Skip to main content
. 2019 Jun 21;2019(6):CD008223. doi: 10.1002/14651858.CD008223.pub3

Yuk‐chi 2005.

Methods Design: RCT
Participants Country: China
Setting: community mental health centre: outpatient clinic in Hong Kong
Sample size calculation: based on prior research, the assumption was made that effect sizes would be small to moderate, calculations showed that approximately 45 participants were required in each group.
Sample size: 90 children
Sex: 77 (90%) = boys, nine (10%) = girls (group one: 39 (87%) = boys, six (13%) = girls; group two: 38 (93%) = boys, three (7%) = girls)
Age: range = seven to 9.9 years, mean = eight years (SD = 0.95) (group one; mean = 7.87 years (SD = 0.77); group two: mean = 8.15 years (SD = 1.11))
Ethnicity: Chinese children
Socioeconomic status: mothers education: elementary or less = 17 (20%), junior high = 20 (23%), high school = 45 (50%), college = four (5%) (group one: elementary or less = six (13%), junior high = 10 (22%), high school = 28 (62%), college = one (2%), group two: elementary or less = 11 (27%), junior high = 10 (24%), high school = 15 (37%), college = three (7%))
IQ: Hong Kong WISC, short form, mean = 111.69 (SD = 13.5) (group one: mean = 111.2 (SD = 13.7); group two: mean = 112.25 (SD = 13.4))
ADHD diagnosis: ADHD combined type required for inclusion
ADHD medication: all participants received methylphenidate treatment
Comorbidity: anxiety = 29%, depression = 6%, ODD = 50%, CD = 6% (group one: anxiety = 27%, depression = 7%, ODD = 60%, CD = 9%, group two: anxiety = 32%, depression = 5%, ODD = 39%, CD = 2%)
Medications for comorbid disorders: not reported
Inclusion criteria:

  1. ADHD‐combined type based on DSM‐IV criteria

  2. seven to 9.9 years of age

  3. studying first to fourth grade

  4. living with a parent, who is the major caretaker

  5. IQ > 80

  6. no significant physical disability

  7. no stimulant medication (methylphenidate) use for more than two weeks previously

  8. parents willingness to accept stimulant medication and psychosocial intervention of this study

  9. parents willingness to accept random allocation

  10. no parent suffering from intellectual impairment or current psychosis


Exclusion criteria: refusal of group one intervention due to parental difficulties to apply leave from work
Baseline characteristics: no significant differences between the two treatment groups in demographic and socioeconomic status, comorbid conditions, and additional intervention received in the first six months of the treatment. No information about between group differences in the medical treatment
Interventions 90 children with ADHD allocated to one of two groups

  1. Group one (n = 45): methylphenidate + psychosocial treatment consisting of three components

    1. Child training*: which provided a rich direct contingency management environment, in which the training of problem‐solving's skills and anger control management was provided. All sessions were videotaped to check treatment integrity. Themes were, for example, feelings, games, problem‐solving, stop & think, role play school and home. 24 weekly sessions each lasting from one hour and 30 minutes to two hours

    2. Cognitive‐behavioural parent training*: themes were, for example, know yourself, attention rules, stress management, child mood management, and homework coaching. 18 weekly sessions in total, each lasting from one hour and 30 minutes to two hours

    3. School consultations: consisted of two telephone consultations in which the therapist in the child groups talked to the teachers about implementing classroom management strategies and reviewing the child's progress in school

  2. Group two (n = 41): methylphenidate treatment alone based on the standard management practice at the outpatient clinic where the study took place. This practice was not described in further detail.


Attendance: adherence in group two was defined as taking 80% of prescription without more than one month of discontinuation during school days. In group one, treatment adherence was defined as above in combination with at least 80% attendance in child and parent sessions.
*The child training and the parent training were developed to be implemented concomitantly. No protocol violations to the programme were detected in either the child or the parent intervention.
Outcomes Secondary outcomes

  1. Core ADHD: SWAN (the Strengths and Weaknesses of ADHD symptoms and Normal behaviour rating scale), parent‐ and teacher‐rated; Matching Familiar Figures Test (MFFT), clinician‐rated

  2. Satisfaction with treatment: single item rating of experience with the intervention, parent‐rated


Outcome assessment: post‐intervention, six and 12‐month follow‐up
Notes Study ID: not reported
Sponsorship source: not reported
Year conducted: "this study was planned in 1999" (quote)
Duration of the study: 17.5 months
Comments: none
Lead author: Yuk‐chi So
Institution: Chinese University of Hong Kong
Email: not reported
Address: not reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Comment: table of random numbers, with block size of two
Allocation concealment (selection bias) Unclear risk Comment: unclear
Blinding of participants and personnel (performance bias) 
 All outcomes High risk Comment: no blinding
Blinding of outcome assessment (detection bias) 
 All outcomes High risk Comment: no blinding on this review's primary outcome
Incomplete outcome data (attrition bias) 
 All outcomes High risk Comment: type of imputation method used was unclear
Selective reporting (reporting bias) Low risk Comment: low risk
Vested interest bias Unclear risk Comment: no information on funding
Other sources of bias? Low risk Comment: no other sources of bias identified