Published September 3, 2012 | Version v1
Journal article Open

Protocol Evaluating the effectiveness of a school-based group programme for parents of children at risk of ADHD: the ‘PArents, Teachers and CHildren WORKing Together (PATCHWORK)’ cluster RCT protocol

Description

Abstract

Introduction Early intervention for childhood behavioural problems may help improve health and educational outcomes in affected children and reduce the likelihood of developing additional difficulties. The National Institute for Health and Clinical Excellence guidelines for attention deficit/hyperactivity disorder (ADHD), a common childhood behavioural disorder, recommend a stepped care approach for the identification and management of these problems. Parents of children with high levels of hyperactivity and inattention may benefit from intervention programmes involving behavioural management and educational approaches. Such interventions may be further enhanced by providing training and feedback to teachers about the strategies discussed with parents. In relation to children with high levels of hyperactivity, impulsiveness and inattention, we aim to test the feasibility and effectiveness of a parenting programme (with and without an accompanying teacher session) in primary schools.

Methods and analysis This clustered (at the level of school) randomised controlled trial (RCT) focuses on children in their first four school years (ages 4–8 years) in the East Midlands area of England. Parents will complete a screening measure, the Strengths and Difficulties Questionnaire, to identify children with high levels of hyperactivity/inattention. Three approaches to reducing hyperactivity and attention problems will be compared: a group programme for parents (parent-only intervention); group programme for parents combined with feedback to teachers (combined intervention); and waiting list control (no intervention). Differences between arms on the short version of Conners’ Parent and Teacher Rating Scales Revised will be compared and also used to inform the sample size required for a future definitive cluster RCT. A preliminary cost-effectiveness analysis will also be conducted.

Ethics and dissemination The outcomes of this study will inform policy makers about the feasibility, acceptability and effectiveness of delivering targeted behavioural interventions within a school setting. The study has received ethical approval from the University of Nottingham Medical School Ethics Committee.

Trial registration ISRCTN87634685

Notes

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

Files

protocol-evaluating-the-effectiveness-of-a-school-based-group-programme-for-parents-of-children-at-risk-of-adhd.pdf

