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Behavioral Interventions in Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis of Randomized Controlled Trials Across Multiple Outcome Domains
Open accessAbstract
Objective Behavioral interventions are recommended as attention-deficit/hyperactivity disorder (ADHD) treatments. However, a recent meta-analysis found no effects on core ADHD symptoms when raters were probably blind to treatment allocation. The present analysis is extended to a broader range of child and parent outcomes.Method A systematic search in PubMed, Ovid, Web of Knowledge, ERIC, and CINAHAL databases (up to February 5, 2013) identified published randomized controlled trials measuring a range of patient and parent outcomes for children and adolescents diagnosed with ADHD (or who met validated cutoffs on rating scales).Results Thirty-two of 2,057 nonduplicate screened records were analyzed. For assessments made by individuals closest to the treatment setting (usually unblinded), there were significant improvements in parenting quality (standardized mean difference [SMD] for positive parenting 0.68; SMD for negative parenting 0.57), parenting self-concept (SMD 0.37), and child ADHD (SMD 0.35), conduct problems (SMD 0.26), social skills (SMD 0.47), and academic performance (SMD 0.28). With probably blinded assessments, significant effects persisted for parenting (SMD for positive parenting 0.63; SMD for negative parenting 0.43) and conduct problems (SMD 0.31).Conclusion In contrast to the lack of blinded evidence of ADHD symptom decrease, behavioral interventions have positive effects on a range of other outcomes when used with patients with ADHD. There is blinded evidence that they improve parenting and decrease childhood conduct problems. These effects also may feed through into a more positive parenting self-concept but not improved parent mental well-being.
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“Although behavioural interventions have minimal effects on symptoms of ADHD”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [199]
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“on the basis of a recent meta-analysis of RCTs restricted to blinded outcomes, behavioural interventions are probably best used to complement - not replace - ADHD medication 199 .”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [199]
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“they have a considerable influence on the quality of parenting and co-occurring c onduct problems in children with ADHD 199 .”
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“The substantial drop in SMDs between most proximal and probably blinded analyses for ADHD symptoms is similar to the pattern seen in previous meta-analyses of nonpharmacological treatments using the EAGG protocol (e.g., behavioral intervention;8 neurofeedback14).”
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“However, a recent meta-analysis8 found no effects on ADHD symptoms when only ratings by assessors blind to treatment allocation were considered.”
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Metadata
- Authors
- Daley, D., van der Oord, S., Ferrin, M., Danckaerts, M., Doepfner, M., Cortese, S., & Sonuga-Barke, E. J. S.
- Affiliations
- University of Nottingham (GB)
- KU Leuven (BE)
- Aarhus University (DK)
- Corresponding author
- Daley, David
- Sonuga-Barke, Edmund J.S.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2014-08
- Volume
- 53
- Issue
- 8
- Pages
- 835-847.e5
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2070684312
- Cited by
- 401
- References
- 160
- Citations by year
- 2026: 28 · 2025: 36 · 2024: 32 · 2023: 28 · 2022: 27 · 2021: 36 · 2020: 44 · 2019: 33 · 2018: 35 · 2017: 36 · 2016: 31 · 2015: 23 · 2014: 12
- FWCI
- 4.73
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
- ePrints Soton (University of Southampton) (submittedVersion)
- edoc (University of Basel) (submittedVersion)
- Nottingham Trent University's Institutional Repository (Nottingham Trent Repository) (submittedVersion)
- Lirias (submittedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- attention deficit hyperactivity disorder, behavioral interventions, parenting quality, conduct problems, social skills, academic performance, child outcomes, children and adolescents
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Behavior Therapy, Child, Child Behavior, Humans, Mental Health, Randomized Controlled Trials as Topic, Parenting, Outcome Assessment, Health Care
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