Attention-Deficit/Hyperactivity Disorder (ADHD) has always been a topic of concern among parents and educators. Dr Alma Au May-lan, Associate Professor at Department of Applied Social Sciences and Director of the Yan Oi Tong Au Suet Ming Child Development Centre, shared the findings of a joint study on the efficacy of the behavioural management training for parents of ADHD children implemented in the collaborating organization.

Why did you conduct this study focusing on ADHD?

There is growing concern both internationally and locally about the need to develop evidence-based interventions beyond the widely accepted pharmacological treatment for ADHD. Furthermore, with the world-wide impetus for developing more inclusive and diversified models of education for children with special needs, it becomes increasingly important not only to control symptoms, but also to find ecologically valid ways for optimizing cognitive, emotional and social functioning of children with ADHD. Parental training has been recommended in the guidelines for National Institute for Health and Care Excellence.

As a research institute having expertise in this field, our team at the Department of Applied Social Sciences is invited to collaborate with a local leading non-governmental organization which has been conducting systematic training for parents of children with ADHD since 2007 to evaluate the efficacy of the training services it offers. Recommendations are also made for Social Welfare Department’s reference.

Please briefly introduce the background of the study.

The current study was designed to examine the effectiveness of an eight-session behavioural management training programme for parents of children with ADHD at local community setting. Children’s disruptive behaviours and the reported parental stress were measured to evaluate its effectiveness. The sustainability of its effectiveness was also evaluated two months after the intervention. Hypotheses include: (1) fewer post-intervention child disruptive behaviours, in terms of both intensity and complexity, than the waitlist control group and (2) lower post-intervention parental stress than the waitlist control group. Among 183 participating parents having children with ADHD aged between 5 to 12 years old, 130 were in the intervention group and 53 in the waitlist control group. 

In addition to demographic data analysis, cognitive assessments on visual and auditory attention and non-verbal intelligence were conducted on children with ADHD. All participating parents were also required to rate child behaviour and parental stress during pre-intervention, post-intervention and the two-month follow-up sessions. 

What is “behavioural management training” mentioned in this study?

Parent behavioural management training for ADHD focused on enhancing parenting skills and child’s behaviour has three parts. First, behavioural features and difficulties encountered by children with ADHD are introduced so that parents will have deeper and more sympathetic understanding of their children. Then, a repertoire of hands-on skills on paying attentions and giving instructions are shared to facilitate children’s optimal functioning. Finally, the importance of and methods for emotional regulation of both parents and children are reinforced.

What are the findings of this study?

The programme was found to be significantly effective in reducing the ratings of child disruptive behaviour through the evaluation tool named Eyberg Child Behaviour Inventory. However, no significant progress was found for reducing parental stress. Treatment effect did not differ significantly with the age, education and socio-economic status of the parents or the cognitive functioning of the child. At the follow-up, the treatment effect on ratings of the number of disruptive behaviours was maintained but not on the intensity score.

These results would suggest that the present programme is useful in reducing negative perception of the disruptive behaviours of the child with ADHD. However, effective reduction of parental stress requires more than an eight-session programme. Finally, continued support is definitely needed to maintain initial treatment gains. Our team will soon be starting a follow-up study to develop and validate longer-term support programmes for these parents in the community setting.