Children are vulnerable to many developmental and growth disorders, one of which includes the attention deficit hyperactivity disorder. A mental disorder specifically attributed to afflictions of neurodevelopment, ADHD is characterized by attention paying deficiencies, excessive activity and behavior that contradicts the individual’s age. Normally a disorder that affects, ADHDis highlighted by its potential interruption with a child’s development physically, mentally and academically. A child suffering from this order is usually faced with problems acclimatizing to some social settings like school or participating in recreational activities. According to WHO (World Health Organization), as of 2013, 39 million around the globe were affected by this order with the majority being children. ADHD is usually more apparent and pronounced in boys than girls (3:1) and sometimes the symptoms are manifested into adulthood. Nevertheless, despite being one of the most common development disorders and certainly the most studied, the specific causes of ADHD are still unknown. However, many studies have been conducted in an effort to discover the causes of the disorder and some of its treatments and interventions. As such, this paper will offer a research review on ADHD by reviewing five articles that focus on ADHD and mainly its treatments and interventions.
The first article under review is Early Intervention for Preschoolers at Risk for Attention-deficit/Hyperactivity disorder: Preschool First Step to Successauthored by researchers Feil, Small, Seeley, Walker and Golly. This study focused on PFS (Preschool First Step) as a method of intervention to prevent children from developing ADHD. The PFS is an intervention methodology that targets children aged 3-5 years facing the problems of externalizing behavior. The idea of this study is to analyze whether using PFS can eradicate the problem of externalizing behavior which is related to ADHD. Objectives of the study includeddetermining whether PFS was actually effective in improving the social functioning and general behavior of preschoolers with evident externalizing behavior and with the risk of developing ADHD. Another objective is to highlight whether PFS is effective in improving social functioning and general behavior directly associated to ADHD. The research uses a subsample of 45 children from 126 used in previous, related study. Each participant was chosen by teacher who testified evidence of signs of ADHD. The subsample of the 45 children chosen had shown the signs of the symptoms of elevated comorbid ADHD. Data was collected and recorded on Conner’s ADHD scales. During the whole process of the study, results were recorded from teacher and parent related or reported measures. Results showed a significant decrease in behavior problems and an increase in social skills as reported by teachers and parents post-intervention. Nevertheless, effect sizes for teachers’ recordings were more positive than parents, especially in social competency indicators, more so those related to ADHD. PFS was designed for all individuals and not specifically this age group; nevertheless, it illustrated success at this level.(Edward G. Feil, Jason W. Small, John R. Seeley, Hill M. Walker, & Annemieke Golly, 2016)
The second article on review is Evidence-Based Psychological Treatments for Children and Adolescents with Attention-Deficit/Hyperactivity Disorderwritten by Evans, Owens and Bunford. This study focuses on the review of evidence-based practices seeking to establish evidence for psychological treatment of ADHD. As such, the researchers completed a systematic review of literature that was published between the years 2007 and 2013; it was an update on Pelham and Fabiano (2008). The objectives of the study include determining the current evidence for psycho-social interventions for ADHD affected children. Another objective includes identifying dynamics that can influence the study of any psychological treatments for ADHD. The study uses the criteria established by the Society of Clinical Child and Adolescent Psychology to identify any articles relevant to the study. In addition, the researchers separate behavioral management from training intervention to extend the conceptualization of treatment research. The study uses five criteria to identify the studies including group design, definition of variables, clarification of population, assessment of outcomes and analysis of adequacy then grouping the studies into the well-established, probably efficacious, possibly efficacious and experimental treatments. According to the results, organization training was a well-established treatment, neurofeedback training was possibly efficacious, combined training programs were possibly efficacious and cognitive training were experimental treatments. Also, the researchers were able to establish that like the previous study foundout;behavioral classroom management, behavioral parent training, and behavioral peer interventions were treatment methodologies that aligned with the well-established treatment criteria.(Steven W. Evans, Julie Sarno Owens, and Nora Bunford, 2014)
The third article under review is A Randomized Controlled Trial of a Play-Based Intervention to Improve the Social Play Skills of Children with Attention deficit Hyperactivity disorder written by Wilkes-Gillan, Bundy, Cordier, Lincoln and Chen. This article focuses on social interventions, play-based intervention, that can be use aid to children suffering from ADHD. It purposely aims to investigate the effectiveness of play in improving the social play skills of children who are affected by attention deficit hyperactivity disorder in peer to peer interactions.It seeks to understand and examine some intervention methodologies like play-based methodologies that can help socially. Objectives of the study included the change in play skills of children suffering from ADHD upon introduction to the intervention group over 10 weeks. Others included the overall change in play after the experiment and the change in social skills post-study. 29 children participateddivided into two cohorts consisting of children who were randomized to an intervention first (n=15) and the other group of 14 children (n=14) were randomized into a control-first intervention group. Notably, the children placed in the second group had to wait for 10 weeks before receiving the intervention. Six play clinic sessions, and weekly home modules coupled a month home follow up were utilizedduring the 10-week period. Top (Test of Playfulness) during the study while ANOVA, Cohen’s –d,and post hoc least Significance difference tests were utilized in measuring of the effects. Friedman’s ANOVA also analyzed the changes in the ToP social items. Also, the researchers utilize linear regression analysis to identify any variables that could predict change. Results illustrated that the intervention-first group showed significantly higher change than the control-first groupduring the wait period. ToP mean of both groups after the intervention were significantly higher. There was a large positive difference between pre and post intervention.The results illustrated that play can be utilized as an effective method of intervention. (Sarah Wilkes-Gillan, Anita Bundy, Reinie Cordier, Michelle Lincoln & Yu-Wei Chen, 2016)
