Children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment: impact on parental practices.
OBJECTIVE
To test the hypothesis that multimodal psychosocial intervention, which includes parent training, combined with methylphenidate significantly enhances the behavior of parents of children with attention-deficit/hyperactivity disorder (ADHD), compared with methylphenidate alone and compared with methylphenidate and nonspecific psychosocial treatment (attention control).


METHODS
One hundred three children with ADHD (ages 7-9), free of conduct and learning disorders, who responded to short-term methylphenidate therapy were randomized for 2 years to receive either (1) methylphenidate treatment alone; (2) methylphenidate plus psychosocial treatment that included parent training and counseling, social skills training, academic assistance, and psychotherapy; or (3) methylphenidate plus attention control treatment. Parents rated their knowledge of parenting principles and negative and positive parenting behavior. Children rated their parents' behavior.


RESULTS
Psychosocial treatment led to significantly better knowledge of parenting principles but did not enhance parenting practices, as rated by parents and children. Significant improvement in mothers' negative parenting occurred across all treatments and was maintained.


CONCLUSIONS
In nonconduct-disordered, stimulant-treated children with ADHD, parent training does not improve self-rated parental behavior. The benefits of brief stimulant treatment for negative parental behavior are sustained with extended treatment.
Hechtman
Lily
L
Department of Psychiatry, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada. lhechtman@po.box.mcgill.ca
Abikoff
Howard
H
Klein
Rachel G
RG
Greenfield
Brian
B
Etcovitch
Joy
J
Cousins
Lorne
L
Fleiss
Karen
K
Weiss
Margaret
M
Pollack
Simcha
S
D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000628:therapy*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000627:therapeutic use*; D011613:Psychotherapy / Q000379:methods*
D000697:Central Nervous System Stimulants; D008774:Methylphenidate