attention - deficit / hyperactivity disorder ( adhd ) is a psychobiological disorder that is described by attention deficit , hyperactivity , and reduced impulse control .
based on the diagnostic and statistical manual of mental disorders , fifth edition ( dsm - v ) , adhd is a  persistent pattern of inattention and/or hyperactivity and impulsivity that interferes with functioning or development .
the inattention manifests behaviorally in adhd as wandering off task , lacking persistence , having difficulty sustaining focus and being disorganized , and is not due to defiance or lack of comprehension .
hyperactivity refers to excessive motor activity ( such as a child running about ) when it is not appropriate , or excessive fidgeting , tapping , or talkativeness ( 1 ) .  based on dsm - v results ,
the 3 subtypes that are related to adhd include predominantly hyperactive , predominantly inattentive , and a combination of one or more of the aforementioned types .
a child must demonstrate at least 6 of the 9 symptoms and adolescents must demonstrate at least 5 of the 9 symptoms in a cluster form before the 3 subtypes ( 1 ) .
past research illustrated that symptoms related to hyperactivity may decrease as the child grows older , while the child s inattentiveness remains relatively unchanged ( 2 , 3 ) .
barkley defined the main characteristic of adhd as difficulty in behavioral inhibition ( 4 ) .
unintentional behavior possessed by the child diagnosed with adhd appeared to affect their academic achievement throughout their academic career .
in addition , these children displayed problems with their social skills and difficulty communicating , due to the apparent frustrations with their academic performance ( 5 ) .
the dsm - v shows that the rate of adhd was greater in males than in females , with a ratio of nearly 2:1 in children and 1.6:1 in adults ( 1 ) .
attention deficit includes the combination of biologically determined reactivity of the nervous system and failure to self - regulate , and environmental disturbances ( 6 , 7 ) .
students who can not centralize their thoughts are impatient and evoke negative responses from their environment , which can provoke a perception of social refusal .
the continued experience of refusal at school mixed with the vulnerability of the child / adolescent nervous system is thought to produce negative perceptions , evoking compensatory behaviors , such as , aggressive comic behavior , feeling alone , and/or a depressive status . to decrease such symptoms , the creation and protection of a supportive and caring home situation would appear to be an important factor .
students must have a feeling of being accepted , the ability to develop trusting relationships , and also a belief that there are methods that can help them .
this situation can be quite difficult to achieve if the parents displays symptoms similar to their child .
adhd indicatorsare not just limited to childhood , and the relative dynamics of this disorder may cause the condition to persevere .
based on previous studies , the principal treatments of adhd have focused on the use of medication , behavioral , cognitive , cognitive - behavioral , and neural treatments ( 8 - 16 ) .
a review of the literature between 2000 and 2013 identified the multimodal treatment of adhd for the adhd child and/or adolescent .
these combination treatments include self - control , self - regulation , cognitive , cognitive - behavioral , cognitive play , behavioral play , motor - perceptual rehearsal , functions management training , verbal self - education training , education of children by parents , positive therapy , training of parents , parental constructive program , and training of stress coping skills .
these studies demonstrated that the mentioned treatments were more successful and had longer lasting effects on attention deficit , social skills , and behavioral problems in adhd than the singular medication treatment or behavioral therapy ( 17 - 28 ) .
in this meta - analysis study , the researcher used published journal articles and theses on the topic of the effectiveness of intervention / treatment programs on adhd from the scientific information database ( sid ) , the iranian research institute for information science and technology ( irandoc ) , the national library and the archives of the islamic republic of iran ( nlai ) , and the united states national library of medicine ( nlm ) and national institutes of health ( pubmed ) websites during 2000 - 2013 .
database search was performed with the following keywords : treatment program and adhd , intervention program and adhd , and instruction . in the preliminary database search
, 72 related articles were obtained from sid , 64 dissertations and abstracts from the irandoc website , 23 dissertations and articles from the nlai website , and 175 dissertations and articles from the pubmed website .
