Psychoeducation Intervention Effectiveness to Improve Social Skills in Young People with ADHD: A Meta-Analysis

Lauren Amy Powell, Jack Parker, Anna Weighall, Valerie Harpin, Lauren Amy Powell, Jack Parker, Anna Weighall, Valerie Harpin

Abstract

Objective: Attention Deficit Hyperactivity Disorder (ADHD) can be associated with limited understanding of the condition and poor social skills. Some evidence favors a psychoeducational approach, but little is known about the effectiveness of psychoeducation.

Methods: Systematic review and meta-analysis of studies assessing psychoeducational interventions that aim to improve social skills of young people with ADHD.

Results: Ten studies, including 943 participants, reported across 13 papers met the inclusion criteria. Although effect sizes were small, findings suggest the included interventions significantly improved social skills in young people with ADHD.

Conclusions: Results show promise for psychoeducational behavioral interventions . However, the recommendations that can be developed from existing evidence are somewhat limited by the low quality of studies. Further rigorous trials are needed. In addition, future research should consider the long-term outcomes for these interventions, they should be iteratively co-designed and research should consider the context they intend to be delivered in.

Keywords: attention deficit disorder with hyperactivity; children; education; social skills.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Search results.
Figure 2.
Figure 2.
Meta-analysis of parent reported outcomes of social skills in CAYP with ADHD. Included in this meta-analysis were five studies reported across eight papers.
Figure 3.
Figure 3.
Meta-analysis of teacher reported outcomes of social skills in CAYP with ADHD. Four studies reported across six papers were included in this meta-analysis.
Figure 4.
Figure 4.
Risk of bias summary: review authors’ judgments about each risk of bias item for each included study.
Figure 5.
Figure 5.
Risk of bias graph: review authors’ judgments about each risk of bias item presented as percentages across all included studies.

