Evidence-Based Psychosocial Treatments for Attention-Deficit/Hyperactivity Disorder

Abstract

Pelham, Wheeler, and Chronis (1998) reviewed the treatment literature on attention-deficit/hyperactivity disorder (ADHD) and concluded behavioral parent training (BPT) and behavioral classroom management (BCM) were well-established treatments for children with ADHD. This review updates and extends the finding of the prior review. Studies conducted since the 1998 review were identified and coded based on standard criteria, and effect sizes were calculated where appropriate. The review reinforces the conclusions of Pelham, Wheeler, and Chronis regarding BPT and BCM. Further, the review shows that intensive peer-focused behavioral interventions implemented in recreational settings (e.g., summer programs) are also well-established. The results of this update are discussed in the context of the existing treatment literature on ADHD. Implications for practice guidelines are suggested, as are directions for future research.

During the preparation of this article, Dr. William Pelham was supported in part by grants from the National Institute of Health (MH62946, MH69614, MH53554, MH69434, MH65899, MH78051, MH062946, NS39087, AA11873, DA12414-01A2, HD42080) and the Department of Education, Institute of Educational Sciences (IES; R305L0300065A). Both authors were additionally supported in part by the IES (R324J06024, R324B06045), and the National Institute of Health (MH78051, and MH62988).

Notes

Note: ES = effect size; BI = behavioral interventions; BPT = parent training; SST = social skills training; N/A = not applicable; STP = summer treatment program; MPH = methylphenidate; PT = parent training; BCM = behavioral classroom management.

^a 1 = Parent–child observations, 2 = parent ratings, 3 = parental functioning, 4 = family functioning, 5 = classroom observations, 6 = teacher ratings, 7 = academic productivity, 8 = academic achievement, 9 = cognitive tests, 10 = peer relationships, 11 = child self-ratings, 12 = clinician ratings, 13 = consumer satisfaction ratings, 14 = behavior frequency counts, 15 = activity-level measures, 16 = recreational setting observations.

^b Contributed to criteria for behavioral parent training.

^c Contributed to criteria for contingency management in peer/recreational settings.

^d In addition to the MTA primary outcome study, numerous other studies report on treatment related outcomes, the total of which would comprise their own review. For a representative sample, see Arnold et al. (2003); Conners et al. (2001); Hinshaw et al. (2002); Hoza et al. (2000);Jensen et al. (2001); MTACG (1999a, 1999b, in press); Owens et al. (2003); and Swanson et al. (2001).

^e Contributed to criteria for contingency management in classroom settings.

^f Separate reports from the same study.

^g These ES are an underestimate because one participant's ES could not be computed because of the mean and standard deviation in the no-treatment condition being 0%, but this child evidenced large behavioral improvement favoring BI.

^h Estimated ES from graphs of on-task behavior for the response cost token economy condition.