all findings were screened for inclusion , based on the title and abstract , using the following restrictions regarding the treatment / intervention program on adhd .
after reviewing the preliminary articles and theses on adhd , a total number of 17 articles were screened for possible inclusion ( table 1 ) .  
these articles had to meet each of the subsequent criteria : the article must have been an original investigated report ( experimental , quasi - experimental research ) , included treatment of at least one independent variable , and the students must have been diagnosed with adhd .
articles excluded if they did not meet the above criteria , and if the students intelligence quotient scale ( iqs ) were below 90 , or if data for the adhd students could not be separated from data of the group without adhd .
a total of 17 articles were screened for inclusion in this meta - analysis . in the present study , the researcher employed coding procedure ( 40 ) .
a coding structure and operational definitions were made to record quantitative information from each of the 17 studies .
preparation training treatments were categorized as either content area preparation or self - regulation preparation .
2 . direct training treatments included teacher - led , explicit , and systematic training .
3 . behavioral treatments included treatments in which the employment of positive reinforcement was dependent on the successful completion of an assignment .
practical treatments contained treatments in which the child was candidate for reiterative performance of an ability that was intended to be already within the student s repertoire , for example : the student would stay for an extra 20 minutes to read the task .
textbook modification included any treatment that modified an original textbook to decrease its stage of difficulty .
the final category included any intervention that did not fit in the above - mentioned categories such as cognitive treatment , cognitive - behavioral treatment , and short - term executive function training .
moreover , the mean and standard deviations of pretests for the 17 adhd studies are illustrated in table 3 .
furthermore , mean and standard deviations of posttests for the 17 adhd studies are provided in table 4 .  
abbreviations : adhd , attention deficit hyperactivity disorder ; cgi - s , clinical global impressions - severity ; csi-4 , children symptom inventory-4 ( screens for adhd and other emotional and behavioral problems ) ; dsm - iv , diagnostic and statistical manual of mental disorders ; gaf , global assessment of functioning ; ssrs , social skill rating system ; wis - r , wechsler intelligence scale for children - revised .   a test to measure adhd children .  
the researcher used continuous means as a part of unmatched group from comprehensive meta - analysis software .
the results are separated into 3 parts : a ) mean , b ) standard deviation , and c ) sample size for each group . to test treatment results of experimental and control groups which were different , the effect size on all samples of each group
means , standard deviations , and cohen s d are given in table 5 .  
abbreviations : ll , low limited ; sd , standard deviation ; se , standard error ; ul , upper limited . the results of the study illustrated that there is a difference between the mean scores of the experimental and control groups .
the overall meta - analysis of these studies illustrated a statistical significance ( figures 1 and 2 ) .
in addition , overall standardized differences in means ranged between 0.79% and 95% , confidence interval ranged between 0.57 and 1.08 , and z - value was equal to -1.45 ( d = mean d = -0.68 ( look at below of equation 1 and equation 2 ) ) .
furthermore , the q statistic for heterogeneity of 347.74 is statistically significant ( p < 0.001 ) ; in addition , i = 95.40 , t = 9.44 , se = 4.30 , s = 18.41 , and tau = 3.07 .
( summary data of standardized differences in means of the fixed - effect model ) .
the standardized differences in means is -0.128 and the 95% confidence interval is -0.301 - 0.046 and p = 0.148 .
the horizontal line represents the primary standardized differences in means for each study , and the vertical lines represent the standard error where available .
moreover , in this study , table 4 indicated that the adhd symptoms are reduced more in the experimental groups compared to the control groups .
based on this table posttest means of the experimental groups were lower than the posttest means of the control groups in 12 studies .
in addition , d average is -0.97 and d ( d= mean , d = -0.68 ) , ( look at below of equation 1 and equation 2 . ) ) is -0.68 which were obtained in equations 1 and 2
this study found several interventions that can reduce symptoms of adhd in children and adolescents . based on pooled effects
, the mentioned treatments can reduce social skills difficulty and behavioral problems . according to the study by cohen
, low effect is below 0.20 , median effect is 0.50 , and high effect is 0.80 ( 41 ) .