References

    1. Acri M., Chacko A., Gopalan G., MacKay M. (2018). Engaging families in treatment for child behavior disorders: A synthesis of the literature. In Lochman J. E., Matthys W. (Eds.), The Wiley handbook of disruptive and impulse-control disorders (pp. 393–409). Wiley Blackwell.
    1. Adler L. D., Nierenberg A. A. (2010). Review of medication adherence in children and adults with ADHD. Postgraduate Medicine, 122(1), 184–191.
    1. Aduen P. A., Day T. N., Kofler M. J., Harmon S. L., Wells E. L., Sarver D. E. (2018). Social problems in ADHD: Is it a skills acquisition or performance problem? Journal of Psychopathology and Behavioral Assessment, 40(3), 440–451.
    1. American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders. A. P. Association.
    1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). American Psychiatric Association.
    1. Anastopoulos A. D., Smith T. F., Garrett M. E., Morrissey-Kane E., Schatz N. K., Sommer J. L., Kollins S. H., Ashley-Koch A. (2011). Self-regulation of emotion, functional impairment, and comorbidity among childrenwith AD/HD. Journal of Attention Disorders, 15(7), 583–592.
    1. Anderson C. M., Hogarty G. E., Reiss D. J. (1980). Family treatment of adult schizophrenic patients: A psycho-educational approach. Schizophrenia Bulletin, 6(3), 490.
    1. APA Publications and Communications Board Working Group on Journal Article Reporting Standards. (2008). Reporting standards for research in psychology: Why do we need them? What might they be? The American Psychologist, 63(9), 839.
    1. Bai G.-N., Wang Y.-F., Yang L., Niu W.-Y. (2015). Effectiveness of a focused, brief psychoeducation program for parents of ADHD children: Improvement of medication adherence and symptoms. Neuropsychiatric Disease and Treatment, 11, 2721.
    1. Barkley R. A. (2014). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. Guilford Publications.
    1. Barlow J. H., Ellard D. R. (2004). Psycho-educational interventions for children with chronic disease, parents and siblings: An overview of the research evidence base. Child: Care, Health and Development, 30(6), 637–645.
    1. Bäuml J., Froböse T., Kraemer S., Rentrop M., Pitschel-Walz G. (2006). Psychoeducation: A basic psychotherapeutic intervention for patients with schizophrenia and their families. Schizophrenia Bulletin, 32(suppl_1), S1–S9.
    1. Bignell S., Cain K. (2007). Pragmatic aspects of communication and language comprehension in groups of children differentiated by teacher ratings of inattention and hyperactivity. British Journal of Developmental Psychology, 25(4), 499–512.
    1. Blower S., Swallow V., Maturana C., Stones S., Phillips R., Dimitri P., Marshman Z., Knapp P., Dean A., Higgins S. (2020). Children and young people’s concerns and needs relating to their use of health technology to self-manage long-term conditions: A scoping review. Archives of Disease in Childhood, 105(11), 1093–1104.
    1. Bonell C., Fletcher A., Morton M., Lorenc T., Moore L. (2012). Realist randomised controlled trials: A new approach to evaluating complex public health interventions. Social Science & Medicine, 75(12), 2299–2306.
    1. Brattberg G. (2006). PTSD and ADHD: Underlying factors in many cases of burnout. Stress and Health: Journal of the International Society for the Investigation of Stress, 22(5), 305–313.
    1. Brignardello-Petersen R., Bonner A., Alexander P. E., Siemieniuk R. A., Furukawa T. A., Rochwerg B., Hazlewood G. S., Alhazzani W., Mustafa R. A., Murad M. H. (2018). Advances in the GRADE approach to rate the certainty in estimates from a network meta-analysis. Journal of clinical epidemiology, 93, 36–44.
    1. Canadian ADHD Practice Guidelines. (2011). Practice Guidelines. Canadian ADHD Resource Alliance.
    1. Castellanos F. X., Tannock R. (2002). Neuroscience of attention-deficit/hyperactivity disorder: The search for endophenotypes. Nature Reviews Neuroscience, 3(8), 617–628.
    1. Chacko A., Wymbs B. T., Wymbs F. A., Pelham W. E., Swanger-Gagne M. S., Girio E., Pirvics L., Herbst L., Guzzo J., Phillips C. (2009). Enhancing traditional behavioral parent training for single mothers of children with ADHD. Journal of Clinical Child & Adolescent Psychology, 38(2), 206–218.
    1. Cordier R., Vilaysack B., Doma K., Wilkes-Gillan S., Speyer R. (2018). Peer inclusion in interventions for children with ADHD: A systematic review and meta-analysis. BioMed Research International, 2018, 7693479.
    1. Cummings C. M., Fristad M. A. (2007). Medications prescribed for children with mood disorders: Effects of a family-based psychoeducation program. Experimental and Clinical Psychopharmacology, 15(6), 555.
