Skip to main content
SpringerLink
Log in

ADHD Symptoms do not Moderate Outcomes to Behavioral Parent Training Delivered in the Voluntary Sector

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

The purpose of the study was to determine the moderating role of baseline levels of attention-deficit/hyperactivity disorder symptoms on parent- and child-level outcomes following the Caring in Chaos behavioral parent training intervention at immediate post-intervention and follow-up assessment. One-hundred sixty-one children between the ages of 3–9 (Mean age = 7.6; 73% male) with parental concerns of attention-deficit/hyperactivity disorder were randomly assigned to the Caring in Chaos behavioral parent training intervention, a task-shifted intervention delivered by a volunteer workforce across 12 community-based settings in Denmark, or to a wait-list control condition. Parent report of parenting behavior, sense of competence, stress, depressive symptoms as well as child attention-deficit/hyperactivity disorder symptoms and child noncompliance were collected at baseline, immediate post-intervention and at follow-up assessment points. Analyses indicated no moderating effect of baseline attention-deficit/hyperactivity disorder symptoms on parent- and child-outcomes, with no to large effects at post-treatment with maintenance of effects at follow-up assessment. The results of these analyses suggest that the Caring in Chaos behavioral parent training intervention can be utilized with young children with varying levels of attention-deficit/hyperactivity disorder symptoms. These findings further support that community-based interventions delivered by nonprofessionals may serve as a beneficial option to increase availability and access to behavioral parent training for the treatment of attention-deficit/hyperactivity disorder.

Highlights

  • Community-based BPT programs delivered by volunteers are a feasible alternative to commercial interventions.

  • Homegrown interventions can improve access to treatments that typically require extensive cost and time.

  • Baseline ADHD symptoms did not moderate parent and child outcomes of the Caring in Chaos intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Acri, M., Chacko, A., Gopalan, G., & McKay, M. (2018). Engaging families in treatment for child behavior disorders: A synthesis of the literature.In J. E. Lochman & W. Matthys (Eds), The Wiley handbook of disruptive and impulse-control disorders (p. 393–409). Wiley Blackwell.

  • Allan, C., & Chacko, A. (2018). Adverse events in behavioral parent training for children with ADHD: An under-appreciated phenomenon. The ADHD Report, 26(1), 4–9.

    Article  Google Scholar 

  • Arnold, D. S., O’leary, S. G., Wolff, L. S., & Acker, M. M. (1993). The Parenting Scale: a measure of dysfunctional parenting in discipline situations. Psychological Assessment, 5(2), 137.

    Article  Google Scholar 

  • Barkley, R. A., & Edelbrock, C. (1987). Assessing situational variation in children’s problem behaviors: The Home and School Situations Questionnaires. In R. Prinz (Ed.), Advances in behavioral assessment of children and families. Greenwich, CT: JAI.

    Google Scholar 

  • Beauchaine, T. P., Webster-Stratton, C., & Reid, M. J. (2005). Mediators, moderators, and predictors of 1-year outcomes among children treated for early-onset conduct problems: a latent growth curve analysis. Journal of Consulting and Clinical Psychology, 73(3), 371.

    Article  Google Scholar 

  • Berry, J. O., & Jones, W. H. (1995). The parental stress scale: Initial psychometric evidence. Journal of Social and Personal Relationships, 12(3), 463–472.

    Article  Google Scholar 

  • Chacko, A., Allan, C., Uderman, J., Cornwell, M., Anderson, L. & Chimiklis, A. (2015a). Training parents of children with ADHD. In R. Barkley (Ed), Attention deficit hyperactivity disorder: a handbook for diagnosis and treatment (4th edn.) (pp. 513–536). New York, NY: Guilford Press.

  • Chacko, A., Fabiano, G. A., Doctoroff, G. L., & Fortson, B. (2018). Engaging fathers in effective parenting for preschool children using shared book reading: a randomized controlled trial. Journal of Clinical Child & Adolescent Psychology, 47(1), 79–93.

    Article  Google Scholar 

  • Chacko, A., Gopalan, G., Franco, L., Dean-Assael, K., Jackson, J., Marcus, S., & McKay, M. (2015b). Multiple family group service model for children with disruptive behavior disorders: child outcomes at post-treatment. Journal of Emotional and Behavioral Disorders, 23(2), 67–77.

    Article  Google Scholar 

  • Chacko, A., Hopkins, K., Acri, M., Mendelsohn, A., & Dreyer, B. (2020). Expanding attention-deficit/hyperactivity disorder service provision in urban socioeconomically disadvantaged communities: a pilot study. Clinical Practice in Pediatric Psychology, 8(2), 189.

