title: Atomoxetine, Parent Training, and Their Combination in Children With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. A Waitlist-Controlled Trial of Behavioral Parent Training for Fathers of Children with ADHD Combined cognitive and parent training interventions for adolescents with ADHD and their mothers: A randomized controlled trial Does intensive multimodal treatment for maternal ADHD improve the efficacy of parent training for children with ADHD? A randomized controlled multicenter trial. Parenting as a Mechanism of Change in Psychosocial Treatment for Youth with ADHD, Predominantly Inattentive Presentation 3-year follow-up of the NIMH MTA study. Enhancing Traditional Behavioral Parent Training for Single Mothers of Children with ADHD The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. Differential effects of parent training and stimulant medication with hyperactives: A progress report. Effectiveness of the Challenging Horizons After-School Program for young adolescents with ADHD. Development and preliminary evaluation of an integrated treatment targeting parenting and depressive symptoms in mothers of children with attention-deficit/hyperactivity disorder. Parent training for preschool ADHD: a randomized controlled trial of specialized and generic programs. The efficacy of problem-solving communication training alone, behavior management training alone, and their combination for parent-adolescent conflict in teenagers with ADHD and ODD. A Randomized Trial Examining the Effects of Aerobic Physical Activity on Attention-Deficit/Hyperactivity Disorder Symptoms in Young Children A comparison of three family therapy programs for treating family conflicts in adolescents with attention-deficit hyperactivity disorder. Combining Parent and Child Training for Young Children with ADHD Preliminary data suggesting the efficacy of attention training for school-aged children with ADHD A comparison of behavioral parent training programs for fathers of children with attention-deficit/hyperactivity disorder. Efficacy of Cognitive-Functional (Cog-Fun) Occupational Therapy Intervention Among Children With ADHD: An RCT Group therapy for adolescents with attention-deficit/hyperactivity disorder: a randomized controlled trial. Working memory training in young children with ADHD: a randomized placebo-controlled trial. Treatment Sequencing for Childhood ADHD: A Multiple-Randomization Study of Adaptive Medication and Behavioral Interventions 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. A randomized controlled trial of cognitive behavioral therapy for ADHD in medication-treated adolescents. Behavioral Outcome Effects of Serious Gaming as an Adjunct to Treatment for Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial Parent-teen behavior therapy + motivational interviewing for adolescents with ADHD. Biochemical and Psychological Effects of Omega-3/6 Supplements in Male Adolescents with Attention-Deficit/Hyperactivity Disorder: A Randomized, Placebo-Controlled, Clinical Trial. Improving Homework Performance Among Children With ADHD: A Randomized Clinical Trial Young Adult Educational and Vocational Outcomes of Children Diagnosed with ADHD Improving Executive Functioning in Children with ADHD: Training Multiple Executive Functions within the Context of a Computer Game. A Randomized Double-Blind Placebo Controlled Trial A small-scale randomized controlled trial of the revised new forest parenting programme for preschoolers with attention deficit hyperactivity disorder A two-site randomized clinical trial of integrated psychosocial treatment for ADHD-inattentive type. A study on the effectiveness of videoconferencing on teaching parent training skills to parents of children with ADHD. Remediating organizational functioning in children with ADHD: immediate and long-term effects from a randomized controlled trial. A Randomized Clinical Trial of an Integrative Group Therapy for Children With Severe Mood Dysregulation. Two novel CBTs for adolescents with ADHD: the value of planning skills A randomised controlled trial of combined EEG feedback and methylphenidate therapy for the treatment of ADHD. Distinct EEG effects related to neurofeedback training in children with ADHD: a randomized controlled trial. Telephone-based mental health interventions for child disruptive behavior or anxiety disorders: randomized trials and overall analysis. A Pilot Study of the Efficacy of a Computerized Executive Functioning Remediation Training With Game Elements for Children With ADHD in an Outpatient Setting Evaluating Clinically Significant Change in Mother and Child Functioning: Comparison of Traditional and Enhanced Behavioral Parent Training
abstract: OBJECTIVE Impairments associated with attention-deficit/hyperactivity disorder ( ADHD ) and noncompliance are prevalent in children with autism spectrum disorder ( ASD ) . However , ADHD response to stimulants is well below rates in typically developing children , with frequent side effects . Group studies of treatments for noncompliance are rare in ASD . We examined individual and combined-effectiveness of atomoxetine ( ATX ) and parent training ( PT ) for ADHD symptoms and noncompliance . METHOD In a 3-site , 10-week , double-blind , 2 × 2 trial of ATX and PT , 128 children ( ages 5 - 14 years ) with ASD and ADHD symptoms were r and omized to  ATX , ATX+PT , placebo+PT , or placebo . ATX was adjusted to optimal dose ( capped at 1.8 mg/kg/day ) over 6 weeks and maintained for 4 additional weeks . Nine PT sessions were provided . Primary outcome measures were the parent-rated DSM ADHD symptoms on the Swanson , Nolan and Pelham ( SNAP ) scale and Home Situations Question naire ( HSQ ) . RESULTS On the SNAP , ATX , ATX+PT and placebo+PT were each superior to placebo ( effect sizes 0.57 - 0.98 ; p values of .0005 , .0004 , and .025 , respectively ) . For noncompliance , ATX and ATX+PT were superior to placebo ( effect sizes 0.47 - 0.64 ; p values .03 and .0028 , respectively ) . ATX was associated with decreased appetite but was otherwise well tolerated . CONCLUSION Both ATX and PT result ed in significant improvement on ADHD symptoms , whereas ATX ( both alone and combined with PT ) was associated with significant decreases on measures of noncompliance . ATX appears to have a better side effects profile than psychostimulants in the population with ASD . CLINICAL TRIAL REGISTRATION INFORMATION Atomoxetine , Placebo and Parent Management Training in Autism ; http:// clinical trials.gov/ ; NCT00844753 Fathers , in general , have been underrepresented in studies of parent training outcome for children with attention deficit hyperactivity disorder ( ADHD ) , and the present study aim ed to investigate the efficacy of a behavioral parent training program developed expressly for fathers . The present investigation r and omly assigned 55 fathers of children ages 6 to 12 with ADHD to the Coaching Our Acting-out Children :  Heightening Essential Skills ( COACHES ) program or a waitlist control group . Outcomes for the study included objective observations of parent behaviors and parent ratings of child behavior . Results indicated that fathers in the COACHES group reduced their rates of negative talk and increased rates of praise as measured in parent – child observations , and father ratings of the intensity of problem behaviors were reduced , relative to the waitlist condition . Groups did not differ on