Additional details

Identifiers

References

  • Department for Education and Skills. Every child matters. London: The Stationery Office, 2004. http://www.education.gov.uk/consultations/downloadableDocs/EveryChildMatters.pdf
  • Department of Health. National service framework for children, young people and maternity services. London: The Stationery Office, 2004.
  • Department of Health. Quality, innovation,productivity and prevention. http://www.dh.gov.uk/en/Healthcare/Qualityandproductivity/index.htm
  • Department for Children, Schools and Families. Targeted Mental Health in Schools Project (DCSF 00784-2008). DCSF Publications, 2008. https://www.education.gov.uk/publications/standard/_arc_SOP/Page11/DCSF-00784-2008
  • National Institute for Health and Clinical Excellence. Attention deficit hyperactivity disorder: diagnosis and management of ADHD in children, young people and adults (Clinical Guideline 72). London: NICE, 2008.
  • Sayal K, Ford T, Goodman R. Trends in recognition and service use for ADHD in Britain. Psychiatr Serv 2010;61:803–10.
  • Sonuga-Barke EJS, Daley D, Thompson M, et al. Parent-based therapies for preschool attention-deficit/hyperactivity disorder: a randomized, controlled trial with a community sample. J Am Acad Child Adolesc Psychiatry 2001;40:402–8.
  • Corkum PV, McKinnon MM, Mullane JC. The effect of involving classroom teachers in a parent training program for families of children with ADHD. Child Fam Behav Ther 2005;27:29–49.
  • Sayal K, Goodman R, Ford T. Barriers to the identification of children with attention deficit/hyperactivity disorder. J Child Psychol Psychiatry 2006;47:744–50.
  • Sayal K, Owen V, White K, et al. Impact of early school-based screening and intervention programs for ADHD on children's outcomes and access to services follow-up of a school-based trial at age 10 years. Arch Pediatr Adolesc Med 2010;164:462–9.
  • Craig P, Dieppe P, Macintyre S, et al. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008;337:a1655.
  • Sayal K, Hornsey H, Warren S, et al. Identification of children at risk of attention deficit/hyperactivity disorder—a school-based intervention. Soc Psychiatry Psychiatr Epidemiol 2006;41:806–13.
  • Daley D, Jones K, Hutchings J, et al. Attention deficit hyperactivity disorder in pre-school children: current findings, recommended interventions and future directions. Child Care Health Dev 2009;35:754–66.
  • Jones K, Daley D, Hutchings J, et al. Efficacy of the incredible years basic parent training programme as an early intervention for children with conduct problems and ADHD. Child Care Health Dev 2007;33:749–56.
  • Jones K, Daley D, Hutchings J, et al. Efficacy of the incredible years programme as an early intervention for children with conduct problems and ADHD: long-term follow-up. Child Care Health Dev 2008;34:380–90.
  • Webster-Stratton CH, Reid MJ, Beauchaine T. Combining parent and child training for young cildren with ADHD. J Clin Child Adolesc Psychol 2011;40:191–203.
  • Hoath FE, Sanders MR. A feasibility study of Enhanced Group Triple P—positive parenting program for parents of children with attention-deficit/hyperactivity disorder. Behav Change 2002;19:191–206.
  • Phelan TW. 1-2-3 Magic: effective discipline for children 2–12. 4th edn. Glen Ellyn, IL: ParentMagic, Inc., 2010.
  • Bradley SJ, Jadaa DA, Brody J, et al. Brief psychoeducational parenting program: an evaluation and 1-year follow-up. J Am Acad Child Adolesc Psychiatry 2003;42:1171–8.
  • Goodman R. The extended version of the strengths and difficulties questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry 1999;40:791–9.
  • Goodman R, Ford T, Simmons H, et al. Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. Br J Psychiatry 2000;177:534–9.
  • Meltzer H, Gatward R, Goodman R, et al. Mental health of children and adolescents in Great Britain. London: The Stationary Office, 2000.
  • Green H, McGinnity A, Meltzer H, et al. Mental health of children and young people, Great Britain 2004. London: Palgrave MacMillan, 2005.
  • Conners CK. Conners’ rating scales—revised technical manual. North Tonawanda, NY: Multi-Health Systems, 1997.
  • Rodgers B, Pickles A, Power C, et al. Validity of the malaise inventory in general population samples. Soc Psychiatry Psychiatr Epidemiol 1999;34:333–41.
  • Wille N, Badia X, Bonsel G, et al. Development of the EQ-5D-Y: a child-friendly version of the EQ-5D. Qual Life Res 2010;19:875–86.
  • Williams A. EUROQOL—a new facility for the measurement of health-related quality-of-life. Health Pol 1990;16:99–208.
  • Stevens KJ. Valuation of the child health utility index 9D (CHU9D). Health economics and decision science discussion paper ScHARR, University of Sheffield, 2010.
  • Canaway AG, Frew EJ. Measuring preference-based quality of life in children aged 6–7 years: a comparison of the performance of the CHU-9D and EQ-5D-Y-the WAVES Pilot Study. Qual Life Res 2012.
  • Beecham J, Knapp M. Costing psychiatric services. In: Thornicroft G, ed., Measuring mental health needs. 2nd edn. London: Gaskell, 2001:200–24.
  • Sayal K, Taylor E, Beecham J. Parental perception of problems and mental health service use for hyperactivity. J Am Acad Child Adolesc Psychiatry 2003;42:1410–14.
  • Cohen J. Statistical power analysis for the behavioural sciences, 2nd edn. Hillsdale, NJ: Lawrence Erlbaum 1988.
  • Curtis L. Unit Costs of Health and Social Care. (2011). http://www.pssru.ac.uk/project-pages/unit-costs/2011/index.php
  • Stinnett AA, Mullahy J. Net health benefits: a new framework for the analysis of uncertainty in cost-effectiveness analysis. Med Decis Making 1998;18:S68–80.