title: Teletherapy delivery of caregiver behavior training for children with attention-deficit hyperactivity disorder.
abstract: BACKGROUND
  Preliminary studies suggest that videoteleconferencing (VTC) may be an effective means to deliver behavioral interventions to families. Subjects consisted of a subsample of children (n=37) and caregivers who participated in the Children's Attention-Deficit Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS) (n=223), a randomized trial testing the effectiveness of delivering treatments for ADHD to families residing in their home communities using distant technologies. Families randomized to the CATTS intervention arm received pharmacotherapy and caregiver behavior training.
  
  
  METHODS
  Thirty-seven families from the CATTS intervention arm participated. All families received pharmacotherapy through VTC. Twelve families received the caregiver behavior training through VTC, or teletherapy, and 25 received the intervention in-person. We assessed children's outcomes at 25 weeks with the Vanderbilt ADHD Parent Rating Scale and the Columbia Impairment Scale. We assessed caregivers' outcomes using measures of distress in caring for a child with ADHD, including depression, stress, strain, and empowerment. We used analysis of covariance to assess outcomes from baseline to 25 weeks.
  
  
  RESULTS
  Families in the two conditions showed comparable attendance at sessions and satisfaction with their care. Caregivers in both conditions reported comparable outcomes for their children's ADHD-related behaviors and functioning, but caregivers in the teletherapy group did not report improvement in their own distress.
  
  
  CONCLUSIONS
  Findings support the feasibility, acceptability, and effectiveness of treating children with ADHD through teletherapy. Future work should investigate how teletherapy may improve caregivers' distress. Teletherapy is a promising modality for delivering behavioral interventions for children with ADHD.
authors.affiliation: 1Seattle Children's Research Institute Center for Child Health, Behavior, and Development, Seattle, Washington.
authors.forename: Yuet Juhn
authors.initials: YJ
authors.lastname: Tse
authors.affiliation: 1Seattle Children's Research Institute Center for Child Health, Behavior, and Development, Seattle, Washington.|2Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: McCarty
authors.affiliation: 1Seattle Children's Research Institute Center for Child Health, Behavior, and Development, Seattle, Washington.|3Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington.|4Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington.
authors.forename: Ann Vander
authors.initials: AV
authors.lastname: Stoep
authors.affiliation: 1Seattle Children's Research Institute Center for Child Health, Behavior, and Development, Seattle, Washington.|3Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Myers
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000628:therapy*; D001521:Behavior Therapy / Q000193:education*; D017028:Caregivers / Q000193:education*; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D006801:Humans; D013663:Teaching / Q000458:organization & administration; D049269:Videoconferencing
keywords: attention-deficit hyperactivity disorder; parent training; telehealth; telemedicine; telemental health; teletherapy; videoconferencing