observations of use of comm and s or father ratings of child behavior problems . Untreated mothers did not significantly improve on observational measures or behavioral ratings . This study provides preliminary evidence for the efficacy of the COACHES parenting program for fathers of children with ADHD . Results are cast in light of the larger literature on behavioral parent training for ADHD as well as how to best work with fathers of children with ADHD in treatment context This study examined the individual and combined effects of two nonpharmacological treatments for attention deficit/hyperactivity disorder ( ADHD ) :  Cogmed working memory training ( CWMT ) for adolescents and  behavioral parent training ( BPT ) for mothers . Ninety-one adolescents ( ages 11–15 ) and their mothers were r and omized to one of four CWMT and BPT treatment and active control ( placebo ) group combinations of 5-week interventions . At pre- and posttest , mothers and teachers completed rating forms , and adolescents completed neuropsychological measures of working memory ( WM ) . Individual intervention effects showed that treatment CWMT significantly improved WM spans , whereas there were no significant differences for treatment or control BPT on reports of parent-related outcomes . Combined treatment effects indicated an overall pattern of greatest improvements for the control CWMT/treatment BPT group , as compared to the other three groups , on adolescent WM deficit , behavioral regulation problems , and global executive deficit . Most significant effects for outcomes were main effects of improvements over time . A combination of CWMT and BPT did not result in increased treatment gains . However , potential effects of combined treatment may have been masked by greater perceived benefits arising from lack of struggle in the nonadaptive , CWMT active control condition . Future combined intervention research should focus on specific , theoretically driven WM deficits among individuals with ADHD , should include possible adaptations to the st and ard CWMT program , should examine effectiveness of cognitive treatments combined with context ual interventions and should utilize appropriate control groups to fully underst and the unique and combined effects of interventions BACKGROUND This is the first r and omized controlled multicenter trial to evaluate the effect of two treatments of maternal attention-deficit hyperactivity disorder ( ADHD ) on response to parent-child training targeting children 's external psychopathology . METHODS Mother-child dyads ( n = 144 ; ADHD according to DSM-IV ; children : 73.5 % males , mean age 9.4 years ) from five specialized university outpatient units in Germany were central ly r and omized to multimodal maternal ADHD treatment [ group psychotherapy plus open methylpheni date medication ; treatment group ( TG ) : n = 77 ] or to clinical management [ supportive counseling without psychotherapy or psychopharmacotherapy ; control group ( CG ) : n = 67 ] . After 12 weeks , the maternal ADHD treatment was supplemented by individual parent-child training for all dyads . The primary outcome was a change in the children 's externalizing symptom scores ( investigator blinded to the treatment assignment ) from baseline to the end of the parent-child training 6 months later . Maintenance therapy continued for another 6 months . An intention-to-treat analysis was performed within a linear regression model , controlling for baseline and center after multiple imputations of missing values . RESULTS Exactly , 206 dyads were assessed for eligibility , 144 were r and omized , and 143 were analyzed ( TG : n = 77 ; CG : n = 66 ) . After 6 months , no significant between-group differences were found in change scores for children 's externalizing symptoms ( adjusted mean TG-mean CG=1.1 , 95 % confidence interval -0.5 - 2.7 ; p = .1854 ) , although maternal psychopathology improved more in the TG . Children 's externalizing symptom scores improved from a mean of 14.8 at baseline to 11.4 ( TG ) and 10.3 ( CG ) after 6 months and to 10.8 ( TG ) and 10.1 ( CG ) after 1 year . No severe harms related to study treatments were found , but adverse events were more frequent in TG mothers than in CG mothers . CONCLUSIONS The response in children 's externalizing psychopathology did not differ between maternal treatment groups . However , multimodal treatment was associated with more improvement in maternal ADHD . Child and maternal treatment gains were stable ( CCT-IS RCT N73911400 ) 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 OBJECTIVE In the intent-to-treat analysis of the Multimodal Treatment Study of Children With ADHD ( MTA ) , the effects of medication management ( MedMgt ) , behavior therapy ( Beh ) , their combination ( Comb ) , and usual community care ( CC ) differed at 14 and 24 months due to superiority of treatments that used the MTA medication algorithm ( Comb+MedMgt ) over those that did not ( Beh+CC ) . This report examines 36-month outcomes , 2 years after treatment by the study ended . METHOD For primary outcome measures ( attention-deficit/hyperactivity disorder [ ADHD ] and oppositional defiant disorder [ ODD ] symptoms , social skills , reading scores , impairment , and diagnostic status ) , mixed-effects regression models and orthogonal contrasts examined 36-month outcomes . RESULTS At 3 years , 485 of the original 579 subjects ( 83.8 % ) participated in the follow-up , now at ages 10 to 13 years , ( mean 11.9 years ) . In contrast to the significant advantage of MedMgt+Comb over Beh+CC for ADHD symptoms at 14 and 24 months , treatment groups did not differ significantly on any measure at 36 months . The percentage of children taking medication > 50 % of the time changed between 14 and 36 months across the initial treatment groups : Beh significantly increased ( 14 % to 45 % ) , MedMed+Comb significantly decreased ( 91 % to 71 % ) , and CC remained constant ( 60%-62 % ) . Regardless of their treatment use changes , all of the groups showed symptom improvement over baseline . Notably , initial symptom severity , sex ( male ) , comorbidity , public assistance , and parental psychopathology ( ADHD ) did not moderate children 's 36-month treatment responses , but these factors predicted worse outcomes over 36 months , regardless of original treatment assignment . CONCLUSIONS By 36 months , the earlier advantage of having had 14 months of the medication algorithm was no longer apparent , possibly due to age-related decline in ADHD symptoms , changes in medication management intensity , starting or stopping medications altogether , or other factors not yet evaluated Behavioral parent training is an efficacious treatment for attention-deficit/hyperactivity disorder ( ADHD ) . However , single-mother households are at high risk for poor outcomes during and following behavioral parent training . This study r and omly assigned cohorts of 120 single mothers of children ( ages 5–12 years ) with ADHD to a waitlist control group , a traditional behavioral parent training program , or an enhanced behavioral parent training program — the Strategies to Enhance Positive Parenting (  STEPP )  program . Intent-to-treat analysis demonstrated benefits of participating in behavioral parent training , in general , and the STEPP program more specifically at immediate posttreatment on child and parental functioning . Moreover , the STEPP program