Effect of Parent Training on Health-Related Quality of Life in Preschool Children with Attention-Deficit/Hyperactivity Disorder: A Secondary Analysis of Data from a Randomized Controlled Trial
Larsen LB, Daley D, Lange AM, Sonuga-Barke E, Thomsen PH, Rask CU
J Am Acad Child Adolesc Psychiatry. 2020 Jun 4. pii: S0890-8567(20)30336-1.
doi: 10.1016/j.jaac.2020.04.014.
Commentary* by Dr. Margaret Weiss: The target of parent training is not just ADHD symptoms.
ABSTRACT
OBJECTIVE: School-aged children with attention-deficit/hyperactivity disorder (ADHD) have reduced health related quality of life (HRQoL) but it is unclear whether this also applies to preschool children. It is unknown whether parent training (PT) improves HRQoL. This study compared HRQoL in preschool children with ADHD with age-matched children from the general population, examined whether PT improves HRQoL, and tested if treatment-related changes in HRQoL are mediated by improvements in ADHD, parent efficacy (PE) and family stress (FS).
METHOD: Parents of 164 children, aged 3-7 years diagnosed with ADHD, participated in a randomized controlled trial, comparing the New Forest Parenting Programme (NFPP) and Treatment As Usual (TAU). Measures of HRQoL, ADHD, PE and FS were completed at baseline (T1), post treatment (T2) and 36 weeks follow-up (T3). Child baseline HRQoL was compared with two general population-based reference groups. PT effects were analyzed using linear models and mediation analyses.
RESULTS: Preschoolers with ADHD had lower HRQoL than the reference groups. NFPP, but not TAU, was associated with improvement in the psychosocial HRQoL at T2 (2.28, 95% CI [0.78; 3.77]) and at T3 (2.05, 95% CI [0.56; 3.54]). This difference between treatment arms was not statistically significant. PE and FS scores at T2 significantly mediated improvements in HRQoL at T3. ADHD scores at T2 did not.
CONCLUSION: ADHD negatively impacts HRQoL in early childhood. PT for ADHD has the potential to improve HRQoL independently of its effects on ADHD symptoms..
* Abstracts are selected for their clinical relevance by Dr. Margaret Weiss, Director of Clinical Research, Child Psychiatry, Cambridge Health Alliance, Harvard University. Her commentary reflects her own opinion. It is not approved or necessarily representative of the CADDRA board.