Child-focused Psychosocial Interventions for Children and Adolescents with Attention-deficit Hyperactivity Disorder (ADHD): A Systematic Review and Meta-analysis

The purpose of this dissertation was to conduct a systematic review and meta-analysis of previous studies that assess the efficaciousness of child-focused psychosocial interventions for children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). The specific outcomes that were examined were internalizing and externalizing symptoms and behaviours, social skills, peer relationships, and family functioning. Although studies solely evaluating core ADHD symptom outcomes were not eligible, when provided in an eligible study, data for core ADHD symptoms (inattention, hyperactivity, and impulsivity) were extracted and analyzed. The aim was to provide clinicians with guidelines for treatment for children and adolescents with ADHD with specific associated symptoms, functional impairments, and comorbid disorders. In spite of identifying 26 studies that met criteria for this review, the data are insufficient to recommend, with confidence, any specific child-focused intervention to treat specific child problems. Results indicated that cognitive behavioural therapy (CBT), mindfulness training, and social skills training (SST) interventions do not meet the criteria outlined by the American Psychological Association for an intervention to be considered as a well-established or probably efficacious intervention (APA Presidential Task Force on Evidence-Based Practice, 2006). Nevertheless, there is some evidence that some of the child-focused psychosocial interventions described in this systematic review and meta-analysis are promising and, as a result, that future research with high quality studies is needed to investigate whether these interventions are efficacious. Individual CBT with simultaneous parent treatment might be promising for improving externalizing and internalizing symptoms, parent-child relationships, and core ADHD symptoms in adolescents concurrently on medication. Furthermore, mindfulness training shows promise in reducing peer relationship problems, internalizing symptoms, and ADHD symptoms of adolescents, and might foster better parent-child relationships. Finally, there is evidence from strong and moderate quality studies that SST interventions are associated with improvements in social skills knowledge and assertion in school-age children. In addition, when SST is offered with concurrent medications, parent treatment and teacher consultation, lower doses of medication are required to achieve the same effect on internalizing symptoms, ODD symptoms, social skills, and personal closeness in parent-child relations.Ph.D