Another study on review is Evidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety written by Higa-McMillan, Francis, Rith-Najarian and Chorpita. This study focuses on studying treatments for anxiety disorders spanning over 50 years. Objectives of the study are to identify the treatments of anxiety disorders by evaluating studies on the treatments available. The study examined 111 studies on treatment outcomes that tested 204 treatments conditions to deal with ADHD. Notably, the researchers utilized the PracticeWise Evidence-Based Services database. Part of the criteria was the study had to have been published between 1967 and the present time. In addition, only studies conducted with children or adolescents (ages 1-19) were included who were suffering from avoidance problems or anxiety problems. The strength of the evidence was studied; effectiveness indicators among treatments families were also studied while also the moderators of the final outcome were examined. From the results, six treatments were identified as well established, 8 as probably efficacious, 2 as possibly efficacious, 6 as experimental and 8 with questionable efficacious. After the overall study CBT (cognitive-behavioral therapy) was identified as the most viable, first-line of treatment. Also, the emergence of other probably efficacious treatments illustrated the presence of other alternative treatments for those children not responding to cognitive-behavioral therapy.(Charmaine K. Higa-McMilan, Sarah E. Francis, Leslie Rith-Najarian & Bruce F. Chorpita, 2016)
The final study is a 14-Month Randomized Clinical Trial for Treatment Strategies for Attention-deficit/Hyperactivity disorder written by the MTA Cooperative Group. Objectives of this study were to investigate the effectiveness of behavior therapy and pharmacotherapy in the treatment of ADHD. There were 579 participants who were children aged 7 to 9.9 years all affected by ADHD. The children were taken through a 14 months period of treatment with medication management and intensive behavioral treatment (inclusive of parents and school). The children were then treated with the combination of the two or using the standard community care. Outcome of the study were then assessed at the end, during and beginning of the treatments to have viable results. Notably, the researchers used regression procedures related to intent-to-treat to analyze the data. According to the results symptoms of ADHD reduced significantly overtime with significant difference between pre and post treatment. Combined treatment was found to be more effective than intensive behavioral treatment but medication management was not. Combined treatment may also be effective for non-ADHD symptoms.(MTA, 1999)
Thoughts on the articles
All the articles indicate in-depth knowledge of the issues of ADHD and its treatment and intervention methodologies. However, each article has its own basis of study thus they cannot be associated. As such, there are different views for each article, including.The first article is well crafted and the research is credible with this intervention methodology proving successful in curbing ADHD among this population. This research would enable me to understanddynamics of ADHD and how PFS can be applied to combat the disorder. The second article greatly elaborates on the psychological treatments of ADHD although it fails to clearly identifying which treatments would be effective at which circumstances and to people of what age. In terms clinical relevance, this article offers the opportunity to identify the unflappable psychological treatments by placing them in the viability levels.The third article clearly illustrates that there are positive effects of using play as an intervention method when dealing with ADHD. This study can be useful in controlling ADHD affected children in a social environment by enhancing their social play skills.The fourth article is well written and all the studies are credible and the analyzing process viable. In terms of clinical relevance, this article can play a huge role in identifying the best treatment as it analyzes numerous credible studies. The fifth article was well written and illustrated that combined treatment was the most viable method of treatment although it did not produce significantly more benefits than when using medication management. Clinically, the article avails a range of information that can be useful in treating ADHD although the results are not very promising. All the thoughts of the articles combined illustrate progress in the search for treatment and intervention but also some mishaps. It is clear from the studies that there are different methodologies of treating ADHD and each effective in its own right. As such, it is vital to evaluate where each study fits or where it is most effective.
All the five studies offer information on ADHD, its treatments and interventions. All the studies are well written and offer credible evidence on the viability of each of the treatments they represent. The findings of the combined articles illustrated that there are different methodologies to treat ADHDand are all viable under different circumstances. Similarities of the articles are in the way they all seek to understand which treatment is more viable. On the other hand, the articles are different because they all get different results. Nevertheless, the articles illustrate some future implications including the lack of a viable treatment for ADHD. Each article proposes a different type of treatment as the best. Such contradictions indicate that knowing the best treatment is a problem. Nevertheless, the studies have provided a foundation which other researchers can use to consistently understand how best to treat ADHD. As a researcher, in the future, due to contradictions on the best treatment or intervention, I would carry out an extensive research in each treatment deemed most successful by each article and looked for the best. Such a study would reduce the need for study to evaluate the best treatment while it would also offer the chance for quicker treatment. In addition, it would avail other alternatives by illustrating the other treatments that follow the main treatment.
Charmaine K. Higa-McMilan, Sarah E. Francis, Leslie Rith-Najarian & Bruce F. Chorpita. (2016). Evidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety. Journal of Clinical Child and Adolescent Psychology, 45(2).
Edward G. Feil, Jason W. Small, John R. Seeley, Hill M. Walker, & Annemieke Golly. (2016). Early Intervention for Preschoolers at Risk for Attention-Deficit/Hyperactivity Disorder: Preschool First Step to Success. Behavioral Disorders, 41 (2) 95-106.
MTA. (1999). A 14-Month Randomized Clinical Trial of Treatment Strategies for Attention-deficit/hyperactivity disorder. Arch Gen Psychiatry, 56(12).
Sarah Wilkes-Gillan, Anita Bundy, Reinie Cordier, Michelle Lincoln & Yu-Wei Chen. (2016). A Randomized Controlled Trial of a Play-Based Intervention to Improve the Social Play Skills of Children with Attention deficit/hyperactivity disorder. PLoS ONE, 11(8) 1-23.
Steven W. Evans, Julie Sarno Owens, and Nora Bunford. (2014). Evidence-Based Psychosocial Treatments for Children and Adolescents with Attention-Deficit. Journal of Clinical Child and Adolescent Psychology, 43(4), 527-551.