Long-term effects of parental skills training for behavioral modification of children with attention deficit hyperactivity disorder
DOI:
https://doi.org/10.64838/jmht.2025.280887Keywords:
ADHD, behavioral modification, long-term effects, parental skillsAbstract
Objective: To examine the long-term effects of a parent skills training (PST) program on the behaviors of children with Attention Deficit Hyperactivity Disorder (ADHD)
Methods: A longitudinal prospective follow-up study was employed among parents of children with ADHD who had previously participated in a quasi-experimental study of a PST program during 2023 - 2024. The first group (n = 30) received a 6-week PST program in addition to usual care, while the second group (n = 30) received only usual care. Children’s inattention, hyperactivity/impulsivity, and oppositional defiant behaviors of children were assessed at 3 months, 6 months, and 1 year post-intervention using the Swanson, Nolan, and Pelham IV (SNAP-IV) scale. Data were analyzed using independent t-tests and analysis of covariance (ANCOVA).
Results: A total of 60 participants were included, most of whom were mothers, with a mean age of 38.80 ± 8.03 years. At 3-month, 6-month, and 1-year follow-up, means scores of all three children’s ADHD behavioral domains in the PST group were significantly lower than baseline and significantly lower than those of the usual-care group during the same period. ANCOVA, adjusted for baseline scores, showed significant changes in all domains within the PST group across the three follow-up periods, while there was no significant changes in the usual-care group.
Conclusion: The PST program added to usual care demonstrated sustained effectiveness for up to 1 year in reducing ADHD behaviors compared with usual care alone.
Downloads
References
Rajaprakash M, Leppert ML. Attention-deficit/hyperactivity disorder. Pediatr Rev. 2022;43(3):135-47. DOI: https://doi.org/10.1542/pir.2020-000612
Young S, Cocallis K. ADHD and offending. J Neural Transm (Vienna). 2021;128(7):1009-19. DOI: https://doi.org/10.1007/s00702-021-02308-0
Peterson BS, Trampush J, Maglione M, Bolshakova M, Rozelle M, Miles J, et al. Treatments for ADHD in Children and Adolescents: A Systematic Review. Pediatrics. 2024;153(4):e2024065787. DOI: https://doi.org/10.1542/peds.2024-065787
Danielson ML, Claussen AH, Bitsko RH, Katz SM, Newsome K, Blumberg SJ, et al. ADHD prevalence among U.S. children and adolescents in 2022: diagnosis, severity, co-occurring disorders, and treatment. J Clin Child Adolesc Psychol. 2024;53(3):343-60. DOI: https://doi.org/10.1080/15374416.2024.2335625
Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345-65. DOI: https://doi.org/10.1111/jcpp.12381
Wisanuyothin T. Prevalence of ADHD in Thailand. Journal of Mental Health of Thailand 2013;21(2):66-75. (In Thai)
Claussen AH, Holbrook JR, Hutchins HJ, Robinson LR, Bloomfield J, Meng L, et al. All in the family? a systematic review and meta-analysis of parenting and family environment as risk factors for attention-deficit/hyperactivity disorder (ADHD) in children. Prev Sci. 2024;25(Suppl 2):249-71. DOI: https://doi.org/10.1007/s11121-022-01358-4
Penuelas-Calvo I, Palomar-Ciria N, Porras-Segovia A, Miguélez-Fernandez C, Baltasar-Tello I, Colmenero SP, et al. Impact of ADHD symptoms on family functioning, family burden and parents’ quality of life in a hospital area in Spain. Eur J Psychiatry. 2021;35(3):166-72. DOI: https://doi.org/10.1016/j.ejpsy.2020.10.003
Zhao X, Page TF, Altszuler AR, Pelham WE 3rd, Kipp H, Gnagy EM, et al. Family burden of raising a child with ADHD. J Abnorm Child Psychol. 2019;47(8):1327-38. DOI: https://doi.org/10.1007/s10802-019-00518-5
Evans S, Ling M, Hill B, Rinehart N, Austin D, Sciberras E. Systematic review of meditation-based interventions for children with ADHD. Eur Child Adolesc Psychiatry. 2018;27(1):9-27. DOI: https://doi.org/10.1007/s00787-017-1008-9
Zarakoviti E, Shafran R, Papadimitriou D, Bennett SD. The efficacy of parent training interventions for disruptive behavior disorders in treating untargeted comorbid internalizing symptoms in children and adolescents: a systematic review. Clin Child Fam Psychol Rev. 2021;24(3):542-52. DOI: https://doi.org/10.1007/s10567-021-00349-1
Chongsuksiri P, Apinuntavech S, Punyapas S. One-year follow-up of parent management training program for children with externalizing behavior problems. Journal of the Psychiatric Association of Thailand. 2019;64(2):163-76. (in Thai)
Mihandoost Z. Treatment programs for students with attention deficit hyperactivity disorder: a meta-analysis study. Iran J Psychiatry Behav Sci. 2015;9(3):e1840. DOI: https://doi.org/10.17795/ijpbs-1840
Kolb D. Experiential learning: experience as the source of learning and development. Englewood Cliffs (NJ): Prentice-Hall; 1984.
