Effectiveness of Specific Techniques in Behavioral Teacher Training for Childhood ADHD Behaviors: Secondary Analyses of a Randomized Controlled Microtrial

Anouck I. Staff*, Saskia van der Oord, Jaap Oosterlaan, Rianne Hornstra, Pieter J. Hoekstra, Barbara J. van den Hoofdakker, Marjolein Luman

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Behavioral teacher training is an effective intervention for children with attention-deficit/hyperactivity disorder (ADHD). Intervention effectiveness may be enhanced by including intervention components that carry the strongest evidence for their effectiveness. A previous article of this group showed that both antecedent- (i.e., stimulus-control) and consequent-based (i.e., contingency management) techniques were highly effective in reducing daily teacher-rated, individually selected problem behaviors in a specific situation of the child. Effects were observed up to three months post intervention. Here, we tested whether effects were also present in teacher-rated and masked DSM-based assessments that comprise the full range of ADHD and oppositional defiant disorder (ODD) symptoms, as well as on teacher-rated impairment. Teachers of 90 children with (subthreshold) ADHD (6–12 years) were randomly assigned to one of three conditions: a short (two sessions), individualized intervention consisting of either a) antecedent-based techniques or b) consequent-based techniques; or c) waitlist. Multilevel analyses showed that both sets of techniques were effective in reducing teacher-rated ADHD symptoms and impairment immediately after the intervention and up to three months later, as compared to waitlist. Masked observations of ADHD behavior were in line with teacher ratings, with effects being most pronounced for inattention. No effects on teacher-rated or masked ODD behavior were found. This study showed that antecedent- and consequent-based techniques were effective in improving classroom ADHD symptoms and impairment. Long-term changes in teacher-rated ADHD are promising. These results extend previous findings and show the potential of short individually tailored interventions in classroom settings as treatment of ADHD symptoms.

Original languageEnglish
Pages (from-to)867-880
Number of pages14
JournalResearch on Child and Adolescent Psychopathology
Volume50
Issue number7
Early online date11 Jan 2022
DOIs
Publication statusPublished - Jul 2022

Bibliographical note

Funding Information:
This work was supported by The Netherlands Organization for Health Research and Development (ZonMw), grant number 729300013.

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • ADHD
  • Antecedent-based techniques
  • Behavioral teacher training
  • Consequent-based techniques
  • Microtrial

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