result ed in increased engagement to treatment . However , results indicated that behavioral parent training does not normalize behavior for most children and treatment gains are not maintained OBJECTIVES To determine any long-term effects , 6 and 8 years after childhood enrollment , of the r and omly assigned 14-month treatments in the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder ( MTA ; N = 436 ) ; to test whether attention-deficit/hyperactivity disorder ( ADHD ) symptom trajectory through 3 years predicts outcome in subsequent years ; and to examine functioning level of the MTA adolescents relative to their non-ADHD peers ( local normative comparison group ; N = 261 ) . METHOD Mixed-effects regression models with planned contrasts at 6 and 8 years tested a wide range of symptom and impairment variables assessed by  parent , teacher , and youth report . RESULTS In nearly every analysis , the originally r and omized treatment groups did not differ significantly on repeated measures or newly analyzed variables ( e.g. , grade s earned in school , arrests , psychiatric hospitalizations , other clinical ly relevant outcomes ) . Medication use decreased by 62 % after the 14-month controlled trial , but adjusting for this did not change the results . ADHD symptom trajectory in the first 3 years predicted 55 % of the outcomes . The MTA participants fared worse than the local normative comparison group on 91 % of the variables tested . CONCLUSIONS Type or intensity of 14 months of treatment for ADHD in childhood ( at age 7.0 - 9.9 years ) does not predict functioning 6 to 8 years later . Rather , early ADHD symptom trajectory regardless of treatment type is prognostic . This finding implies that children with behavioral and sociodemographic advantage , with the best response to any treatment , will have the best long-term prognosis . As a group , however , despite initial symptom improvement during treatment that is largely maintained after treatment , children with combined-type ADHD exhibit significant impairment in adolescence . Innovative treatment approaches targeting specific areas of adolescent impairment are needed Abstract During a 3-month intervention program , 43 hyperactive children and their families were assessed and followed . Families were r and omly assigned to one of three groups : parent training in behavior modification while the child was administered a placebo ; parent training plus methylpheni date ; and methylpheni date only . All groups showed improved home and school behavior . However , only with medication were there also gains on measures of attention and impulse control . The results also revealed greater improvement in the area of academic achievement and classroom behavior in the medication groups as compared with children on placebo . There was no evidence of significant benefit from the addition of parent training to the administration of medication There are no empirically supported psychosocial treatments for adolescents with attention-deficit hyperactivity disorder ( ADHD ) .  This study examined the treatment benefits of the Challenging Horizons Program ( CHP ) , a psychosocial treatment program design ed to address the impairment and symptoms associated with this disorder in young adolescents . In addition to evaluating social and academic functioning outcomes , two critical questions from previous studies pertaining to the timing , duration , and family involvement in treatment were addressed . Forty-nine students recruited in two cohorts were r and omly assigned to receive either the CHP or a  community care condition . Outcomes suggested that students who received the CHP  improved compared to students in the control condition on measures of symptoms and impairment . Implication s related to timing , duration , and family involvement are reported , as well as recommendations for future studies OBJECTIVE More than 50 % of mothers of children with attention-deficit/hyperactivity disorder ( ADHD ) have a lifetime history of major depressive disorder ( MDD ) . Maternal depressive symptoms are associated with impaired parenting and predict adverse developmental and treatment outcomes for children with ADHD . For these reasons , we developed and examined the preliminary efficacy of an integrated treatment targeting parenting and depressive symptoms for mothers of children with ADHD . This integrated intervention incorporated elements of 2 evidence -based treatments : behavioral parent training ( BPT ) and cognitive behavioral depression treatment . METHOD Ninety-eight mothers with at least mild depressive symptoms were r and omized to receive either st and ard BPT ( n = 51 ) or the integrated parenting intervention for ADHD ( IPI-A ; n = 47 ) . Participants were assessed at baseline , posttreatment , and 3- to 6-month follow-up on measures of ( a ) self-reported maternal depressive symptoms , ( b ) observed positive and negative parenting , and ( c ) observed and mother-reported child disruptive behavior and mother-reported child and family impairment . RESULTS The IPI-A produced effects of small to moderate magnitude relative to BPT  on maternal depressive symptoms , observed negative parenting , observed child deviance , and child impairment at posttreatment and on maternal depressive symptoms , child disruptive behavior , child impairment and family functioning at follow-up . Contrary to expectations , the BPT group demonstrated moderate to large effects relative to IPI-A on observed positive parenting at follow-up . CONCLUSIONS This treatment development study provides encouraging preliminary support for the integrated intervention targeting parenting and depressive symptoms in mothers of children with ADHD . Future studies should examine whether this integrated intervention improves long-term developmental outcomes for children with ADHD . ( PsycINFO Data base Record ( c ) 2013 APA , all rights reserved ) BACKGROUND The ' New Forest Parenting Package ' ( NFPP ) , an 8-week home-based intervention for parents of preschoolers with attention-deficit/hyperactivity disorder ( ADHD ) , fosters constructive parenting to target ADHD-related dysfunctions in attention and impulse control . Although NFPP has improved parent and laboratory measures of ADHD in community sample s of children with ADHD-like problems , its efficacy in a clinical sample , and relative to an active treatment comparator , is unknown . The aims are to evaluate the short- and long-term efficacy and generalization effects of NFPP compared to an established clinic-based parenting intervention for treating noncompliant behavior [ ' Helping the Noncompliant Child ' ( HNC ) ] in young children with ADHD . METHODS A r and omized controlled trial with three parallel arms was the design for this study . A total of 164 3 - 4-year-olds , 73.8 % male , meeting DSM-IV ADHD diagnostic criteria were r and omized to NFPP  ( N = 67 ) , HNC ( N = 63 ) , or wait-list control ( WL , N = 34 ) . All participants were assessed at post-treatment . NFPP and HNC participants were assessed at follow-up in the next school year . Primary outcomes were ADHD ratings by teachers blind to and uninvolved in treatment , and by parents . Secondary ADHD outcomes included clinician assessment s , and laboratory measures of on-task behavior and delay of gratification . Other outcomes included parent and teacher ratings of oppositional behavior , and parenting