대한감각통합치료학회지 (The Journal of Korean Academy of Sensory Integration)

  • 제18권1호
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  • Pages.56-72
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  • 2020
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  • 1738-0405(pISSN)
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  • 2384-115X(eISSN)
대한감각통합치료학회 (Korean Academy of Sensory Integration)
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ADHD 아동을 위한 부모훈련 중재의 효과 연구: 메타분석

The Effects of Parental Training Interventions on ADHD in Children: A Meta-Analysis

  • 라대엽 (솔파란 아동연구소) ;
  • 박혜연 (연세대학교 보건과학대학 작업치료학과)
  • 투고 : 2020.04.17
  • 심사 : 2020.06.19
  • 발행 : 2020.06.30
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⟨ 이전 논문 다음 논문 ⟩

초록

목적 : 주의력결핍 과잉행동장애(Attention Deficit Hyperactivity Disorder; ADHD)의 증상을 완화시키는데 있어 부모 훈련 중재(Parent Training Intervention)의 효과를 분석하고 어떠한 효과가 있는지 그 근거를 제시하는데 목적이 있다. 연구방법 : 2009년부터 2019년까지 10년간 해외 학술지에 게재된 문헌을 Proquest, Scopus 데이터베이스를 통하여 수집하였다. 검색용어는 (ADHD OR Attention Deficit Hyperactivity Disorder) AND (Parent OR Mother OR Father) AND (Training OR Program OR Therapy OR Intervention) AND (Randomized OR Randomised OR Randomly)를 사용하였다. 연구의 질적 평가를 위해 PEDro척도를 활용하였고, Comprehensive Meta-Analysis 3.0을 통해 메타분석을 실시하였다. 결과 : 1차 검색된 628개의 연구를 확인하였고, 최종 20개의 논문을 선정하였다. ADHD 아동에 대한 부모 훈련 중재의 전체효과크기(0.431) 및 부모 대상 중재(0.391), 부모-아동 대상 중재(0.639)는 모두 중간 효과크기로 나타났다. 부모 대상 중재는 ADHD 증상-과잉행동 및 충동성(0.921), 아동 행동(1.075), 아동 정서(0.834)에서 큰 효과크기가 나타났으며, 부모-아동 대상 중재는 ADHD 증상-과잉행동 및 충동성(0.922), 아동 정서(1.335), 반항성 및 품행장애(2.555), 학교 기능 및 사회기술(0.990)에서 큰 효과크기가 나타났다. 이질성 검정 결과 유의미한 결과가 나타나 랜덤효과모형을 선택하였다. 결론 : 부모 훈련 중재가 ADHD 아동의 증상에 미치는 효과를 알 수 있었다. 이는 작업치료사에게 임상적 근거를 제공하기 위한 근거 자료로 사용될 수 있을 것이다. 추후에는 국내실정에 맞는 부모 훈련 중재와 관련된 다양한 연구들이 진행되어야 할 것이다.

Objective : The purpose is to analyze the effects of parent training interventions in reducing the symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and to provide a basis for the effects. Methods : We collected literature published in international academic journals from 2009 to 2019 through ProQuest and Scopus databases. The search key terms were (ADHD OR Attention Deficit Hyperactivity Disorder) AND (Parent OR Mother OR Father) AND (Training OR Program OR Therapy OR Intervention) AND (Randomized OR Randomised OR Randomly). The PEDro scale was used to evaluate the quality of the studies, and a meta-analysis was conducted through Comprehensive Meta-Analysis 3.0. Results : Of 628 studies that we reviewed, 20 were eligible for inclusion. of parental training interventions for children with ADHD appeared close to a medium effect size while parent-child interventions (0.639) appeared to have a medium to large effect size. Oppositional defiant behavior and conduct disorder (0.737) in children and children's emotions (0.679) appeared close to a large effect size. ADHD symptoms hyperactivity and impulsivity (0.590) and child behavior (0.521) appeared to be over a medium effect size. We chose a random-effects model since heterogeneity tests showed significant results. Conclusion : We were able to confirm the effects of parent training interventions on the symptoms of children with ADHD. This will be used as evidence to provide a clinical basis for occupational therapists. More research related to parental training interventions should be carried out to ensure better reporting in the future.

