Components of Behavioral Parent Training for Children With Attention-Deficit/Hyperactivity Disorder: A Series of Replicated Single-Case Experiments

Rianne Hornstra*, Patrick Onghena, Barbara J. van den Hoofdakker, Lianne van der Veen-Mulders, Marjolein Luman, Anouck I. Staff, Saskia van der Oord

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Behavioral parent training (BPT) is an evidence-based treatment for children with attention-deficit/hyperactivity disorder (ADHD). Stimulus control techniques (antecedent-based techniques, e.g., clear rules, instructions) and contingency management techniques (consequent-based techniques, e.g., praise, ignore) are the most common ones that are being taught to parents in BPT. However, research into the additive effects of these techniques is scarce. In this replicated single-case experimental ABC phase design, including six children on stable medication for ADHD (8–11 years) and their parents, the added efficacy of consequent-based techniques on top of antecedent-based techniques was evaluated. After a baseline period (phase A), we randomized the commencement time of two sessions parent training in antecedent-based techniques and two sessions parent training in consequent-based techniques for each child. Children’s behaviors were assessed by daily parent ratings of selected problem behaviors and an overall behavior rating. Although visual inspection showed that behavior improved for most children in both phases, randomization tests did not demonstrate the added efficacy of the consequent-based techniques on top of the antecedent-based techniques. Limitations of the study and recommendations for future single-case experiments in this population are discussed.

Original languageEnglish
Pages (from-to)1042-1070
Number of pages29
JournalBehavior Modification
Volume47
Issue number5
Early online date13 Apr 2023
DOIs
Publication statusPublished - Sept 2023

Bibliographical note

Funding Information:
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Rianne Hornstra, Patrick Onghena, Anouck I. Staff, and Saskia van der Oord report no conflicts of interest. Barbara van den Hoofdakker received research grants from ZonMw, NWO (The Netherlands Organisation for Scientific Research); UMCG (University Medical Centre Groningen), and receives royalties as one of the editors of “Sociaal Onhandig.” She is and has been involved in the development and evaluation of parent and teacher training programs, without financial interests; she is a member of Dutch ADHD guideline and practice standard groups. Lianne van der Veen-Mulders receives royalties as one of the editors of “Sociaal Onhandig” (published by Van Gorcum), a Dutch book for parents that can be used in parent training. She is and has been involved in the development and evaluation of parent and teacher training programs, without financial interests. Marjolein Luman co-developed a self-help teacher training, without financial interests. She received research grants from ZonMw and was an advisor of the Dutch ADHD guideline groups.

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was funded by the Dutch Organization for Health Research and Development (ZonMw), grant number 729300013 and by the Research Foundation Flanders (FWO), grant number G.0845.19N.

Publisher Copyright:
© The Author(s) 2023.

Funding

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Rianne Hornstra, Patrick Onghena, Anouck I. Staff, and Saskia van der Oord report no conflicts of interest. Barbara van den Hoofdakker received research grants from ZonMw, NWO (The Netherlands Organisation for Scientific Research); UMCG (University Medical Centre Groningen), and receives royalties as one of the editors of “Sociaal Onhandig.” She is and has been involved in the development and evaluation of parent and teacher training programs, without financial interests; she is a member of Dutch ADHD guideline and practice standard groups. Lianne van der Veen-Mulders receives royalties as one of the editors of “Sociaal Onhandig” (published by Van Gorcum), a Dutch book for parents that can be used in parent training. She is and has been involved in the development and evaluation of parent and teacher training programs, without financial interests. Marjolein Luman co-developed a self-help teacher training, without financial interests. She received research grants from ZonMw and was an advisor of the Dutch ADHD guideline groups. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was funded by the Dutch Organization for Health Research and Development (ZonMw), grant number 729300013 and by the Research Foundation Flanders (FWO), grant number G.0845.19N.

Keywords

  • antecedent-based techniques
  • attention-deficit/hyperactivity disorder
  • behavioral parent training
  • children
  • consequent-based techniques
  • single-case experimental design

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