measures . ( Trial name : Home-Based Parent Training in ADHD Preschoolers ; Registry : Clinical Trials.gov Identifier : NCT01320098 ; URL : http://www/ clinical trials.gov/ct2/show/NCT01320098 ) . RESULTS In both treatment groups , children 's ADHD and ODD behaviors , as well as aspects of parenting , were rated improved by parents at the end of treatment compared to controls . Most of these gains in the children 's behavior and in some parenting practice s were sustained at follow-up . However , these parent-reported improvements were not corroborated by teacher ratings or objective observations . NFPP was not significantly better , and on a few outcomes significantly less effective , than HNC . CONCLUSIONS The results do not support the cl aim that NFPP addresses putative dysfunctions underlying ADHD , bringing about generalized change in ADHD , and its underpinning self-regulatory processes . The findings support documented difficulties in achieving generalization across nontargeted setting s , and the importance of using blinded measures to provide meaningful assessment s of treatment effects Two family therapies were compared using teens with attention-deficit/hyperactivity disorder . Ninety-seven families were assigned to either 18 sessions of problem-solving communication training ( PSCT ) alone or behavior management training ( BMT ) for 9 sessions followed by PSCT for 9 sessions ( BMT/PSCT ) . Both treatments demonstrated significant improvement in ratings of parent-teen conflicts at the midpoint but did not differ . By posttreatment , both produced improvement on ratings and observations but did not differ . Significantly more families dropped out of PSCT alone than out of BMT/PSCT . At most , 23 % of families showed reliable change either by midpoint or by posttreatment , with no differences between therapies . Yet 31%-70 % of families were normalized . Group-level change and normalization rates support treatment efficacy , whereas indices of reliable change are less impressive The goal of this study was to compare the effects of before school physical activity ( PA ) and sedentary classroom-based ( SC ) interventions on the symptoms , behavior , moodiness , and peer functioning of young children ( Mage = 6.83 ) at risk for attention-deficit/hyperactivity disorder ( ADHD-risk ; n = 94 ) and typically developing children ( TD ; n = 108 ) . Children were r and omly assigned to either PA or SC and participated in the assigned intervention 31 min per day , each school day , over the course of 12 weeks . Parent and teacher ratings of ADHD symptoms ( inattention , hyperactivity/impulsivity ) , oppositional behavior , moodiness , behavior toward peers , and reputation with peers , were used as dependent variables . Primary analyses indicate that the PA intervention was more effective than the SC intervention at reducing inattention and moodiness in the home context . Less conservative follow-up analyses within ADHD status and intervention groups suggest that a PA intervention may reduce impairment associated with ADHD-risk in both home and school domains ; interpretive caution is warranted , however , given the liberal approach to these analyses . Unexpectedly , these findings also indicate the potential utility of a before school SC intervention as a tool for managing ADHD symptoms . Inclusion of a no treatment control group in future studies will enable further underst and ing of PA as an alternative management strategy for ADHD symptoms Sixty-one 12- to 18-year-olds were r and omized to 8 - 10 sessions of behavior management training ( n = 20 ) , problem-solving and communication training ( n = 21 ) , or structural family therapy ( n = 20 ) . Families were assessed at pre- and posttreatment and 3-month follow-up . All treatments result ed in significant reductions in negative communication , conflicts , and anger during conflicts and improved ratings of school adjustment , reduced internalizing and externalizing symptoms , and decreased maternal depressive symptoms . Most outcomes remained stable between posttreatment and follow-up , and some continued to improve over this time . Despite group improvements , analyses of clinical ly significant change and clinical recovery within Ss showed that only 5 - 30 % reliably improved from treatment and only 5 - 20 % recovered following treatment . The three treatments did not differ in these rates 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 A pilot r and omized clinical trial was conducted to examine the initial efficacy of Pay Attention ! , an intervention training sustained , selective , alternating , and divided attention , in children diagnosed with Attention-Deficit/Hyperactivity Disorder ( ADHD ) . After a diagnostic and baseline evaluation , school-aged children with ADHD were r and omized to receive 16 bi-weekly sessions of Pay Attention ! ( n=54 ) or to a waitlist control group ( n=51 ) . Participants completed an outcome evaluation approximately 12 weeks after their baseline evaluation . Results showed significant treatment effects for parent and clinician ratings of ADHD symptoms , child self-report of ability to focus , and parent ratings of executive functioning . Child performance on neuropsychological tests showed significant treatment-related improvement on strategic planning efficiency , but no treatment effects were observed on other neuropsychological outcomes . Treatment effects were also not observed for teacher ratings of ADHD . These data add to a growing body of literature supporting effects of cognitive training on attention and behavior , however , additional research is warranted 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 Objective : To examine the efficacy of a Cognitive-Functional ( Cog-Fun ) intervention for children with ADHD .  Method : R and om allocation of 107 children to study or control groups preceded 10 parent – child weekly Cog-Fun sessions emphasizing executive strategy training in games and daily activities . Controls received treatment after crossover . Study participants were followed up 3 months post-treatment . Outcomes included parent/teacher ratings of executive functions , ADHD symptoms , and parent ratings of quality of life . Results : Eight children withdrew prior to treatment . All children in both groups who began treatment completed it . Mixed effects ANOVA revealed significant Time × Group interaction effects on all parent-reported outcomes . Treatment effects were moderate to large , replicated after crossover in the control group and not moderated by medication . Parent-reported treatment gains in the study group were maintained at follow-up . No significant Time × Group interaction effects were found on teacher outcomes . Conclusion : Cog-Fun occupational therapy ( OT ) intervention shows positive context -specific effects on parent , but not teacher , ratings OBJECTIVE To determine the efficacy of group cognitive-behavioral therapy ( CBT ) on adolescents with attention-deficit/hyperactivity disorder ( ADHD ) who were in pharmacological treatment but still had persistent symptoms . METHOD We conducted a multicenter , r and omized , rater-blinded , controlled trial between April 2012 and May 2014 in a cohort of 119 adolescents ( 15 - 21 years of age ) . Participants were r and omly assigned to 12 manualized group CBT sessions ( n = 45 ) or a waiting list control group ( n = 44 ) . Primary outcomes were assessed