Juengsiragulwit D, Chaiudomsom C, Rueng P, Poowichai C. A pilot study of the efficacy of group teacher training for behavioral modification in school-aged children at-risk for emotional and behavioral problems. Journal of the Psychiatric Association of Thailand. 2018;63(2):115-26. (in Thai)
Saboonma J, Rodcumdee B, Suktrakul S. The effect of group experiential learning for parents on aggressive behaviors of children with attention-deficit/hyperactivity disorder. Journal of Nursing Science. 2012;30(2):23-34. (in Thai)
Seehapanya K, Suebpha N. Effects of parent skills training program for modifying the behavior of children with attention deficit hyperactivity disorder. Journal of Boromarajonani College of Nursing, Surin. 2024;14(2):42-63. (in Thai)
Pityaratstian N, Booranasuksakul T, Juengsiragulwit D, Benyakorn S. ADHD screening properties of the Thai version of swanson, nolan, and pelham iv scale (SNAP-IV) and strengths and difficulties questionnaire (SDQ). Journal of the Psychiatric Association of Thailand. 2014;59(2):97-110. (in Thai)
Mishra P, Pandey CM, Singh U, Gupta A, Sahu C, Keshri A. Descriptive statistics and normality tests for statistical data. Ann Card Anaesth. 2019;22(1):67-72. DOI: https://doi.org/10.4103/aca.ACA_157_18
Rimestad ML, Lambek R, Zacher Christiansen H, Hougaard E. Short- and long-term effects of parent training for preschool children with or at risk of ADHD: a systematic review and meta-analysis. J Atten Disord. 2019;23(5):423-34. DOI: https://doi.org/10.1177/1087054716648775
Chronis-Tuscano A, Wang CH, Woods KE, Strickland J, Stein MA. Parent ADHD and evidence-based treatment for their children: review and directions for future research. J Abnorm Child Psychol. 2017;45(3):501-17. DOI: https://doi.org/10.1007/s10802-016-0238-5
Dekkers TJ, Hornstra R, van der Oord S, Luman M, Hoekstra PJ, Groenman AP, et al. Meta-analysis: which components of parent training work for children with attention-deficit/hyperactivity disorder? J Am Acad Child Adolesc Psychiatry. 2022;61(4):478-94. DOI: https://doi.org/10.1016/j.jaac.2021.06.015
Sharma S, Govindan R, Kommu JVS. Effectiveness of parent-to-parent support group in reduction of anxiety and stress among parents of children with autism and attention deficit hyperactivity disorder. Indian J Psychol Med. 2022;44(6):575-9. DOI: https://doi.org/10.1177/02537176211072984
Pfiffner LJ, Rooney ME, Jiang Y, Haack LM, Beaulieu A, McBurnett K. Sustained effects of collaborative school-home intervention for attention-deficit/hyperactivity disorder symptoms and impairment. J Am Acad Child Adolesc Psychiatry. 2018;57(4):245-51. DOI: https://doi.org/10.1016/j.jaac.2018.01.016
Yap M, Jorm A, Bazley R, Kelly C, Ryan S, Lubman D. Web-based parenting program to prevent adolescent alcohol misuse: rationale and development. Australas Psychiatry. 2011;19(4):339-44. DOI: https://doi.org/10.3109/10398562.2011.603334
Janz NK, Becker MH. The health belief model: a decade later. Health Educ Q. 1984;11(1):1-47. DOI: https://doi.org/10.1177/109019818401100101
Wattanasoontorn P, Wattanaburanon A, Sitakalin P, Jaidee W. Knowledge and health belief model affecting fever management in children of caregivers. Journal of Liberal Arts Maejo University. 2022;10(2):70-86. (in Thai)
Kerdsangs U. The development of the health belief enhancement program on health belief perception and positive aspects of caregiving among caregivers of patients with schizophrenia. Interdisciplinary Academic and Research Journal. 2023;3(3):299-320. (in Thai)
Kummabutr J, Phuphaibul R, Nityasuddhi D, Suwonnaroop N. One-year follow-up effects of a parent training program in conjunction with a life skills training program on the life skills of school-age children. Journal of The Royal Thai Army Nurses. 2018;19(1):221-32. (in Thai)
D'Aiello B, Di Vara S, De Rossi P, Vicari S, Menghini D. The effect of a single dose of methylphenidate on attention in children and adolescents with ADHD and comorbid Oppositional Defiant Disorder. PLoS One. 2024;19(8):e0299449. DOI: https://doi.org/10.1371/journal.pone.0299449
Klein O, Walker C, Aumann K, Anjos K, Terry J. Peer support groups for parent-carers of children with attention deficit hyperactivity disorder: the importance of solidarity as care. Disabil Soc. 2019;34(9-10):1445-61. DOI: https://doi.org/10.1080/09687599.2019.1584090
Webster-Stratton C, Reid MJ. The Incredible Years parents, teachers, and children training series: a multifaceted treatment approach for young children with conduct problems. In: Weisz JR, Kazdin AE, editors. Evidence-based psychotherapies for children and adolescents. 3rd ed. New York: The Guilford Press; 2018. p. 122-41.
Kuppens S, Ceulemans E. Parenting styles: a closer look at a well-known concept. J Child Fam Stud. 2019;28(1):168-81. DOI: https://doi.org/10.1007/s10826-018-1242-x
Vasiou A, Kassis W, Krasanaki A, Aksoy D, Favre CA, Tantaros S. Exploring parenting styles patterns and children's socio-emotional skills. Children (Basel). 2023;10(7):1107. DOI: https://doi.org/10.3390/children10071126
Valerie V, Wijaya E, Setiawan A, Astiarani Y, Surya J. Association between parental stress and adolescent behavior mediated by parenting style in public junior and senior high school students in North Jakarta. Paediatr Indones. 2024;64(1):61-70. DOI: https://doi.org/10.14238/pi65.1.2025.61-70
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Journal of Mental Health of Thailand
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
- Authorization to photocopy items for internal or personal use of specific clients, is granted. The consent does not extend to other kinds of copying, such as for general distribution, for advertising, or for resale.
- Unless otherwise states, the views and opinion expressed in Journal of Mental Health of Thailand are those of authors of the papers, and do not represent those of the editorial board or the Department of Mental Health.