키워드

참고문헌

  1. Abikoff, H. B., Thompson, M., Laver-Bradbury, C., Long, N., Forehand, R. L., Miller Brotman, L., et al. (2015). Parent training for preschool ADHD: A randomized controlled trial of specialized and generic programs. Journal of Child Psychology and Psychiatry, 56(6), 618-631. https://doi.org/10.1111/jcpp.12346
  2. Aghebati, A., Gharraee, B., Shoshtari, M. H., & Gohari, M. R. (2014). Triple p-positive parenting program for mothers of ADHD children. Iranian Journal of Psychiatry and Behavioral Sciences, 8(1), 59-65.
  3. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
  4. American Psychiatrie Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
  5. Atkinson, M., & Hollis, C. (2010). NICE guideline: attention deficit hyperactivity disorder. Archives of Disease in Childhood-Education and Practice, 95(1), 24-27. http://doi.org/10.1136/adc.2009.175943
  6. Au, A., Lau, K. M., Wong, A. H. C., Lam, C., Leung, C., Lau, J., et al. (2014). The efficacy of a group triple p (positive parenting program) for chinese parents with a child diagnosed with ADHD in Hong Kong: A pilot randomised controlled Study. Australian Psychologist, 49(3), 151-162. https://doi.org/10.1111/ap.12053
  7. Azevedo, A. F., Seabra-Santos, M. J., Gaspar, M. F., & Homem, T. C. (2013). The incredible years basic parent training for portuguese preschoolers with AD/HD behaviors: Does it make a difference? In Child & Youth Care Forum, 42(5), 403-424. https://doi.org/10.1007/s10566-013-9207-0
  8. Barbaresi, W. J., Katusic, S. K., Colligan, R. C., Weaver, A. L., & Jacobsen, S. J. (2007). Long-term school outcomes for children with attention-deficit/hyperactivity disorder: A population-based perspective. Journal of Developmental & Behavioral Pediatrics, 28(4), 265-273. https://doi.org/265-273.10.1097/DBP.0b013e31811ff87d
  9. Barkley, R. A. (1997). Defiant children: A clinician's manual for parent training (2nd ed.). New York: Guilford press.
  10. Bor, W., Sanders, M. R., & Markie-Dadds, C. (2002). The effects of the triple p-positive parenting program on preschool children with co-occurring disruptive behavior and attentional/hyperactive difficulties. Journal of Abnormal Child Psychology, 30(6), 571-587. https://doi.org/10.1023/A:1020807613155
  11. Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2011). Introduction to meta-analysis. Hoboken, NJ: John Wiley & Sons.
  12. Centers for Disease Control and Prevention (2020). Treatment of ADHD. 12 April, 2020. Retrieved from https://www.cdc.gov/ncbddd/adhd/treatment.html
  13. Chacko, A., Wymbs, B. T., Wymbs, F. A., Pelham, W. E., Swanger-Gagne, M. S., Girio, E., et al. (2009). Enhancing traditional behavioral parent training for single mothers of children with ADHD. Journal of Clinical Child & Adolescent Psychology, 38(2), 206-218. https://doi.org/10.1080/15374410802698388
  14. Charach, A., Carson, P., Fox, S., Ali, M. U., Beckett, J., & Lim, C. G. (2013). Interventions for preschool children at high risk for ADHD: A comparative effectiveness review. Pediatrics, 131(5), e1584-e1604. https://doi.org/10.1542/peds.2012-0974
  15. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.
  16. Conners, C. K. (2008). Conners 3rd edition: Manual. Toronto, ON: Multi-Health Systems Inc.
  17. Conners, C. K., Sitarenios, G., Parker, J. D., & Epstein, J. N. (1998a). The revised Conners' Parent Rating Scale (CPRS-R): Factor structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26(4), 257-268. https://doi.org/10.1023/A:1022602400621
  18. Conners, C. K., Sitarenios, G., Parker, J. D., & Epstein, J. N. (1998b). Revision and restandardization of the Conners Teacher Rating Scale (CTRS-R): Factor structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26(4), 279-291. https://doi.org/10.1023/A:1022606501530