this should be taken into consideration , as there were a range of intervention and evaluation methods .
these overall results described that about 75% of children and adolescents in the experimental groups showed a greater reduction in symptoms of adhd than children and adolescents in the control groups .
effects from studies on far transfer of working memory therapy , cognitive - behavioral therapy and neurofeedback , and ritalin and the combinations of drugs prescribed reduced the symptoms of adhd in higher percentages of children compared to the control group .
the aim of this study was to perform a comparative study on the effects of treatment programs in reducing adhd symptoms in children .
results of this study demonstrated that treatments with the highest levels of effectiveness ( > 0.80 ) included cognitive - behavioral therapy , pharmacological treatment , and combinational treatment .
this study , like the meta - analysis by nigg et al . showed that treatment programs reduced symptoms of adhd in children and adolescents ( 42 ) .
the difference between overall mean change for treatment and control groups ranged from -0.08- to- 4.45 .
this showed that the groups receiving treatment programs illustrated significantly larger improvements in term of adhd symptoms .
consistent evidence from both experimental and quasi - experimental studies suggests that treatment programs had desirable effects for the majority of adhd studies ( 43 , 44 ) .
effective treatment programs for adhd students reduced problems in social skills and academic performance , and behavior disorders , which are the cause of the disruption of daily life functioning .
these treatment programs are a necessity for children with adhd in order to overcome the challenges that accompany an adhd diagnosis over the course of their education .
consequently , improvements in daily life functioning and decreasing of functional disorders are the important , socially suitable standards against which treatment results must be evaluated .
the majority of studies regarding effective treatment programs on adhd illustrated that treatment programs are effective on adhd . in this meta - analysis ,
the treatment programs used included cognitive treatments , cognitive - behavioral treatments , behavioral treatments , pharmacological treatments , and combinational treatments .
previous studies have demonstrated that students , who received treatment in the various therapy programs , had a higher potential of being mainstreamed into society and showing improvement in their academic and social skills in comparison to students who did not receive some types of therapy .
based on the findings of this research , it is recommended that cognitive - behavioral treatment and pharmacological treatment be used for a higher rate of success in aiding with the adhd symptoms in children and adolescents .
in this meta - analysis , the treatment programs used included cognitive treatments , cognitive - behavioral treatments , behavioral treatments , pharmacological treatments , and combinational treatments .
previous studies have demonstrated that students , who received treatment in the various therapy programs , had a higher potential of being mainstreamed into society and showing improvement in their academic and social skills in comparison to students who did not receive some types of therapy .
based on the findings of this research , it is recommended that cognitive - behavioral treatment and pharmacological treatment be used for a higher rate of success in aiding with the adhd symptoms in children and adolescents .
 context : the aim of this study was to determine the experimental evidence of treatment / intervention programs for deficits in social skills , attention , and behavioral disorder in children and adolescents with attention deficit hyperactivity disorder ( adhd).evidence acquisition : meta - analysis procedures were employed to investigate whether children and adolescents with adhd exhibit deficits in attention and social skills . 
 a total of 17 empirical research studies published between 2000 and 2013 met our inclusion criteria . 
 attention and social skills measures were categorized according to both modality and type of processing required.results:children with adhd exhibited deficits in multiple components of attention and social skills that were not related to language - learning disorders and weaknesses in general intellectual abilities . the overall percentage effect for attention and social skills in students with adhd was calculated ( effect size = 0 . 
 79 , confidence interval = 0.57 - 1.08 ) . 
 this meta - analysis study showed that treatment programs reduced attention deficit and social skills in adhd children and adolescents.conclusions:the evidence of attention and social skills deficits in children with adhd supports recent studies in adhd deficits . 
 further research is required to explain in detail the nature , severity , and specificity of the deficits in individuals with adhd . 
1. Context
2. Evidence Acquisition
3. Results
4. Discussion
4.1. Conclusions