Evaluation of the Family Intervention Service for children presenting with characteristics associated with Attention Deficit Hyperactivity Disorder
Helen Rogers
Victorian Parenting Centre, Melbourne VIC
Warren Cann
Victorian Parenting Centre, Melbourne VIC
Daisy Cameron
Victorian Parenting Centre, Melbourne VIC
Lyn Littlefield
Victorian Parenting Centre, Melbourne VIC
Vince Lagioia
Victorian Parenting Centre, Melbourne VIC
PP: 216 - 225
Abstract
The Victorian Parenting Centre Family Intervention Service (FIS) conducts brief group and individual parent training programs (Triple P) intended as preventative interventions for families of children at risk of developing emotional and behavioural problems.
This paper reports on an evaluation of a Triple P intervention specifically with children exhibiting ADHD characteristics. Pre and post-intervention parental self-report data were analysed for 83 children aged 2 to 15 years. Following the FIS intervention there was a reduction in problem behaviour scores of children perceived to have a high frequency of behaviours typical of ADHD. Mothers also reported reduced depression, anxiety and stress, increased feelings of satisfaction and competency in parenting, less negative parenting behaviour, and reduction in parental conflict. Furthermore, they expressed a high level of satisfaction with the program.
These evaluation findings are consistent with those of controlled investigations of the impact of behavioural family intervention on problematic behaviours of children with ADHD.
Keywords
parent training, program evaluation, Triple P, attention deficit hyperactivity disorder, family intervention
Article Text
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed childhood mental health disorders (Pelham & Gnagy, 1999). Children and adolescents diagnosed with ADHD present with a range of symptoms that fall into two main clusters: inattention-disorganisation and hyperactivity-impulsivity (American Psychiatric Association: APA, 1994; Barkley, 1996). According to the currently used diagnostic criteria for ADHD, there are three subtypes of the disorder: predominantly inattentive, predominantly hyperactive-impulsive, or combined (APA, 1994).
In addition to their primary problems of inattention, impulsivity, and hyperactivity, outcome studies indicate that children diagnosed with ADHD have an increased likelihood of developing chronic social, emotional, and behavioural difficulties, and will manifest more academic problems than non-ADHD children.
The significant impairment experienced by children with ADHD, combined with their negative prognosis and impact on families, highlights the need for effective intervention and treatment. There is scant scientific evidence supporting the use of many treatment methods that have been popularised and promoted at various times in the community. Empirical support, however, does exist for pharmacological interventions, psychosocial interventions, and combined psychosocial-pharmacological interventions (National Health & Medical Research Council, 1997).
The most commonly used intervention for children with ADHD is pharmacological, involving the prescription of stimulant medication (APS, 1997). Psychostimulants have been shown to be effective in reducing the core symptoms of ADHD. However, there has been controversy in Australia and other parts of the world over this form of medical intervention, and alarm over the high levels of stimulants being prescribed, particularly to preschool aged children (Jarman, 1996; Rey, Walter & Hazell, 2000).
Concerns have also been expressed about the diagnosis and labelling processes associated with ADHD. There are dangers in inappropriate diagnosis, especially in young children where the assessment often relies totally on parent report and where it can be difficult to discriminate ADHD symptoms from normal variation in the behaviour and development of young children.
This paper briefly describes the evaluation of a field based behavioural family intervention program to reduce behaviour problems in pre-adolescent children who presented with characteristics typical of ADHD. The data reported are a subset of data from an ongoing evaluation of the Family Intervention Service: Metropolitan Project (FIS). The program targets lower socio-economic areas in Melbourne's northern suburbs and attempts to engage high-risk families by working closely with local primary care and educational services.
The aim of the current study was to examine the impact of the program on children with a high level of behaviours typically associated with ADHD. This question was addressed by analysing existing parent reported pre and post-intervention data for a subset of children whose parents rated them as having high levels of ADHD symptomatology according to a measure of child problem behaviour, the Eyberg Child Behavior Inventory (Eyberg & Pincus, 1999), that is routinely used in Triple P programs.
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