  19. Daley, D., & O' Brien, M. (2013). A small-scale randomized controlled trial of the self-help version of the new forest parent training programme for children with ADHD symptoms. European Child & Adolescent Ppsychiatry, 22(9), 543-552. https://doi.org/10.1007/s00787-013-0396-8
  20. Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109), 629-634. https://doi.org/10.1136/bmj.315.7109.629
  21. Fabiano, G. A., Pelham, W. E., Cunningham, C. E., Yu, J., Gangloff, B., Buck, M., et al. (2012). A waitlist-controlled trial of behavioral parent training for fathers of children with ADHD. Journal of Clinical Child & Adolescent Psychology, 41(3), 337-345. https://doi.org/10.1080/15374416.2012.654464
  22. Ferrin, M., Moreno-Granados, J. M., Salcedo-Marin, M. D., Ruiz-Veguilla, M., Perez-Ayala, V., & Taylor, E. (2014). Evaluation of a psychoeducation programme for parents of children and adolescents with ADHD: Immediate and long-term effects using a blind randomized controlled trial. European Child & Adolescent Psychiatry, 23(8), 637-647. https://doi.org/10.1007/s00787-013-0494-7
  23. Graham, J., Banaschewski, T., Buitelaar, J., Coghill, D., Danckaerts, M., Dittmann, R. W., et al. (2011). European guidelines on managing adverse effects of medication for ADHD. European Child & Adolescent Psychiatry, 20(1), 17-37. https://doi.org/10.1007/s00787-010-0140-6
  24. Gross, D., & Grady, J. (2002). Group-based parent training for preventing mental health disorders in children. Issues in Mental Health Nursing, 23(4), 367-383. https://doi.org/10.1080/01612840290052578
  25. Grusec, J. E. (1992). Social-learning theory and developmental psychology: The legacies of Robert Sears and Albert Bandura. Developmental Psychology, 28(5), 776-786. https://doi.org/10.1037//0012-1649.28.5.776
  26. Herbert, S. D., Harvey, E. A., Roberts, J. L., Wichowski, K., & Lugo-Candelas, C. I. (2013). A randomized controlled trial of a parent training and emotion socialization program for families of hyperactive preschool-aged children. Behavior Therapy, 44(2), 302-316. https://doi.org/10.1016/j.beth.2012.10.004
  27. Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327(7414), 557-560. https://doi.org/10.1136/bmj.327.7414.557
  28. Hong, S. P., Yoo, Y. H., & Park, H. Y. (2019). Effects of cognitive rehabilitation therapy for occupation performance among Korean literature: A meta-analysis. Journal of Korean Society of Occupational Therapy, 27(3), 91-104. https://doi.org/10.14519/kjot.2019.27.3.07
  29. Jones, K., Daley, D., Hutchings, J., Bywater, T., & Eames, C. (2007). Efficacy of the incredible years basic parent training programme as an early intervention for children with conduct problems and ADHD. Child: Care, Health and Development, 33(6), 749-756. https://doi.org/10.1111/j.1365-2214.2007.00747.x
  30. Klassen, A. F., Miller, A., & Fine, S. (2004). Health-related quality of life in children and adolescents who have a diagnosis of Attention-Deficit/Hyperactivity Disorder. Pediatrics, 114(5), e541-e547. https://doi.org/10.1542/peds.2004-0844
  31. Langberg, J. M., Arnold, L. E., Flowers, A. M., Epstein, J. N., Altaye, M., Hinshaw, S. P., et al. (2010). Parent-reported homework problems in the MTA study: Evidence for sustained improvement with behavioral treatment. Journal of Clinical Child & Adolescent Psychology, 39(2), 220-233. https://doi.org/10.1080/15374410903532700
  32. Lange, A. M., Daley, D., Frydenberg, M., Houmann, T., Kristensen, L. J., Rask, C., et al. (2018). Parent training for preschool ADHD in routine, specialist care: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 57(8), 593-602. https://doi.org/10.1016/j.jaac.2018.04.014
