4. Discussion
reduced difficulties, hyperactivity, hyperactivity disorder, ADHD
In this multicenter, randomized controlled study, we investigated the therapeutic effects on symptoms of ADHD in preschool-aged children through a parent group based on systems theory emphasizing bidirectional parent-child interactive behavior analysis. Compared to the control group that did not receive parental group intervention, our research data indicates that after participating in the parent group for 8 weeks, with 1.5-hour sessions once a week, the core symptoms of ADHD in affected children, especially inattention, were significantly improved. According to the within-group effect analysis results, the parent group was able to significantly improve ADHD's emotional symptoms, conduct problems, hyperactivity symptoms, and peer interaction issues at the end of the 2-month intervention. It also enhanced daily life functioning and reduced difficulties encountered in the learning process. Moreover, the therapeutic effects were maintained to a certain extent during the 6-month follow-up period after enrollment, particularly in the improvement of emotional symptoms.According to the statistical results after the intervention and follow-up in this study, the group that received parent training intervention showed significant improvement in ADHD-RS scores (Based on the changes in SDQ and QCD scores, we observed significant functional improvements in children with ADHD as reported by parents after parent group sessions. However, the improvements in the intervention group in terms of QCD and SDQ were not significant in the variance analysis, and one potential reason for this finding is that this may be related to the impact of the pandemic. During the pandemic, many schools sporadically suspended offline courses and switched to online classes at home, disrupting the usual school routine. Children with ADHD faced more challenges and maladjustments in learning, emotions, behavior, and social interactions [Emotional difficulties are common in children with ADHD [Overall, this study, grounded in systems theory, proposes a training intervention method for preschool ADHD children based on parent-child interaction. Systems theory emphasizes the analysis of mutual interactions and bidirectional influences between parents and children, rather than viewing behavior as the product of isolated factors. Within the context of parent-child interaction, the perspective of systems theory focuses on how the behaviors of parents and children mutually influence each other in a continuous, interrelated process. Our research findings support this view, indicating that enhancing parental behavior management skills can positively affect the symptoms of children with hyperactivity disorder. Parent training enables parents to implement more effective behavior management according to the child's needs. In turn, this may help improve parent-child interaction, as well as the child's emotional regulation and symptoms of hyperactivity disorder. Our study demonstrates the practicality of the systems theory approach in conceptualizing and treating preschool ADHD by focusing on the interactions within parent-child relationships.