Maternal and Child Health Journal

, Volume 22, Issue 8, pp 1172–1182 | Cite as

Longitudinal Impact of a Randomized Clinical Trial to Improve Family Function, Reduce Maternal Stress and Improve Child Outcomes in Families of Children with ADHD

  • Shervin S. ChurchillEmail author
  • Michael C. Leo
  • Eileen M. Brennan
  • Claudia Sellmaier
  • Judy Kendall
  • Gail M. Houck


Objective Evaluate the efficacy of a 12 month nursing case-management intervention over a period of 18 months, 6 months after the end of intervention, for families of children attention deficit hyperactivity disorder (ADHD). Methods Mother and child dyads were enrolled to participate in a randomized controlled clinical trial. Children were 4–18 years old. Data were collected at baseline, 6, 12, and 18 months or 6 months after the termination of direct intervention. Longitudinal analyses, using generalized estimating equations, were conducted to assess change in study outcomes relating to family function, maternal stress, and child behavior over the 18 month period. Results Compared to control families, some family function outcomes were moderately improved in the intervention group. In particular, intervention families demonstrated substantial improvement in implementing family behavior controls (p value = 0.038) and improvement in family satisfaction (not statistically significant p = 0.062). Although there was improvement in the overall family function measure there was not a statistically significant difference between groups. Maternal stress and child behavior outcomes were not significantly different between control and intervention groups by the end of the intervention. Conclusions for Practice Addressing ADHD is complex and requires the assessment of comorbidities that might exacerbate negative behavior. Our findings support the latest American Academy of Pediatrics guidelines to use behavioral therapy as the first line of treatment in young children. Nursing case-management interventions that provide direct family education and improve family function, especially with respect to providing structure and behavior control, may complement and facilitate behavioral therapy for treatment of ADHD and improving child behavior.


ADHA Family function Maternal stress Child outcomes 



This research was supported by a grant from NIH/NINR Nurse Case Management Intervention for ADHD Families, R01NR5001. Preparation of the manuscript was supported in part by a grant from the National Institute of Disability, Independent Living, and Rehabilitation Research, and from the Center for Mental Health Services Substance Abuse and Mental Health Services Administration, United States Department of Health and Human Services, NIDILRR grant 90RT5030.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Shervin S. Churchill
    • 1
    • 2
    Email author
  • Michael C. Leo
    • 3
  • Eileen M. Brennan
    • 4
  • Claudia Sellmaier
    • 5
  • Judy Kendall
    • 6
  • Gail M. Houck
    • 1
  1. 1.Family and Child NursingUniversity of WashingtonSeattleUSA
  2. 2.School of Nursing and Health StudiesUniversity of Washington BothellBothellUSA
  3. 3.Center for Health ResearchKaiser Permanente NorthwestPortlandUSA
  4. 4.School of Social WorkPortland State UniversityPortlandUSA
  5. 5.Social Work and Criminal JusticeUniversity of Washington—TacomaTacomaUSA
  6. 6.Cascadia Behavioral Health CarePortlandUSA

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