations , and improved teachers ' knowledge about the strategies directed toward responding to the children 's educational needs Background : Several parent training programmes and behavioural teacher training programmes built on learning theory have been developed for problem prevention and treatment of attention-deficit/hyperactivity disorder ( ADHD ) and /or oppositional defiant disorder ( ODD ) during the last few decades . Group format has often been used for parent training but single-subject design s are more common in teacher training . More studies have focussed on pre-school children than on older children , and a minority have been conducted in public mental health setting s. Aim : This study aim ed to evaluate a combined parent and teacher manual-based group training programme for children with ADHD conducted by the staff at a child and adolescent psychiatric clinic in Sweden . Method : The intervention was a modified version of Barkley 's programme .  Children were r and omized to an Intervention or a Control group .  Sixty-one parents and 68 teachers answered questions about ADHD and ODD symptoms , and about behavioural problems when the study started and at a 3-month follow-up . Results : Results showed that the intervention result ed in a reduction of the number of children who met DSM-IV criteria for ADHD and /or ODD . Effects were more pronounced in the home setting than in the school setting , and were further accentuated when both parents and teachers of the same child took part in the intervention . Teachers with more problematic classroom situations benefited most from the intervention . Conclusion : The programme , “ Strategies in Everyday Life ” , has , in a regular clinical setting , demonstrated promising effects on children 's disruptive behaviour , and a clinical implication was to recommend involving both parents and teachers in the programme Children with ADHD are ' a group at risk ' as far as their further emotional and social development and educational possibilities are concerned , and the consequences of the lack of an appropriate therapy appears to be serious . Some of these children do not respond to prevailing therapy methods . It is reported that dietetic factors can play a significant role in the etiology of ADHD syndrome , and magnesium deficiency can help in revealing hyperactivity in children . The aim of our work was to assess the influence of magnesium supplementation on hyperactivity in patients with ADHD . The examination comprised 50 hyperactive children , aged 7 - 12 years , who fulfilled DSM IV criteria for ADHD syndrome , with recognized deficiency of magnesium in the blood ( blood serum and red blood cells ) and in hair using atomic absorption spectroscopy . In the period of 6 months those examined regularly took magnesium preparations in a dose of about 200 mg/day . 30 of those examined with ADHD showed coexisting disorders specific to developmental age , and 20 of them showed disruptive behaviour . The control group consisted of 25 children with ADHD and magnesium deficiency , who were treated in a st and ard way , without magnesium preparations . 15 members of this group showed coexisting disorders specific for developmental age , and 10 members showed disruptive behaviour . Hyperactivity was assessed with the aid of psychometric scales : the Conners Rating Scale for Parents and Teachers , Wender 's Scale of Behavior and the Quotient of Development to Freedom from Distractibility . In the group of children given 6 months of magnesium supplementation , independently of other mental disorders coexisting with hyperactivity , an increase in magnesium contents in hair and a significant decrease of hyperactivity of those examined has been achieved , compared to their clinical state before supplementation and compared to the control group which had not been treated with magnesium OBJECTIVE The purpose of this study was to investigate the effects of therapy balls as seating on in-seat behavior and legible word productivity of students with attention deficit hyperactivity disorder ( ADHD ) . Additionally , social validity was assessed to evaluate teacher and student opinions regarding the intervention . METHOD A single subject , A-B-A-B interrupted time series design was employed across 3 students ( 2 males , 1 female ) with ADHD . The study was conducted in a 4th grade inclusive classroom during daily language arts . During phases 1 and 3 , the 3 participants and all other class members sat on chairs ( in-seat on chair ) ; during phases 2 and 4 , everyone sat on therapy balls ( in-seat on ball ) . Dependent variables were in-seat behavior and legible word productivity . Data were graphed and visually analyzed for differences between phases . RESULTS Results demonstrated increases in in-seat behavior and legible word productivity for the students with ADHD when seated on therapy balls . Social validity findings indicated that generally the teacher and students preferred therapy balls . CONCLUSION This study provides evidence that use of therapy balls for students with ADHD may facilitate in-seat behavior and legible word productivity Objective . This study examined the efficacy of 2 computer-based training systems to teach children with attention deficit/hyperactivity disorder ( ADHD ) to attend more effectively . Design / methods . A total of 41 children with ADHD from 2 middle schools were r and omly assigned to receive 2 sessions a week at school of either neurofeedback ( NF ) or attention training through a st and ard computer format ( SCF ) , either immediately or after a 6-month wait ( waitlist control group ) . Parents , children , and teachers completed question naires pre- and postintervention . Results . Primary parents in the NF condition reported significant ( P < .05 ) change on Conners ’s Rating Scales — Revised ( CRS-R ) and Behavior Assessment Scales for Children ( BASC ) subscales ; and in the SCF condition , they reported significant ( P < .05 ) change on the CRS-R Inattention scale and ADHD index , the BASC Attention Problems Scale , and on the Behavioral Rating Inventory of Executive Functioning ( BRIEF ) . Conclusion . This r and omized control trial provides preliminary evidence of the effectiveness of computer-based interventions for ADHD and supports the feasibility of offering them in a school setting We examined 9-month data from the 14-month NIMH Multimodal Treatment Study of Children with ADHD ( the MTA ) as a further check on the relative effect of medication ( MedMgt ) and behavioral treatment ( Beh ) for attention – deficit/hyperactivity disorder ( ADHD ) while Beh was still being delivered at greater intensity than at 14-month endpoint , and conversely as a check on the efficacy of the MTA behavioral generalization/maintenance procedures . Intention-to-treat analysis at 9 months showed essentially the same results as at 14 months , after Beh had been completely faded ; MedMgt and the combination ( Comb ) of medication and Beh were significantly superior to Beh and community care ( CC ) for ADHD and oppositional – defiant ( ODD ) symptoms , with mixed results for social skills and internalizing symptoms . All treatment-group differences examined as changes in slopes from 9 to 14 months were nonsignificant ( we found general improvement for all groups ) . Slopes from baseline to 9 months correlated highly ( r > .74 , p < .0001 ) with slopes from baseline to 14 months for all groups . The time function from baseline to 14 months showed a significant linear , but not quadratic , trend for the main outcome measure ( a composite of parent- and teacher-rated ADHD and ODD symptoms ) for all groups . Findings suggest that in contrast to the hypothesized deterioration in the relative benefit of Beh between 9 and 14 months ( after completion of fading ) , the MTA Beh generalization and maintenance procedures implemented through 9 months apparently yielded continuing improvement through 14 months , with preservation of the relative position of Beh compared to other treatment strategies
The content of the social skills interventions were comparable and based on a cognitive behavioural model .
The review suggests that there is little evidence to support or refute social skills training for adolescents with ADHD .
BACKGROUND Attention Deficit Hyperactivity Disorder ( ADHD ) in children is associated with hyperactivity and impulsitivity , attention problems , and difficulties with social interactions .
Pharmacological treatment may alleviate symptoms of ADHD but seldom solves difficulties with social interactions .
Social skills training may benefit ADHD children in their social interactions .
We examined the effects of social skills training on children 's  social competences , general behaviour , ADHD symptoms , and performance in school .
OBJECTIVES To assess the effects of  social skills training in children and adolescents with ADHD .