  33. Leijten, P., Raaijmakers, M. A., Orobio de Castro, B., van den Ban, E., & Matthys, W. (2017). Effectiveness of the incredible years parenting program for families with socioeconomically disadvantaged and ethnic minority backgrounds. Journal of Clinical Child & Adolescent Psychology, 46(1), 59-73. https://doi.org/10.1080/15374416.2015.1038823
  34. Leung, C., Tsang, S., Ng, G. S., & Choi, S. Y. (2017). Efficacy of parent-child interaction therapy with Chinese ADHD children: Randomized controlled trial. Research on Social Work Practice, 27(1), 36-47. https://doi.org/10.1177/1049731516643837
  35. Mikami, A. Y., Lerner, M. D., Griggs, M. S., McGrath, A., & Calhoun, C. D. (2010). Parental influence on children with Attention-Deficit/Hyperactivity Disorder: II. results of a pilot intervention training parents as friendship coaches for children. Journal of Abnormal Child Psychology, 38(6), 737-749. https://doi.org/10.1007/s10802-010-9403-4
  36. Molina, B. S., Hinshaw, S. P., Swanson, J. M., Arnold, L. E., Vitiello, B., Jensen, P. S., et al. (2009). The MTA at 8 years: Prospective follow-up of children treated for combined-type ADHD in a multisite study. Journal of the American Academy of Child & Adolescent Psychiatry, 48(5), 484-500. https://doi.org/10.1097/CHI.0b013e31819c23d0
  37. Montoya, A., Colom, F., & Ferrin, M. (2011). Is psychoeducation for parents and teachers of children and adolescents with ADHD efficacious? A systematic literature review. European Psychiatry, 26(3), 166-175. https://doi.org/10.1016/j.eurpsy.2010.10.005
  38. National Institute for Health and Care Excellence (2019). Attention Deficit Hyperactivity Disorder: Diagnosis and management NICE guideline NG87. 12 April, 2020. Retrieved from https://www.nice.org.uk/guidance/ng87/resources/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933
  39. Nijmeijer, J. S., Minderaa, R. B., Buitelaar, J. K., Mulligan, A., Hartman, C. A., & Hoekstra, P. J. (2008). Attention-deficit/hyperactivity disorder and social dysfunctioning. Clinical Psychology Review, 28(4), 692-708. https://doi.org/10.1016/j.cpr.2007.10.003
  40. Noreika, V., Falter, C. M., & Rubia, K. (2013). Timing deficits in attention-deficit/hyperactivity disorder (ADHD): Evidence from neurocognitive and neuroimaging studies. Neuropsychologia, 51(2), 235-266. https://doi.org/10.1016/j.neuropsychologia.2012.09.036
  41. Pastor, P. N., Reuben, C. A., Duran, C. R., & Hawkins, L. D. (2015). Association between diagnosed ADHD and selected characteristics among children aged 4-17 years: United States, 2011-2013. NCHS data brief, no 201. Hyattsville, MD: National Center for Health Statistics.
  42. Pelham Jr, W. E., Wheeler, T., & Chronis, A. (1998). Empirically supported psychosocial treatments for attention deficit hyperactivity disorder. Journal of Clinical Child Psychology, 27(2), 190-205. https://doi.org/10.1207/s15374424jccp2702_6
  43. Podolski, C. L., & Nigg, J. T. (2001). Parent stress and coping in relation to child ADHD severity and associated child disruptive behavior problems. Journal of Clinical Child Psychology, 30(4), 503-513. https://doi.org/10.1207/S15374424JCCP3004_07
  44. Rosenthal, R., & Rubin, D. B. (1982). A simple, general purpose display of magnitude of experimental effect. Journal of Educational Psychology, 74(2), 166-169. https://doi.org/10.1037/0022-0663.74.2.166
  45. Sawilowsky, S. S. (2009). New effect size rules of thumb. Journal of Modern Applied Statistical Methods, 8(2), 467-474. https://doi.org/10.22237/jmasm/1257035100