    Article  Google Scholar 

  • Chacko, A., Jensen, S. A., Lowry, L. S., Cornwell, M., Chimklis, A., Chan, E., & Pulgarin, B. (2016). Engagement in behavioral parent training: review of the literature and implications for practice. Clinical Child and Family Psychology Review, 19(3), 204–215.

    Article  Google Scholar 

  • Chacko, A., & Scavenius, C. (2018). Bending the curve: a community-based behavioral parent training model to address adhd-related concerns in the voluntary sector in denmark. Journal of Abnormal Child Psychology, 46(3), 505–517.

    Article  Google Scholar 

  • Chacko, A., Uderman, J. Z., & Zwilling, A. (2013). Lessons learned in enhancing behavioral parent training for high-risk families of youth with ADHD. The ADHD Report, 21(4), 6–11.

    Article  Google Scholar 

  • Chacko, A., Wymbs, B. T., Wymbs, F. A., Pelham, W. E., Swanger-Gagne, M. S., Girio, E., … & O’Connor, B. (2009). Enhancing traditionalbehavioral parent training for single mothers of children with ADHD. Journal of Clinical Child & Adolescent Psychology, 38(2), 206–218.

    Article  Google Scholar 

  • Chorpita, B. F., & Daleiden, E. L. (2009). Mapping evidence-based treatments for children and adolescents: application of the distillation and matching model to 615 treatments from 322 randomized trials. Journal of Consulting and Clinical Psychology, 77(3), 566.

    Article  Google Scholar 

  • Chronis-Tuscano, A., Chacko, A., & Barkley, R. (2013). Key issues relevant to the efficacy of behavioral treatment for ADHD. American Journal of Psychiatry, 170(7), 799–799.

    Article  Google Scholar 

  • Colalillo, S., & Johnston, C. (2016). Parenting cognition and affective outcomes following parent management training: a systematic review. Clinical Child and Family Psychology Review, 19(3), 216–235.

    Article  Google Scholar 

  • Daley, D., Van Der Oord, S., Ferrin, M., Cortese, S., Danckaerts, M., Doepfner, M., & Banaschewski, T. (2018). Practitioner review: current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with attention deficit hyperactivity disorder. Journal of Child Psychology and Psychiatry, 59(9), 932–947.

    Article  Google Scholar 

  • Daley, D., Van der Oord, S., Ferrin, M., Danckaerts, M., Doepfner, M., & Cortese, S., European ADHD Guidelines Group. (2014). Behavioral interventions in attention-deficit/hyperactivity disorder: a meta-analysis of randomized controlled trials across multiple outcome domains. Journal of the American Academy of Child & Adolescent Psychiatry, 53(8), 835–847.

    Article  Google Scholar 

  • Fabiano, G. A., Pelham, Jr, W. E., Coles, E. K., Gnagy, E. M., Chronis-Tuscano, A., & O’Connor, B. C. (2009). A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review, 29(2), 129–140.

    Article  Google Scholar 

  • Gardner, F., Burton, J., & Klimes, I. (2006). Randomised controlled trial of a parenting intervention in the voluntary sector for reducing child conduct problems: outcomes and mechanisms of change. Journal of Child Psychology and Psychiatry, 47(11), 1123–1132.

    Article  Google Scholar 

  • Gardner, F., Montgomery, P., & Knerr, W. (2016). Transporting evidence-based parenting programs for child problem behavior (age 3–10) between countries: Systematic review and meta-analysis. Journal of Clinical Child & Adolescent Psychology, 45(6), 749–762.

    Article  Google Scholar 

  • Garland, A. F., Hawley, K. M., Brookman-Frazee, L., & Hurlburt, M. S. (2008). Identifying common elements of evidence-based psychosocial treatments for children’s disruptive behavior problems. Journal of the American Academy of Child & Adolescent Psychiatry, 47(5), 505–514.

    Article  Google Scholar 

  • Hautmann, C., Hoijtink, H., Eichelberger, I., Görtz‐Dorten, A., Hanisch, C., Plück, J., & Döpfner, M. (2013). Any Indication for Bias due to Participation? Comparison of the effects of a parent management training rated by participating and non‐participating parents. Clinical Psychology & Psychotherapy, 20(5), 384–393.

    Google Scholar 

  • Kadesjö, B., Janols, L. O., Korkman, M., Mickelsson, K., Strand, G., Trillingsgaard, A., & Gillberg, C. (2004). The FTF (Five to Fifteen): the development of a parent questionnaire for the assessment of ADHD and comorbid conditions. European Child & Adolescent Psychiatry, 13(3), iii3–iii13.

    Google Scholar 

  • Karpenko, V., Owens, J. S., Evangelista, N. M., & Dodds, C. (2009). Clinically significant symptom change in children with attention‐deficit/hyperactivity disorder: does it correspond with reliable improvement in functioning? Journal of Clinical Psychology, 65(1), 76–93.

