Outcome of parent-mediated treatment of preschoolers with attention deficit disorder with hyperactivity.

Despite the early onset of attention deficit disorder with hyperactivity (ADDH), there is a dearth of treatment studies with preschoolers with this disorder. Forty-six families with ADDH preschoolers were randomly assigned to either an immediate or a delayed group parent training program aimed at improving child compliance. Groups were balanced on demographic variables. Treatment outcome was evaluated by comparing the groups at pre- and posttreatment and 3-month follow-up on measures of parent-child interactions during free play, a compliance task, and parent-supervised activities, as well as on parent-completed Conners Hyperkinesis Index scores. Positive treatment effect was obtained on measures of compliance, parental style of interaction, and management skills. These improvements were maintained at 3-month follow-up. Evaluation of treatment effects on nontargeted child behaviors indicated no generalization.

The role of parent training in treatment of preschoolers with ADDH.

The efficacy of group parent training was assessed in improving compliance and time on task in preschoolers with attention-deficit disorder with hyperactivity. Positive effects were obtained on measures of child compliance, but not on measures of attention. Parental compliance-management skills and overall style of interaction were also positively affected. The use of parent training for early intervention with ADDH children is discussed.

Gender differences in response to a physical activity intervention in overweight and obese children.

BACKGROUND: This study evaluated the effects of gender on response to a behavioral intervention that rewarded increases in physical activity (PA) with increases in access to TV viewing. METHODS: We performed a secondary analysis of a clinical trial that randomized 30 overweight or obese, 8- to 12-year-old children to an intervention (8 boys, 6 girls) or control (7 boys, 9 girls) group. Participants wore accelerometers every day for 8 weeks and attended biweekly meetings to download the activity monitors. For the intervention group, accumulating 400 counts of PA on accelerometers earned 1 hour of TV time, which was controlled by a Token TV electronic device. Controls wore activity monitors but had free access to TV. RESULTS: Compared with girls, boys in the intervention group exhibited greater increases in overall daily PA counts (110% versus 40%, P < .05) and minutes per day of moderate-to-vigorous physical activity (MVPA; +18.1 versus +2.7, P < .05). Neither boys nor girls in the control group showed significant changes in overall PA or intensity of PA. CONCLUSION: Wearing an accelerometer in combination with rewarding PA with TV might be a more effective intervention for increasing overall PA and time spent in MVPA in overweight and obese boys than it is for overweight or obese girls.

Effects of modifying physical activity and sedentary behavior on psychosocial adjustment in overweight/obese children.

OBJECTIVES: To evaluate the relationship between changes in physical activity (PA), sedentary behavior, and physical self-perceptions and global self-worth in 30, 8-12 years old, overweight/obese children (13 boys, 17 girls). METHODS: Secondary analyses from a randomized controlled trial designed to increase PA and reduce sedentary behavior. PA was measured by accelerometers worn by participants every day for 8 weeks. Sedentary behavior, defined as minutes per day spent in television viewing, was assessed by self-report. RESULTS: Increases in PA were associated with increases in perceived physical conditioning (r = .54, p < .01), body satisfaction (r = .55, p < .01), and overall physical self-worth (r = .44, p < .05) independent of changes in body mass index (BMI). Reductions in TV viewing were also related to increased physical and global self-worth. CONCLUSIONS: Increases in PA are associated with improvements in physical self-perceptions but not global self-worth, while reductions in TV viewing are associated with increased physical and global self-worth, and these psychosocial benefits appear to be independent of changes in adiposity.

Effects of open-loop feedback on physical activity and television viewing in overweight and obese children: a randomized, controlled trial.

OBJECTIVES: Television viewing and physical inactivity increase the risk of obesity in youth. Thus, identifying new interventions that increase physical activity and reduce television viewing would be helpful in the prevention and treatment of pediatric obesity. This study evaluated the effects of open-loop feedback plus reinforcement versus open-loop feedback alone on physical activity, targeted sedentary behavior, body composition, and energy intake in youth. METHODS: Thirty overweight or obese 8- to 12-year-old children were randomly assigned to an intervention (n = 14) or control group (n = 16). Participants wore accelerometers every day for 8 weeks and attended biweekly meetings to download the activity monitors. For children in the open-loop feedback plus reinforcement (intervention) group, accumulating 400 counts of physical activity on pedometers earned 1 hour of television/VCR/DVD time, which was controlled by a Token TV electronic device. Open-loop feedback control subjects wore activity monitors but had free access to targeted sedentary behavior. RESULTS: Compared with controls, the open-loop feedback plus reinforcement group demonstrated significantly greater increases in daily physical activity counts (+65% vs +16%) and minutes per day of moderate-to-vigorous physical activity (+9.4 vs +0.3) and greater reductions in minutes per day spent in television viewing (-116.1 vs +14.3). The intervention group also showed more favorable changes in body composition, dietary fat intake, and energy intake from snacks compared with controls. Reductions in sedentary behavior were directly related to reductions in BMI, fat intake, snack intake, and snack intake while watching television. CONCLUSIONS: Providing feedback of physical activity in combination with reinforcing physical activity with sedentary behavior is a simple method of modifying the home environment that may play an important role in treating and preventing child obesity.