by a blinded evaluator ( ADHD Rating Scale [ ADHD-RS ] , Clinical Global Impression Scale for Severity [ CGI-S ] , Global Assessment of Functioning [ GAF ] ) before and after treatment , as well as by self-report and parent informant ratings . RESULTS Of the initial 119 participants enrolled , 89 completed treatment . A mixed-effects model analysis revealed that participants who were assigned to the group CBT sessions experienced significantly reduced ADHD symptoms compared to the control group ( ADHD-RS Adolescent : -7.46 , 95 % CI = -9.56 to -5.36 , p < .001 , d = 7.5 ; ADHD-RS Parents : -9.11 , 95 % CI = -11.48 to -6.75 , p < .001 , d = 8.38 ; CGI-S Self-Report : -0.68 , 95 % CI = -0.98 to -0.39 , p < .001 , d = 3.75 ; CGI-S Clinician : -0.79 , 95 % CI = -0.95 to -0.62 , p < .001 ; d = 7.71 ) . Functional impairment decreased significantly in the CBT group according to parents ( Weiss Functional Impairment Scale -4.02 , 95 % CI = -7.76 to -0.29 , p < .05 , d = 2.29 ) and according to the blinded evaluator ( GAF : -7.58 , 95 % CI = -9.1 to -6.05 , p < .001 , d = 7.51 ) . CONCLUSION Group CBT associated with pharmacological treatment is an efficacious intervention for reducing ADHD symptoms and functional impairment in adolescents . Clinical trial registration information-CBT Group for Adolescents With ADHD : a R and omized Controlled Trial ; http:// clinical trials.gov/ ; NCT02172183 BACKGROUND Until now , working memory training has not reached sufficient evidence as effective treatment for ADHD core symptoms in children with ADHD ; for young children with ADHD , no studies are available . To this end , a triple-blind , r and omized , placebo-controlled study was design ed to assess the efficacy of Cogmed Working Memory Training ( CWMT ) in young children with ADHD . METHODS Fifty-one children ( 5 - 7 years ) with a DSM-IV-TR diagnosis of ADHD ( without current psychotropic medication ) were r and omly assigned to the active ( adaptive ) or placebo ( nonadaptive ) training condition for 25 sessions during 5 weeks . The compliance criterion ( > 20 sessions ) was met for 47 children . The primary outcome measure concerned the core behavioural symptoms of ADHD , measured with the ADHD Rating Scale IV ( ADHD-RS ) . Secondary outcome measures were neurocognitive functioning , daily executive functioning , and global clinical functioning . The influence of the increase in difficulty level ( Index-Improvement ) for the treatment group was also analysed . Clinical trial registration information - ' Working Memory Training in Young ADHD Children ' ; www . clinical trials.gov ; NCT00819611 . RESULTS A significant improvement in favour of the active condition was found on a verbal working memory task ( p = .041 ; adapted Digit Span WISC-III , backward condition ) . However , it did not survive correction for multiple testing . No significant treatment effect on any of the primary or other secondary outcome measurements was found . The Index-Improvement significantly contributed to ADHD-RS and the Behavior Rating Inventory of Executive Function , both rated by the teacher , but revealed no significant group difference . CONCLUSIONS This study failed to find robust evidence for benefits of CMWT over the placebo training on behavioural symptoms , neurocognitive , daily executive , and global clinical functioning in young children with ADHD Behavioral and pharmacological treatments for children with attention deficit/hyperactivity disorder ( ADHD ) were evaluated to address whether endpoint outcomes are better depending on which treatment is initiated first and , in case of insufficient response to initial treatment , whether increasing dose of initial treatment or adding the other treatment modality is superior . Children with ADHD ( ages 5–12 , N = 146 , 76 % male ) were treated for 1 school year . Children were r and omized to initiate treatment with low doses of either ( a ) behavioral parent training ( 8 group sessions ) and brief teacher consultation to establish a Daily Report Card or ( b ) extended-release methylpheni date ( equivalent to .15 mg/kg/dose bid ) . After 8 weeks or at later monthly intervals as necessary , insufficient responders were rer and omized to secondary interventions that either increased the dose/intensity of the initial treatment or added the other treatment modality , with adaptive adjustments monthly as needed to these secondary treatments . The group beginning with behavioral treatment displayed significantly lower rates of observed classroom rule violations ( the primary outcome ) at study endpoint and tended to have fewer out-of-class disciplinary events . Further , adding medication secondary to initial behavior modification result ed in better outcomes on the primary outcomes and parent/teacher ratings of oppositional behavior than adding behavior modification to initial medication . Normalization rates on teacher and parent ratings were generally high . Parents who began treatment with behavioral parent training had substantially better attendance than those assigned to receive training following medication . Beginning treatment with behavioral intervention produced better outcomes overall than beginning treatment with medication 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 To test cognitive behavioral therapy ( CBT ) for persistent attention-deficit hyperactivity disorder ( ADHD ) symptoms in a sample of medication-treated adolescents . METHODS Forty-six adolescents ( ages 14 - 18 ) , with clinical ly significant ADHD symptoms despite stable medication treatment were r and omly assigned to receive CBT for ADHD or wait list control in a cross-over design . Twenty-four were r and omized to CBT , 22 to wait list , and 15 crossed-over from wait list to CBT . A blind independent evaluator ( IE ) rated symptom severity on the ADHD Current Symptom Scale , by adolescent and parent report , and rated each subject using the Clinical Global Impression Severity Scale ( CGI ) , a global measure of distress and impairment . These assessment s were performed at baseline , 4-months ( post-CBT or post wait list ) , and 8-months ( post-treatment for those originally assigned to the wait list condition and 4-month follow-up for those originally assigned to CBT ) . TRIAL REGISTRATION http:// clinical trials.gov/show/NCT01019252 . RESULTS Using all available data , mixed effects modeling , and pooling for the wait list cross-over , participants who received CBT received a mean score 10.93 lower on the IE-rated parent assessment of symptom severity ( 95 % CI : -12.93 , -8.93 ; p < .0001 ) , 5.24 lower on the IE-rated adolescent assessment of symptom severity ( 95 % CI : -7.21 , -3.28 ; p < .0001 ) , and 1.17 lower IE-rated CGI ( 95 % CI : -1.39 , -.94 ; p < .0001 ) . Results were consistent across 100 multiple imputations ( all p < .0001 ) . There was a greater proportion of responders after CBT by parent ( 50 % vs. 18 % , p = .00 ) and adolescent ( 58 % vs. 18 % p = .02 ) report . CONCLUSIONS This study demonstrates initial efficacy of CBT for adolescents with ADHD who continued to exhibit persistent symptoms despite medications 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 ) OBJECTIVE This study evaluates a  parent-teen skills-based therapy for attention deficit/hyperactivity disorder ( ADHD ) blended with motivational interviewing ( MI ) to enhance family engagement . Supporting Teens ' Autonomy Daily ( ST AND ) is an adolescent-specific treatment for ADHD that targets empirically identified adolescent ( i.e. , organization , time management , and planning , or OTP skills ) and parent-based ( i.e. , monitoring and contingency management ) mechanisms of long-term outcome through individual parent-teen sessions . METHOD The current r and omized trial ( N = 128 ) evaluates efficacy at posttreatment and 6-month follow-up . Participants were ethnically diverse teens ( 7.7 % non-Hispanic White , 10.8 % African American , 78.5 % Hispanic , 3.0 % other ) r and omly assigned to ST AND  or Treatment As Usual ( TAU ) . RESULTS Primary findings were that ( 1 ) ST AND was delivered in an MI-adherent fashion and most families fully engaged in treatment ( 85 % completed ) ; ( 2 ) ST AND produced a range of significant acute effects on ADHD symptoms , OTP skills , homework behavior , parent-teen contracting , implementation of home privileges , parenting stress , and daily homework recording ; and ( 3 ) 6 months after treatment ceased , effects on ADHD symptom severity , OTP skills , and parenting stress maintained , while parent use of contracting and privilege implementation strategies , as well as teen daily homework recording and homework behavior gains , were not maintained . CONCLUSION Skills-based behavior therapy blended with MI is an acutely efficacious treatment for adolescents with ADHD although more work is needed to establish the nature of long-term effects . ( PsycINFO Data base BACKGROUND An abnormality in long chain-polyunsaturated fatty acid ( LC-PUFA ) levels has been implicated in attention-deficit/hyperactivity disorder ( ADHD ) . Studies evaluating LC-PUFA supplementation for therapeutic efficacy in ADHD have shown mixed and , therefore , inconclusive results . METHODS Seventy-six male adolescents ( age 12 - 16 years , mean = 13.7 ) with ADHD were assessed for the effects of 12 weeks omega-3 and omega-6 supplements on biochemical and psychological outcomes in a r and omized , placebo-controlled , clinical trial . The primary outcome measure was change in the Conners ' Teacher Rating Scales ( CTRS ) following 12 weeks of supplementation of LC-PUFA or placebo . At baseline , the placebo and treatment groups had comparable levels of LC-PUFA as measured by red blood cell phosphatidylcholine . In the treatment group , supplementation enhanced eicosapentaenoic acid ( EPA ) , docosahexaenoic acid ( DHA ) , and total omega-3 fatty acid levels . RESULTS No superiority of LC-PUFAs to placebo was observed on the primary outcome . Further , there were no reliable treatment effects on aggression , impulsivity , depression , and anxiety . CONCLUSIONS Future studies should use larger sample sizes and longer supplementation period to detect small-modest effects for clinical recommendations in ADHD Objective : Evidence indicates that children with Attention Deficit Hyperactivity Disorder ( ADHD ) experience acute and prolonged academic impairment and underachievement including marked difficulty with completing homework . This study is the first to examine the effects of behavioral , psychostimulant , and combined treatments on homework problems , which have been shown to predict academic performance longitudinally . Method : Children with ADHD ( ages 5–12 , N = 75 , 71 % male , 83 % Hispanic/Latino ) and their families were r and omly assigned to either behavioral treatment ( homework-focused parent training and a daily report card ; BPT + DRC ) or a waitlist control group . Children also participated in a concurrent psychostimulant crossover trial conducted in a summer treatment program . Children ’s objective homework completion and accuracy were measured as well as parent-reported child homework behaviors and parenting skills . Results : BPT + DRC had large effects on objective measures of homework completion and accuracy ( Cohen ’s ds from 1.40 to 2.21 , ps < .001 ) . Other findings , including unimodal medication and incremental combined treatment benefits , were not significant . Conclusions : Behavioral treatment focused on homework problems results in clear benefits for children ’s homework completion and accuracy ( the difference between passing and failing , on average ) , whereas long-acting stimulant medication result ed in limited and largely nonsignificant acute effects on homework performance Decreased success at work and educational attainment by adulthood are of concern for children with ADHD given their widely documented academic difficulties ; however there are few studies that have examined this empirically and even fewer that have studied predictors and individual variability of these outcomes . The current study compares young adults with and without a childhood diagnosis of ADHD on educational and occupational outcomes  and the predictors of these outcomes . Participants were from the Pittsburgh ADHD Longitudinal Study ( PALS ) , a prospect i ve study with yearly data collection . Significant group differences were found for nearly all variables such that educational and occupational attainment was lower for adults with compared to adults without histories of childhood ADHD . Despite the mean difference , educational functioning was wide-ranging . High school academic achievement significantly predicted enrollment in post-high school education and academic and disciplinary problems mediated the relationship between childhood ADHD and post-high school education . Interestingly , ADHD diagnosis and disciplinary problems negatively predicted occupational status while enrollment in post-high school education was a positive predictor . Job loss was positively predicted by a higher rate of academic problems and diagnosis of ADHD . This study supports the need for interventions that target the child and adolescent predictors of later educational and occupational outcomes in addition to continuing treatment of ADHD in young adulthood targeting developmentally appropriate milestones , such as completing post-high school education and gaining and maintaining stable employment Introduction Executive functions ( EFs ) training interventions aim ed at ADHD-symptom reduction have yielded mixed results . Generally , these interventions focus on training a single cognitive domain ( e.g. , working memory [ WM ] , inhibition , or cognitive-flexibility ) . However , evidence suggests that most children with ADHD show deficits on multiple EFs , and that these EFs are largely related to different brain regions . Therefore , training multiple EFs might be a potentially more effective strategy to reduce EF-related ADHD symptoms . Methods Eighty-nine children with a clinical diagnosis of ADHD ( aged 8–12 ) were r and omized to either a full-active-condition where visuospatial WM , inhibition and cognitive-flexibility were trained , a partially-active-condition where inhibition and cognitive-flexibility were trained and the WM-training task was presented in placebo-mode , or to a full placebo-condition . Short-term and long-term ( 3-months ) effects of this gamified , 25-session , home-based computer-training were evaluated on multiple outcome domains . Results During training compliance was high ( only 3 % failed to meet compliance criteria ) . After training , only children in the full-active condition showed improvement on measures of visuospatial short-term-memory ( STM ) and WM . Inhibitory performance and interference control only improved