Effectiveness Study of a Behavioral Teacher Program Targeting ADHD Symptoms

August 7, 2015 updated by: Betty Veenman, VU University of Amsterdam

A Randomized Controlled Trial Into the Effectiveness of a Behavioral Teacher Program Targeting ADHD Symptoms

The goal of this study was to investigate the effectiveness of a behavioral teacher program addressing symptoms of Attention-Deficit Hyperactivity Disorder (ADHD) in the classroom.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Background:

Most behavioral teacher programs involve intensive and expensive teacher trainings by health care specialists, which may limit successful large-scale implementation. This behavioral program, on the contrary, involves a self-containing manual that does not require expert training in order to increase the likelihood of successful implementation (if proven effective). The aim was to investigate the program's effects on behavioral, socio-emotional and school functioning in primary school children.

Methods:

Children with ADHD symptoms were randomly assigned at school level to the intervention condition (receiving the program during 18 weeks) or control group (not receiving the program but who were allowed to receive care as usual).

Measures to assess program's effectiveness:

  • Strengths and Weaknesses of ADHD-symptoms and Normal Behavior,
  • Strengths and Difficulties Questionnaire
  • Social Skills Rating Scale
  • Spence Children's Anxiety Scale
  • Classroom Observation Code
  • Actigraphy
  • Sociometric measures (peer nomination and peer rating)
  • Dutch arithmetic test (Tempo-Test-Rekenen)
  • reading test (Drie-Minuten-Toets) and writing test (PI-dictee).

Additional measures:

  • Wechsler Intelligence Scale for Children (Block Design and Vocabulary; used to estimate IQ);
  • Sensitivity to Punishment and Sensitivity to Reward Questionnaire and several neuropsychological computer tasks

Study Type

Interventional

Enrollment (Actual)

114

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

6 years to 13 years (CHILD)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • sub-threshold or clinical level of ADHD symptoms as observed by participant's teacher through the Dutch version of the Disruptive Behavior Disorders Rating Scale (Pelham, Gnagy, Greenslade, & Milich, 1992)
  • at least one clinical and three sub-threshold ADHD symptoms as measured by the Teacher Telephone Interview (Holmes et al., 2004), a semi-structured interview which is based on the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000)

Exclusion Criteria:

  • (medication) treatment for ADHD at study entry or in preceding 6 months;
  • neurological or severe physical condition
  • IQ < 80 based on a short version of the Wechsler Intelligence Scale for Children (Block Design and Vocabulary; Legerstee, van der Reijden-Lakeman, Lechner-van der Noort, & Ferdinand, 2004; Hrabok, Brooks, Fay-McClymont, & Sherman, 2014)
  • participant enrolled in a daily contingency management program or other teacher program targeting behavior or social problems at study entry or in the preceding month
  • Maximum of 2 children per classroom and 5 classrooms per school (in order to limit teachers' burden and increase heterogeneity of teacher and classroom settings)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Behavioral teacher program
The behavioral teacher program was used by the participant's teacher in the classroom during 18 weeks.
Behavioral: Behavioral Teacher Program
This program was based on the evidence-based Summer Treatment Program (MTA Cooperative Group, 1999), involving psycho-education for the teacher and universal and individual behavioral techniques that focused on classroom structure and contingency management
No Intervention: Control group
Children within the control group did not receive the behavioral teacher program but were allowed to receive regular care

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change from Baseline in Strengths and Weaknesses of ADHD-symptoms and Normal Behavior Scale (SWAN; Young, Levi, Martin, & Hay, 2009)
Time Frame: 6 weeks and 18 weeks after baseline assessment
The teacher and parent version of the SWAN were used
6 weeks and 18 weeks after baseline assessment
Change from Baseline in Strengths and Difficulties Questionnaire (SDQ; Van Widenfelt, Goedhart, Treffers, & Goodman, 2003)
Time Frame: 6 weeks and 18 weeks after baseline assessment
The teacher and parent-version of the SDQ were administered, using the following subscales: ADHD, Conduct Problems, Internalizing Behavior (combining Emotional Symptoms and Peer Problems), and Impact On Daily Functioning
6 weeks and 18 weeks after baseline assessment
Change from Baseline in hyperactivity during school hours using Actigraphy (Cambridge Neurotechnology, 2008)
Time Frame: 6 weeks and 18 weeks after baseline assessment
It concerned an actigraph worn on the wrist of the non-dominated hand during 5 school days
6 weeks and 18 weeks after baseline assessment
Change from Baseline in Disruptive Classroom Behavior measured by the Classroom Observation Code (COC; Abikoff, Gittelman, & Klein, 1980)
Time Frame: 6 weeks and 18 weeks after baseline assessment
The observation was performed by well-trained psychology students not involved in treatment delivery. Each participant was observed twice on the same school day for 8 minutes, using the average score as outcome measure
6 weeks and 18 weeks after baseline assessment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change from Baseline in Social Skills Scale of the Social Skills Rating Scale (SSRS; Merrell & Popinga, 1994)
Time Frame: 6 weeks and 18 weeks after baseline assessment
The teacher and parent version of the SSRS were used
6 weeks and 18 weeks after baseline assessment
Change from Baseline in Spence Children's Anxiety Scale (SCAS)
Time Frame: 6 weeks and 18 weeks after baseline assessment
SCAS is a self-report administered to the child
6 weeks and 18 weeks after baseline assessment
Change from Baseline in Sociometric Measure (Bukowski, Cillessen, & Velasquez, 2012)
Time Frame: 6 weeks and 18 weeks after baseline assessment
The sociometric measure includes both a peer nomination and a peer rating scale
6 weeks and 18 weeks after baseline assessment
Change from Baseline in Performance on Dutch Reading Test (Drie-Minuten Toets; Verhoeven, 1995)
Time Frame: 6 weeks and 18 weeks after baseline assessment
6 weeks and 18 weeks after baseline assessment
Change from Baseline in Performance on Dutch Writing Test (PI-dictee; Geelhoed & Reitsma, 2000)
Time Frame: 6 weeks and 18 weeks after baseline assessment
6 weeks and 18 weeks after baseline assessment
Change from Baseline in Performance on Dutch Arithmetic Test (Tempo-Test Rekenen; De Vos, 1992)
Time Frame: 6 weeks and 18 weeks after baseline assessment
6 weeks and 18 weeks after baseline assessment
Teacher's treatment fidelity averaged over 18 similar checklists (self-constructed), containing 13 items on a 3-point Likert scale regarding the use of each intervention element (0=not used or inadequate use, 1=adequate use, and 2=good use)
Time Frame: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, and 18 weeks after start of the intervention
Only teachers in the intervention group needed to fill in this rating scale
1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, and 18 weeks after start of the intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

VU University of Amsterdam

Collaborators

Stichting Kinderpostzegels Nederland
Nederlandse Stichting voor het Gehandicapte Kind, The Netherlands
Stichting Weeshuis der Doopsgezinden, The Netherlands
Stichting Zonnige Jeugd, The Netherlands

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 2011

Primary Completion (Actual)

July 1, 2014

Study Completion (Actual)

July 1, 2014

Study Registration Dates

First Submitted

August 5, 2015

First Submitted That Met QC Criteria

August 7, 2015

First Posted (Estimate)

August 10, 2015

Study Record Updates

Last Update Posted (Estimate)

August 10, 2015

Last Update Submitted That Met QC Criteria

August 7, 2015

Last Verified

August 1, 2015

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • METc VUmc 2011/196
  • 5930790 (Other Grant/Funding Number: KPZ)
  • 20110028 (Other Grant/Funding Number: NSGK)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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