    1. Dahl V., Ramakrishnan A., Spears A. P., Jorge A., Lu J., Bigio N. A., Chacko A. (2020). Psychoeducation interventions for parents and teachers of children and adolescents with ADHD: A systematic review of the literature. Journal of Developmental and Physical Disabilities, 32(2), 257–292.
    1. Danielson M. L., Bitsko R. H., Ghandour R. M., Holbrook J. R., Kogan M. D., Blumberg S. J. (2018). Prevalence of parent-reported ADHD diagnosis and associated treatment among US children and adolescents, 2016. Journal of Clinical Child & Adolescent Psychology, 47(2), 199–212.
    1. Davis N. O., Kollins S. H. (2012). Treatment for co-occurring attention deficit/hyperactivity disorder and autism spectrum disorder. Neurotherapeutics, 9(3), 518–530.
    1. De Boo G. M., Prins P. J. (2007). Social incompetence in children with ADHD: Possible moderators and mediators in social-skills training. Clinical Psychology Review, 27(1), 78–97.
    1. DuPaul G. J., Evans S. W., Mautone J. A., Owens J. S., Power T. J. (2020). Future directions for psychosocial interventions for children and adolescents with ADHD. Journal of Clinical Child & Adolescent Psychology, 49(1), 134–145.
    1. DuPaul G. J., Weyandt L. L., Janusis G. M. (2011). ADHD in the classroom: Effective intervention strategies. Theory into Practice, 50(1), 35–42.
    1. Fabiano G. A., Pelham W. E., Jr., Coles E. K., Gnagy E. M., Chronis-Tuscano A., O’Connor B. C. (2009). A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review, 29(2), 129–140.
    1. Fekete G., Lucero A. (2019). P(L)AY ATTENTION! Co-designing for and with children with attention deficit hyperactivity disorder (ADHD). IFIP Conference on Human-Computer Interaction.
    1. Ferrin M., Moreno-Granados J., Salcedo-Marin M., 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.
    1. Ferrin M., Perez-Ayala V., El-Abd S., Lax-Pericall T., Jacobs B., Bilbow A., Taylor E. (2016). A randomized controlled trial evaluating the efficacy of a psychoeducation program for families of children and adolescents with ADHD in the United Kingdom: Results after a 6-month follow-up. Journal of Attention Disorders, 2016, 1087054715626509.
    1. Fristad M. A. (2006). Psychoeducational treatment for school-aged children with bipolar disorder. Development and Psychopathology, 18(4), 1289–1306.
    1. Ghirardi L., Brikell I., Kuja-Halkola R., Freitag C. M., Franke B., Asherson P., Lichtenstein P., Larsson H. (2018). The familial co-aggregation of ASD and ADHD: a register-based cohort study. Molecular Psychiatry, 23(2), 257–262.
    1. Ginsburg G. S., Albano A. M., Findling R. L., Kratochvil C., Walkup J. (2005). Integrating cognitive behavioral therapy and pharmacotherapy in the treatment of adolescent depression. Cognitive and Behavioral Practice, 12(2), 252–262.
    1. Greenhalgh T., Jackson C., Shaw S., Janamian T. (2016). Achieving research impact through co-creation in community-based health services: Literature review and case study. The Milbank Quarterly, 94(2), 392–429.
    1. Guías de Práctica Clínica en el SNS. (2017). Grupo de trabajo de la Guía de Práctica Clínica sobre las Intervenciones Terapéuticas en el Trastorno por Déficit de Atención con Hiperactividad (TDAH).
    1. Haack L. M., Villodas M., McBurnett K., Hinshaw S., Pfiffner L. J. (2017). Parenting as a mechanism of change in psychosocial treatment for youth with ADHD, predominantly inattentive presentation. Journal of Abnormal Child Psychology, 45(5), 841–855.
    1. Higgins J. P., Altman D. G. (2008). Assessing risk of bias in included studies. In Cochrane handbook for systematic reviews of interventions: Cochrane book series (pp. 187–241). Wiley.
    1. Hoza B., Gerdes A. C., Mrug S., Hinshaw S. P., Bukowski W. M., Gold J. A., Arnold L. E., Abikoff H. B., Conners C. K., Elliott G. R. (2005). Peer-assessed outcomes in the multimodal treatment study of children with attention deficit hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 34(1), 74–86.
    1. Hult N., Kadesjö J., Kadesjö B., Gillberg C., Billstedt E. (2018). ADHD and the QbTest: Diagnostic validity of QbTest. Journal of Attention Disorders, 22(11), 1074–1080.
    1. Humphreys K. L., Galán C. A., Tottenham N., Lee S. S. (2016). Impaired social decision-making mediates the association between ADHD and social problems. Journal of Abnormal Child Psychology, 44(5), 1023–1032.
    1. Jones R. B., Thapar A., Stone Z., Thapar A., Jones I., Smith D., Simpson S. (2018). Psychoeducational interventions in adolescent depression: A systematic review. Patient Education and Counseling, 101(5), 804–816.