    Article  Google Scholar 

  • Kling, Å., Forster, M., Sundell, K., & Melin, L. (2010). A randomized controlled effectiveness trial of parent management training with varying degrees of therapist support. Behavior Therapy, 41(4), 530–542.

    Article  Google Scholar 

  • Leijten, P., Melendez-Torres, G. J., Knerr, W., & Gardner, F. (2016). Transported versus homegrown parenting interventions for reducing disruptive child behavior: a multilevel meta-regression study. Journal of the American Academy of Child & Adolescent Psychiatry, 55(7), 610–617.

    Article  Google Scholar 

  • Leijten, P., Raaijmakers, M. A., Orobio de Castro, B., van den Ban, E., & Matthys, W. (2015). Effectiveness of the incredible years parenting program for families with socioeconomically disadvantaged and ethnic minority backgrounds. Journal of Clinical Child and Adolescent Psychology. https://doi.org/10.1080/15374416.2015.1038823.

  • Lundahl, B., Risser, H. J., & Lovejoy, M. C. (2006). A meta-analysis of parent training: moderators and follow-up effects. Clinical Psychology Review, 26(1), 86–104.

    Article  Google Scholar 

  • McGilloway, S., Mhaille, G. N., Bywater, T., Furlong, M., Leckey, Y., Kelly, P., & Donnelly, M. (2012). A parenting intervention for childhood behavioral problems: a randomized controlled trial in disadvantaged community-based settings. Journal of Consulting and Clinical Psychology, 80(1), 116.

    Article  Google Scholar 

  • O’Connor, B. C., Garner, A. A., Peugh, J. L., Simon, J., & Epstein, J. N. (2015). Improved but still impaired: symptom-impairment correspondence among youth with attention-deficit hyperactivity disorder receiving community-based care. Journal of Developmental And Behavioral Pediatrics, 36(2), 106.

    Article  Google Scholar 

  • Ohan, J. L., Leung, D. W., & Johnston, C. (2000). The Parenting Sense of Competence scale: evidence of a stable factor structure and validity. Canadian Journal of Behavioural Science, 32(4), 251.

    Article  Google Scholar 

  • Olsen, L. R., Jensen, D. V., Noerholm, V., Martiny, K., & Bech, P. (2003). The internal and external validity of the Major Depression Inventory in measuring severity of depressive states. Psychological Medicine, 33(2), 351–356.

    Article  Google Scholar 

  • Puffer, E. S., Green, E. P., Chase, R. M., Sim, A. L., Zayzay, J., Friis, E., & Boone, L. (2015). Parents make the difference: a randomized-controlled trial of a parenting intervention in Liberia. Global Mental Health, 2, e15.

    Article  Google Scholar 

  • Setyawan, J., Fridman, M., Grebla, R., Harpin, V., Korst, L. M., & Quintero, J. (2015). Variation in presentation, diagnosis, and management of children and adolescents with ADHD across European countries. Journal of Attention Disorders, https://doi.org/10.1177/1087054715597410.

  • Somech, L. Y., & Elizur, Y. (2012). Promoting self-regulation and cooperation in pre-kindergarten children with conduct problems: a randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 51(4), 412–422.

    Article  Google Scholar 

  • Webster-Stratton, C. H., Reid, M. J., & Beauchaine, T. (2011). Combining parent and child training for young children with ADHD. Journal of Clinical Child & Adolescent Psychology, 40(2), 191–203.

    Article  Google Scholar 

  • Weisz, J. R., Ugueto, A. M., Cheron, D. M., & Herren, J. (2013). Evidence-based youth psychotherapy in the mental health ecosystem. Journal of Clinical Child & Adolescent Psychology, 42(2), 274–286.

    Article  Google Scholar 

  • Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., & Holbrook, J. R. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528.

    Article  Google Scholar 

Download references

Funding

Funding for this study was provided by Trygfonden (Denmark).

Author information

Authors and Affiliations

  1. SFI–The Danish National Centre for Social Research, Herluf Trollesgade 11, DK-1052, Copenhagen, Denmark

    Christoffer Scavenius

  2. Department of Applied Psychology, Steinhardt School of Culture, Education and Human Development, New York University, 246 Greene Street, New York, NY, 10003, USA

    Anil Chacko & E. Parham Horn

Authors
  1. Christoffer Scavenius
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anil Chacko
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Parham Horn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anil Chacko.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at SFI- The Danish National Centre for Social Research and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Scavenius, C., Chacko, A. & Horn, E.P. ADHD Symptoms do not Moderate Outcomes to Behavioral Parent Training Delivered in the Voluntary Sector. J Child Fam Stud 30, 51–64 (2021). https://doi.org/10.1007/s10826-020-01856-5

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-020-01856-5

Keywords

Search

Navigation