  46. Sibley, M. H., Graziano, P. A., Kuriyan, A. B., Coxe, S., Pelham, W. E., Rodriguez, L., et al. (2016). Parent-teen behavior therapy+ motivational interviewing for adolescents with ADHD. Journal of Consulting and Clinical Psychology, 84(8), 699-712. https://doi.org/10.1037/ccp0000106
  47. Sonuga-Barke, E. J., Barton, J., Daley, D., Hutchings, J., Maishman, T., Raftery, J., et al. (2018). A comparison of the clinical effectiveness and cost of specialised individually delivered parent training for preschool attention-deficit/hyperactivity disorder and a generic, groupbased programme: A multi-centre, randomised controlled trial of the new forest parenting programme versus incredible years. European Child & Adolescent Psychiatry, 27(6), 797-809. https://doi.org/10.1007/s00787-017-1054-3
  48. Sonuga-Barke, E. J., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., et al. (2013). Nonpharmacological interventions for ADHD: Systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. American Journal of Psychiatry, 170(3), 275-289. https://doi.org/10.1176/appi.ajp.2012.12070991
  49. Stattin, H., Enebrink, P., Ozdemir, M., & Giannotta, F. (2015). A national evaluation of parenting programs in Sweden: The short-term effects using an RCT effectiveness design. Journal of Consulting and Clinical Psychology, 83(6), 1069-1084. https://doi.org/10.1037/a0039328
  50. Storebo, O. J., Gluud, C., Winkel, P., & Simonsen, E. (2012). Social-skills and parental training plus standard treatment versus standard treatment for children with ADHD-the randomised SOSTRA trial. Plos One, 7(6), e37280. https://doi.org/10.1371/journal.pone.0037280
  51. Storebo, O. J., Ramstad, E., Krogh, H. B., Nilausen, T. D., Skoog, M., Holmskov, M., et al. (2015). Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). Cochrane Database of Systematic Reviews, 11, 1-695. https://doi.org/10.1002/14651858.CD009885.pub2
  52. The Society of Clinical Child and Adolescent Psychology (2020). Behavior Therapy. 26 May, 2020. Retrieved from https://effectivechildtherapy.org/therapies/what-is-behavior-therapy/
  53. Thompson, M. J., Laver-Bradbury, C., Ayres, M., Le Poidevin, E., Mead, S., Dodds, C., et al. (2009). A small-scale randomized controlled trial of the revised new forest parenting programme for preschoolers with attention deficit hyperactivity disorder. European Child & Adolescent Psychiatry, 18(10), 605-616. https://doi.org/10.1007/s00787-009-0020-0
  54. Tooth, L., McCluskey, A., Hoffmann, T., McKenna, K., & Lovarini, M. (2005). Appraising the quality of randomized controlled trials: Inter-rater reliability for the OTseeker evidence database. Journal of Evaluation in Clinical Practice, 11(6), 547-555. https://doi.org/10.1111/j.1365-2753.2005.00574.x
  55. Ward, M. A., Theule, J., & Cheung, K. (2016). Parent-child interaction therapy for child disruptive behaviour disorders: A meta-analysis. Child & Youth Care Forum, 45(5), 675-690. https://doi.org/10.1007/s10566-016-9350-5
  56. Webster-Stratton, C. H., Reid, M. J., & Beauchaine, T. (2011). Combining parent and child training for young children with ADHD. Journal of Clinical Child & Adolescent Psychology, 40(2), 191-203. https://doi.org/10.1080/15374416.2011.546044
  57. Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., et al. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528
  58. Wolraich, M., & Hagan Jr, J. F. (2019). ADHD: What every parent needs to know. St. IL. Itasca: American Academy of Pediatrics.
  59. Yusuf, O., Gonka, O., & Aynur, A. P. (2019). The effects of the triple p-positive parenting programme on parenting, family functioning and symptoms of attention-deficit/hyperactivity disorder: A randomized controlled trial. Psychiatry and Clinical Psychopharmacology, 29(4), 665-673. https://doi.org/10.1080/24750573.2018.1542189