    1. Lee P.-C., Niew W.-I., Yang H.-J., Chen V. C.-H., Lin K.-C. (2012). A meta-analysis of behavioral parent training for children with attention deficit hyperactivity disorder. Research in Developmental Disabilities, 33(6), 2040–2049.
    1. MacKay L., Corkum P. (2006). Evaluation of a demystification workshop for children with ADHD. Journal of Developmental and Physical Disabilities, 18(3), 319–332.
    1. Marsland A. L., Gentile D., Hinze-Crout A., von Stauffenberg C., Rosen R. K., Tavares A., Votruba-Drzal E., Cohen S., McQuaid E. L., Ewing L. J. (2019). A randomized pilot trial of a school-based psychoeducational intervention for children with asthma. Clinical & Experimental Allergy, 49(5), 591–602.
    1. McGee R., Partridge F., Williams S., Silva P. A. (1991). A twelve-year follow-up of preschool hyperactive children. Journal of the American Academy of Child & Adolescent Psychiatry, 30(2), 224–232.
    1. McKenzie J. E., Brennan S. E., Ryan R. E., Thomson H. J., Johnston R. V., Thomas J. (2019). Defining the criteria for including studies and how they will be grouped for the synthesis. In Cochrane handbook for systematic reviews of interventions (pp. 33–65). Cochrane.
    1. Mikami A. Y., Jia M., Na J. J. (2014). Social skills training. Child and Adolescent Psychiatric Clinics, 23(4), 775–788.
    1. 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.
    1. Moher D., Liberati A., Tetzlaff J., Altman D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine, 151(4), 264–269.
    1. 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.
    1. Morris S., Sheen J., Ling M., Foley D., Sciberras E. (2020). Interventions for adolescents with ADHD to improve peer social functioning: A systematic review and meta-analysis. Journal of Attention Disorders, 16(3), 179–189.
    1. Muñoz-Organero M., Powell L., Heller B., Harpin V., Parker J. (2019). Using recurrent neural networks to compare movement patterns in ADHD and normally developing children based on acceleration signals from the wrist and ankle. Sensors, 19(13), 2935.
    1. National Institute for Health and Clinical Excellence (NICE). (2008). Attention deficit hyperactivity disorder: Diagnosis and management Clinical guideline [CG72]. Retrieved October 1, 2020, from
    1. National Institute for Health and Clinical Excellence (NICE). (2018). Attention deficit hyperactivity disorder: NICE quality standard QS39. Retrieved January 28, 2020, from
    1. Nussey C., Pistrang N., Murphy T. (2013). How does psychoeducation help? A review of the effects of providing information about T ourette syndrome and attention-deficit/hyperactivity disorder. Child: Care, Health and Development, 39(5), 617–627.
    1. Östberg M., Rydell A.-M. (2012). An efficacy study of a combined parent and teacher management training programme for children with ADHD. Nordic Journal of Psychiatry, 66(2), 123–130.
    1. Owens JS., Goldfine ME., Evangelista NM., Hoza B., Kaiser NM. (2007). A critical review of self-perceptions and the positive illusory bias in children with ADHD. Clinical child and family psychology review, 10(4), 335-351.
    1. Pawson R., Tilley N., Tilley N. (1997). Realistic evaluation. Sage.
    1. Pfiffner L. J., McBurnett K. (1997). Social skills training with parent generalization: Treatment effects for children with attention deficit disorder. Journal of Consulting and Clinical Psychology, 65(5), 749.
    1. Pfiffner L. J., Hinshaw S. P., Owens E., Zalecki C., Kaiser N. M., Villodas M., McBurnett K. (2014). A two-site randomized clinical trial of integrated psychosocial treatment for ADHD-inattentive type. Journal of Consulting and Clinical Psychology, 82(6), 1115.
    1. Pfiffner L. J., Mikami A. Y., Huang-Pollock C., Easterlin B., Zalecki C., McBurnett K. (2007). A randomized, controlled trial of integrated home-school behavioral treatment for ADHD, predominantly inattentive type. Journal of the American Academy of Child & Adolescent Psychiatry, 46(8), 1041–1050.
    1. Pfiffner L. J., Rooney M. E., Jiang Y., Haack L. M., Beaulieu A., McBurnett K. (2018). Sustained effects of collaborative school-home intervention for attention-deficit/hyperactivity disorder symptoms and impairment. Journal of the American Academy of Child & Adolescent Psychiatry, 57(4), 245–251.
    1. Pfiffner L. J., Rooney M., Haack L., Villodas M., Delucchi K., McBurnett K. (2016). A randomized controlled trial of a school-implemented school–home intervention for attention-deficit/hyperactivity disorder symptoms and impairment. Journal of the American Academy of Child & Adolescent Psychiatry, 55(9), 762–770.