in the full-active- and the partially-active condition . No Treatment-condition x Time interactions were found for cognitive-flexibility , verbal WM , complex-reasoning , nor for any parent- , teacher- , or child-rated ADHD behaviors , EF-behaviors , motivational behaviors , or general problem behaviors . Nonetheless , almost all measures showed main Time-effects , including the teacher-ratings . Conclusions Improvements on inhibition and visuospatial STM and WM were specifically related to the type of treatment received . However , transfer to untrained EFs and behaviors was mostly nonspecific ( i.e. , only interference control improved exclusively in the two EF training conditions ) . As such , in this multiple EF-training , mainly nonspecific treatment factors – as opposed to the specific effects of training EFs — seem related to far transfer effects found on EF and behavior . Trial Registration trialregister.nl NTR2728 . Registry name : improving executive functioning in children with ADHD : training executive functions within the context of a computer game ; registry number : NTR2728 The revised new forest parenting programme ( NFPP ) is an 8-week psychological intervention design ed to treat ADHD in preschool children by targeting , amongst other things , both underlying impairments in self-regulation and the quality of mother – child interactions . Forty-one children were r and omized to either the revised NFPP or treatment as usual conditions . Outcomes were ADHD and ODD symptoms measured using question naires and direct observation , mothers ’ mental health and the quality of mother – child interactions . Effects of the revised NFPP on ADHD symptoms were large ( effect size > 1 ) and significant and effects persisted for 9 weeks post-intervention . Effects on ODD symptoms were less marked . There were no improvements in maternal mental health or parenting behavior during mother – child interaction although there was a drop in mothers ’ negative and an increase in their positive comments during a 5-min speech sample . The small-scale trial , although limited in power and generalizability , provides support for the efficacy of the revised NFPP . The findings need to be replicated in a larger more diverse sample 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 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 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 Nonepisodic irritability is a common and impairing problem , leading to the development of the diagnoses severe mood dysregulation ( SMD ) and disruptive mood dysregulation disorder ( DMDD ) . No psychosocial therapies have been formally evaluated for either , with medication being the most common treatment . This study examined the feasibility and efficacy of a joint parent-child intervention for SMD . METHOD A total of 68 participants aged 7 to 12 years with attention-deficit/hyperactivity disorder ( ADHD ) and SMD were r and omly assigned to the 11-week therapy or community-based psychosocial treatment . All participants were first stabilized on psychostimulant medication by study physicians . Of the participants , 56 still manifested impairing SMD symptoms and entered the therapy phase . Masked evaluators assessed participants at baseline , midpoint , and endpoint , with therapy participants reassessed 6 weeks later . RESULTS All but 2 therapy participants attended the majority of sessions ( n = 29 ) , with families reporting high levels of satisfaction . The primary outcome of change in mood symptoms using the Mood Severity Index ( MSI ) did not reach significance except in the subset attending the majority of sessions ( effect size = 0.53 ) . Therapy was associated with significantly greater improvement in parent-rated irritability ( effect size = 0.63 ) . Treatment effects for irritability but not MSI diminished after therapy stopped . Little impact on ADHD symptoms was seen . Results may not be generalizable to youth with SMD and comorbidities different from those seen in this sample of children with ADHD , and are limited by the lack of a gold st and ard for measuring change in SMD symptoms . CONCLUSION While failing to significantly improve mood symptoms versus community treatment , the integrative therapy was found to be a feasible and efficacious treatment for irritability in participants with SMD and ADHD . CLINICAL TRIAL REGISTRATION INFORMATION Group-Based Behavioral Therapy Combined With Stimulant Medication for Treating Children With Attention Deficit Hyperactivity Disorder and Impaired Mood ; http:// clinical trials.gov/ ; NCT00632619 Adolescents with ADHD have planning problems , often affecting school- and social functioning . Evidence -based treatments for adolescents with ADHD are scarce and treatment drop-out rates are substantial . The effectiveness of two new , individual , short-term cognitive behavioral therapies ( CBT ) was investigated : One with an aim on improving planning skills  and one solution-focused treatment ( SFT ) without such an aim . Motivational Interviewing elements were added to both treatments to enhance treatment compliance . In a multi-center r and omized clinical trial , 159 adolescents ( 12–17 years ) with ADHD were r and omly assigned to one of both treatments . Pre- , post- and 3-month follow-up data were gathered on five domains : Parent-rated ADHD , planning problems and executive functioning ( primary outcomes ) , neuropsychological measures of planning , comorbid symptoms , general functioning , and teacher measures . Attrition was low in both treatments ( 5 % ) . Adolescents improved significantly between pre- and post-test with large effect sizes on all domains . Improvements remained stable or continued to improve from post-test to follow-up , also when controlling for medication use . Marginally significant differences were found in favor of the planning-focused treatment : parents and therapists evaluated this treatment more positively than SFT and the planning-focused treatment showed more reduction of parent-rated planning problems . Two new CBTs with integrated motivational components were feasible and attrition was low . ADHD symptoms and co-existing problems of the adolescents improved from pre-test to 3 months after treatment . As the planning-focused treatment was evaluated more positive and had marginal additional beneficial effects to SFT , especially planning-focused CBT seems promising to fill the gap in available treatments for adolescents with ADHD PURPOSE To evaluate the efficacy of combined methylpheni date and EEG feedback treatment for children with ADHD . METHODS Forty patients with ADHD were r and omly assigned to the combination group ( methylpheni date therapy and EEG feedback training ) or control group ( methylpheni date therapy and non-feedback attention training ) in a 1:1 ratio using the double-blind method . These patients , who met the DSM-IV diagnostic criteria and were aged between 7 and 16 years , had obtained optimal therapeutic effects by titrating the methylpheni date dose prior to the trial . The patients were assessed using multiple parameters at baseline , after 20 treatment sessions , after 40 treatment sessions , and in 6-month follow-up studies . RESULTS Compared to the control group , patients in the combination group had reduced ADHD symptoms and improved in related behavioural and brain functions . CONCLUSION The combination of EEG feedback and methylpheni date treatment is more effective than methylpheni date alone . The combined therapy is especially suitable for children and adolescents with ADHD who insufficiently respond to single drug treatment or experience drug side effects In a r and omized controlled trial , neurofeedback ( NF ) training was found to be superior to a computerised attention skills training concerning the reduction of ADHD symptomatology ( Gevensleben et al. , 2009 ) . The aims of this investigation were to assess the impact of different NF protocol s ( theta/beta training and training of slow cortical potentials , SCPs ) on the resting EEG and the association between distinct EEG measures and behavioral improvements . In 72 ( of initially 102 ) children with ADHD , aged 8 - 12 , EEG changes after either a NF training ( n=46 ) or the control training ( n=26 ) could be studied . The combined NF training consisted of one block of theta/beta training and one block of SCP training , each block comprising 18 units of 50 minutes ( balanced order ) .  