title: An eighteen-month follow-up of a pilot parent-delivered play-based intervention to improve the social play skills of children with attention deficit hyperactivity disorder and their playmates.
abstract: BACKGROUND
  Children with attention deficit hyperactivity disorder (ADHD) experience significant ongoing social difficulties which occur in multiple contexts. Interventions designed to improve these social difficulties have demonstrated minimal effectiveness. Thus, there is a clear need to establish interventions that are effective in addressing the social difficulties of children with ADHD across contexts and in the long term.
  
  
  OBJECTIVE
  To examine the long-term effectiveness and appropriateness of a pilot parent-delivered intervention designed to improve the social play skills of children with ADHD and their playmates.
  
  
  METHODS
  Participants included five children with ADHD who had completed the intervention 18-months prior, their typically developing playmates and mothers of children with ADHD. Blinded ratings from the Test of Playfulness were used to measure children's social play: post-intervention and 18-months following the intervention in the home and clinic. Wilcoxon signed-ranks and Cohen's-d calculations were used to measure effectiveness. Parents' perspectives of the appropriateness of the intervention were explored through semi-structured interviews and data were analysed thematically.
  
  
  RESULTS
  The social play skills of children with ADHD and their playmates were maintained following the intervention in the home and clinic. Thematic analysis revealed four core-themes against an intervention appropriateness framework: new parenting tools, a social shift, adapting strategies over time and the next developmental challenge.
  
  
  CONCLUSIONS
  The parent-delivered intervention demonstrated long-term effectiveness and appropriateness for improving children's social play skills.
  
  
  CONCLUSIONS
  These preliminary results are promising as maintaining treatment effects and achieving generalisation across contexts has remained an unachieved goal for most psycho-social interventions.
authors.affiliation: Discipline of Occupational Therapy, The University of Sydney, Lidcombe, New South Wales, Australia.
authors.forename: Alycia
authors.initials: A
authors.lastname: Cantrill
authors.affiliation: Discipline of Occupational Therapy, The University of Sydney, Lidcombe, New South Wales, Australia.|School of Allied Health Occupational Therapy, Australian Catholic University, North Sydney, New South Wales, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wilkes-Gillan
authors.affiliation: Discipline of Occupational Therapy, The University of Sydney, Lidcombe, New South Wales, Australia.
authors.forename: Anita
authors.initials: A
authors.lastname: Bundy
authors.affiliation: Discipline of Occupational Therapy, The University of Sydney, Lidcombe, New South Wales, Australia.|School of Occupational Therapy and Social Work, Curtin University, Bentley, Western Australia, Australia.
authors.forename: Reinie
authors.initials: R
authors.lastname: Cordier
authors.affiliation: School of Nursing and Midwifery, University of Western Sydney, Richmond, New South Wales, Australia.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Wilson
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000534:rehabilitation*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers; D009788:Occupational Therapy / Q000379:methods*; D016487:Parenting; D010988:Play and Playthings; D016037:Single-Blind Method; D012919:Social Behavior
keywords: appropriateness; effectiveness; generalisation; parent-involvement; peer-mediated; social-skills