    1. Polanczyk G. V., Salum G. A., Sugaya L. S., Caye A., Rohde L. A. (2015). Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56(3), 345–365
    1. Powell L., Parker J., Harpin V. (2017). University of sheffield researchers used lego to involve children with ADHD and their parents in research! NIHR involve. Retrieved April 21, 2020, from
    1. Raggi V. L., Chronis A. M. (2006). Interventions to address the academic impairment of children and adolescents with ADHD. Clinical Child and Family Psychology Review, 9(2), 85–111.
    1. Rimestad M. L., Lambek R., Zacher Christiansen H., Hougaard E. (2019). Short-and long-term effects of parent training for preschool children with or at risk of ADHD: A systematic review and meta-analysis. Journal of Attention Disorders, 23(5), 423–434.
    1. Ronk M. J., Hund A. M., Landau S. (2011). Assessment of social competence of boys with attention-deficit/hyperactivity disorder: Problematic peer entry, host responses, and evaluations. Journal of Abnormal Child Psychology, 39(6), 829.
    1. Ros R., Graziano P. A. (2018). Social functioning in children with or at risk for attention deficit/hyperactivity disorder: A meta-analytic review. Journal of Clinical Child & Adolescent Psychology, 47(2), 213–235.
    1. Rycroft-Malone J., Fontenla M., Bick D., Seers K. (2010). A realistic evaluation: The case of protocol-based care. Implementation Science, 5(1), 38.
    1. Sikora D. M., Vora P., Coury D. L., Rosenberg D. (2012). Attention-deficit/hyperactivity disorder symptoms, adaptive functioning, and quality of life in children with autism spectrum disorder. Pediatrics, 130(Supplement 2), S91–S97.
    1. Snead K., Ackerson J., Bailey K., Schmitt M. M., Madan-Swain A., Martin R. C. (2004). Taking charge of epilepsy: The development of a structured psychoeducational group intervention for adolescents with epilepsy and their parents. Epilepsy & Behavior, 5(4), 547–556.
    1. Sonuga-Barke E. J., Brandeis D., Cortese S., Daley D., Ferrin M., Holtmann M., Stevenson J., Danckaerts M., Van der Oord S., Döpfner M. (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.
    1. Storebø O. J., Andersen M. E., Skoog M., Hansen S. J., Simonsen E., Pedersen N., Tendal B., Callesen H. E., Faltinsen E., Gluud C. (2019). Social skills training for Attention Deficit Hyperactivity Disorder (ADHD) in children aged 5 to 18 years. Cochrane Database of Systematic Reviews (12), CD008223.
    1. Tarver J., Daley D., Sayal K. (2014). Attention-deficit hyperactivity disorder (ADHD): An updated review of the essential facts. Child: Care, Health and Development, 40(6), 762–774.
    1. The Cochrane Collaboration. (2014). Review manager (RevMan) version 5.3. The Nordic Cochrane Centre.
    1. 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.
    1. Webster-Stratton C., Reid M. J., Beauchaine T. P. (2013). One-year follow-up of combined parent and child intervention for young children with ADHD. Journal of Clinical Child & Adolescent Psychology, 42(2), 251–261.
    1. Wehmeier P. M., Schacht A., Barkley R. A. (2010). Social and emotional impairment in children and adolescents with ADHD and the impact on quality of life. Journal of Adolescent Health, 46(3), 209–217.
    1. Wilkes-Gillan S., Bundy A., Cordier R., Lincoln M., Chen Y.-W. (2016). A randomised controlled trial of a play-based intervention to improve the social play skills of children with attention deficit hyperactivity disorder (ADHD). PLoS One, 11(8), e0160558.
    1. Willis D., Siceloff E. R., Morse M., Neger E., Flory K. (2019). Stand-alone social skills training for youth with ADHD: A systematic review. Clinical Child and Family Psychology Review, 22(3), 348–366.
    1. Wolraich M. L., Wibbelsman C. J., Brown T. E., Evans S. W., Gotlieb E. M., Knight J. R., Ross E. C., Shubiner H. H., Wender E. H., Wilens T. (2005). Attention-deficit/hyperactivity disorder among adolescents: A review of the diagnosis, treatment, and clinical implications. Pediatrics, 115(6), 1734–1746.
    1. World Health Organisation (WHO). (2018). International classification of functioning, disability and health (ICF). Retrieved February 26, 2020, from
    1. Young S., Hollingdale J., Absoud M., Bolton P., Branney P., Colley W., Craze E., Dave M., Deeley Q., Farrag E. (2020). Guidance for identification and treatment of individuals with attention deficit/hyperactivity disorder and autism spectrum disorder based upon expert consensus. BMC Medicine, 18, 1–29.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する