Spontaneous EEG  was recorded in a two-minute resting condition before the start of the training , between the two training blocks and after the end of the training . Activity in the different EEG frequency b and s was analyzed . In contrast to the control condition , the combined NF training was accompanied by a reduction of theta activity . Protocol -specific EEG changes ( theta/beta training : decrease of posterior-midline theta activity ; SCP training : increase of central -midline alpha activity ) were associated with improvements in the German ADHD rating scale . Related EEG-based predictors were obtained . Thus , differential EEG patterns for theta/beta and SCP training provide further evidence that distinct neuronal mechanisms may contribute to similar behavioral improvements in children with ADHD OBJECTIVE Most children with mental health disorders do not receive timely care because of access barriers . These initial trials aim ed to determine whether distance interventions provided by nonprofessionals could significantly decrease the proportion of children diagnosed with disruptive behavior or anxiety disorders  compared with usual care . METHOD In three practical r and omized controlled trials , 243 children ( 80 with oppositional-defiant , 72 with attention-deficit/hyperactivity , and 91 with anxiety disorders ) were stratified by DSM-IV diagnoses and r and omized to receive the Strongest Families intervention ( treatment ) or usual care ( control ) . Assessment s were blindly conducted and evaluated at 120 , 240 , and 365 days after r and omization . The intervention consisted of evidence -based participant material s ( h and books and videos ) and weekly telephone coach sessions . The main outcome was mental health diagnosis change . RESULTS Intention-to-treat analysis showed that for each diagnosis significant treatment effects were found at 240 and 365 days after r and omization . Moreover , in the overall analysis significantly more children were not diagnosed as having disruptive behavior or anxiety disorders in the treatment group than the control group ( 120 days : χ(2)(1 ) = 13.05 , p < .001 , odds ratio 2.58 , 95 % confidence interval 1.54 - 4.33 ; 240 days : χ(2)(1 ) = 20.46 , p < .001 , odds ratio 3.44 , 95 % confidence interval 1.99 - 5.92 ; 365 days : χ(2)(1 ) = 13.94 , p < .001 , odds ratio 2.75 , 95 % confidence interval 1.61 - 4.71 ) . CONCLUSIONS Compared with usual care , telephone-based treatments result ed in significant diagnosis decreases among children with disruptive behavior or anxiety . These interventions hold promise to increase access to mental health services . CLINICAL TRIAL REGISTRATION INFORMATION Strongest Families : Pediatric Disruptive Behaviour Disorder , http://www . clinical trials.gov , NCT00267579 ; Strongest Families : Pediatric Attention-Deficit/Hyperactivity Disorder , http://www . clinical trials.gov , NCT00267605 ; and Strongest Families : Pediatric Anxiety , http://www . clinical trials.gov , NCT00267566 Objective : This pilot study tested the short- and long-term efficacy ( 9 weeks follow-up ) of an executive functioning ( EF ) remediation training with game elements for children with ADHD in an outpatient clinical setting , using a r and omized controlled wait-list design . Furthermore , in a sub sample , that is , those treated with methylpheni date , additive effects of the EF training were assessed . Method : A total of 40 children ( aged 8 - 12 years ) were r and omized to the EF training or wait-list . The training consisted of a 25-session training of inhibition , cognitive flexibility , and working memory . Treatment outcome was assessed by parent- and teacher-rated EF , ADHD , oppositional deviant disorder , and conduct disorder symptoms . Results : Children in the EF training showed significantly more improvement than those in the wait-list condition on parent-rated EF and ADHD behavior in the total sample and in the sub sample treated with methylpheni date . Effects were maintained at follow-up . Conclusion : This pilot study shows promising evidence for the efficacy of an EF training with game elements The Strategies to Enhance Positive Parenting ( STEPP ) program , an enhanced behavioral parent training ( BPT ) intervention , was developed to improve engagement in and outcomes following treatment for single-mother families of school-age youth with attention-deficit/hyperactivity disorder ( ADHD ) . A previous r and omized clinical trial of the STEPP program demonstrated that the intervention result ed in statistically significant improvements at the group-level in child oppositional behavior , various areas of child impairment , parental stress , and parenting behavior , relative to a wait-list control condition and a traditional BPT group . Despite benefits at the group-level , little is known about outcomes at the individual-level of enhanced BPT relative to traditional BPT for various child- and parent-level outcomes . The current study compares the extent to which traditional BPT and the STEPP program result in reliable change and recovery across various child- and parent-level outcomes in a sample of 80 , 5–12 year old youth with ADHD ( 70 % male ) . Analyses demonstrated the benefit of participating in either BPT treatment ; and participation in the STEPP program compared to traditional BPT was associated with only minimal incremental clinical benefit . Results , as well as clinical and research implication s for assessment and treatment of high-risk families of youth with ADHD enrolled in BPT  are discussed
target: The results revealed that findings are becoming increasingly nuanced with variations in levels of evidence related to ages of the children and characteristics of the specific treatment .
  In addition , we focused our critique on generalization of treatment effects across setting s and time and on sample diversity ( with regard to ethnicity and levels of parent education ) in relation to the population .
  Children of parents with higher levels of education than average appear to be overrepresented in the literature .
background: The purpose of this research was to up date the series of articles on evidence -based treatment for children and adolescents with attention deficit/hyperactivity disorder that have appeared in this journal ( Evans , Owens & Bunford , 2014 ; Pelham & Fabiano , 2008 ; Pelham , Wheeler , & Chronis , 1998 ) .