Table 5.

Published Non-controlled Studies of Psychosocial Treatments in Preschool Children with Attention Deficit Hyperactivity Disorder: Parent Training

Authors	Age range in years Mean age ± SD)	N/n < 6 years	Procedure for ADHD Diagnosis & Inclusion Criteria	Psychosocial intervention	Study Design/Duration	Outcome Assessment (for ADHD and disruptive behaviors)	Study Outcome
Drash et al., 1976	2–4.8 (2.81)	5/5	Clinical diagnosis of ADHD	Weekly 3-hour parent classes (two mother-child pairs also received direct training), child group training in a classroom setting	Case series, prospective, no control group, open-label treatment/9 months	Parent-rated Behar Preschool Behavior Questionnaire (BPBQ), direct behavior observation during group classroom situation and a standardized task completion activity	Parent-rated BPBQ Hyperactivity and Distractibility subscale scores, decreased from 90th percentile to 52nd percentile, high rates of compliance rates across settings Two children received psychotropic medication
Henry, 1987	4.5–10.5 (7.31)	6/n < 6 years not specified	DSM- III diagnosis of ADHD by a psychiatrist and a psychologist, stabilized on psychostintulant medication	Four 20-minute symbolic modeling sessions with the child followed by six 60-minute combined symbolic modeling and parent training sessions administered	Case study, prospective, no control group, open-label treatment/10 weeks	Parent Conners' Symptom Questionnaire, observation of child compliance to parental task during a structured task	3/5 children improved on the parent ratings of the Conners' Symptom Questionnaire. A combination of medication, symbolic modeling and parent training was more effective than a combination of medication and symbolic modeling or medication alone in reducing noncompliance. Parent training for time-out procedure was most effective. Combined symbolic modeling and medication was not any more effective than medication alone. Gains maintained at 6 months
Erhardt and Baker, 1990	5.2–5.8	2/2	Diagnosed as being hyperactive by the pediatrician, parent score of >15 on the Abbreviated Symptom Questionnaire (CASQ)	Six 2-hour group parent training and four 1-hour individual consultation and parent-child interactive sessions	Case study, prospective, no control group, open-label treatment/10 sessions	Parent ratings on the CASQ Iowa Conners' Rating Scale. Werry-Weiss-Peters Activity Scale (WWPAS), Child Behavior Checklist (CBCL)	Improved parental ratings of hyperactivity, tantrums, aggression, compliance and social functioning
Danforth, 1999	4.0 (Twins)	2/2	DSM IV diagnosis of ADHD and oppositional defiant disorder (ODD), clinical diagnosis by the referring pediatrician	Eight 1-hour weekly parent training sessions using the Behavior Management Flow Chart	Case study, prospective, no control group, open-label treatment/8 sessions	Conners' Rating Scale-Parent (CRS-P), CBCL, Parent Daily Report telephone checklist, direct observation of mother-child interaction	CRS-P Hyperactive Index T scores decreased from 80 to 50 for one twin and remained unchanged for the other twin; increased compliance and decreased aggressive behavior on direct observation of mother-child interaction
Huang et al., 2003	3–6 (5.42 1.1)	23/23	Diagnosis of ADHD on Barkley's semistructured interview questionnaire	Nine 1-hour weekly group parent training sessions and 1 booster session 4 weeks later	Prospective, no control treatment condition, open-label treatment/10 sessions	Disruptive Behavior Rating Scale-Parent Form, Child Attention Profile, and Home Situations Questionnaire	Improved parental ratings for ADHD and ODD symptoms, significant decline in the severity of symptoms and problem behaviors at home. Outcome reported for completers (n = 14, 61% of the recruited sample) only Four children were also taking stimulants during the trial
Chang et al., 2004	4–6 (6 ± 0.8)	8/8	DSM IV diagnosis of ADHD by 2 child psychiatrists	Eight 2-hour weekly group parent training and joint parent-child social skills training group sessions	No control group/8 sessions	No information provided regarding how outcome assessment was conducted	Parents reported improved ADHD behaviors in 3 (37.5%) children; improvement in emotional expression/regulation, less parental frustration and increased satisfaction regarding child's behavior at home.

¹SD not provided.

ADHD = attention-deficit/hyperactivity disorder.