Behavioral Parent Training for School-Aged Children With ADHD: A Systematic Review of Randomized Control Trials.

BACKGROUND: All guidelines for the treatment of ADHD in children include behavioral parent training in combination with other strategies. In the past, several systematic reviews have been carried out that were either outdated or not sufficiently specific to ADHD. We wanted to conduct a new review focusing on a specific ADHD population of school age (4-12 years) and on behavioral and cognitive programs. We aimed to test our hypothesis that behavioral parent training would improve parents' difficulties, children's symptomatology, and the quality of life of families with ADHD. METHODS: PUBMED, PsychInfo, Web of Science, ERIC, and Cochrane databases were searched for original articles on randomized control trials on behavioral parent training group for children with ADHD aged from 4 to 12 years until July 2023. RESULTS: A total of 20 studies were included in the systematic review. The results were divided into four categories: parent data, child data collected by parents, teachers, or researchers. A qualitative analysis revealed for parents, effects on parental stress, feelings of parental efficacy, and negative parental educational behavior. As regard children, only effects are noted for parental assessment, on ADHD symptomatology, externalized disorders, and social skills. CONCLUSION: Despite the heterogeneity or small number of studies in some categories, BPTs have positive effects on both parents and children. There are no convincing results to support the generalization of progress. This would seem to indicate that it remains essential to consider actions specific to each problematic environment for the child.

PENDAH program for parents with children with attention deficit hyperactivity disorder. French adaptation of a behavioral parent training group: pilot study.

Behavioral parent training (BPT) is recognized as an effective part of the care offered to children with attention deficit hyperactivity disorder (ADHD). The aim of this pilot study was to objectively examine the effect that this intervention may have on motor activity, in addition to the measures classically found in this type of study. Parents of 24 school-aged children (6-12 year) with ADHD who met eligibility criteria were enrolled in the study. Before, after and five months after the intervention, we used three-dimensional accelerometers over one-week periods to measure the children's motor activity, and questionnaires for parental stress, quality of life, ADHD symptoms, anxiety and sensory disorders. To measure motor activity, a control group of normotypic children matched for age, sex and socio-professional category was set up. The experimental group showed slight decreases in motor activity compared with the control group, particularly in the classroom. The intervention showed improvements for parents in average stress and quality of life, and for children in average intensity global ADHD symptom, inattention, opposition and aggression, in line with previous studies on the effectiveness of BPT. The trial is the first clinical study to assess the effects of BPT on motor activity in children with ADHD.

Lateralized inhibition of symmetric contractions is associated with motor, attentional and executive processes.

Mirror movements (MM) refer to involuntary contractions occurring in homologous muscles contralateral to the voluntary movements. In right-handers, greater MM occur in the right hand during movements of the non-dominant left hand than conversely. However, it remains to know if such behavioural asymmetry of MM relies only on motor processes or if it is also related to attentional and executive processes. This study explores MM behavioural asymmetry and its cerebral correlates with electroencephalography in 14 right-handed healthy adults. We investigated the quantity and the intensity of MM and the associated task-related power changes in the beta band over central regions (motor processes), in the alpha band over the parietal regions (attentional processes) and in the theta band over frontal regions (executive processes). Behavioural results revealed greater MM in the right hand when the left hand was active than the reverse. This behavioural asymmetry was associated with asymmetry in the cortical activations over motor areas. Greater MM in the right hand correlated with activation over the contralateral left motor region, revealing that selective inhibition of one hand induced activation of the motor cortex leading to MM. In addition, increased cortical activations over parietal and fronto-mesial regions suggest that an increase of attentional and executive processes is required to inhibit one hand, independently of its side. All in all, this study highlights that side-specific motor and non-side-specific attentional and executive processes are associated to the MM asymmetry.