Parent management training for the families of children diagnosed with attention deficit hyperactivity disorder : four case studies with a multiple baseline across participants design using the Incredible Years Parent Training Series : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
Attention deficit hyperactivity disorder (ADHD) is a commonly diagnosed behavioural disorder of childhood that has had a dramatic increase in diagnosis in recent years. It has long-term adverse effects on educational and psychosocial outcomes, and is a major health problem for individuals, families and society. Parents of children with ADHD often lack the skills to manage difficult behaviour effectively. Family functioning may also be compromised. This includes increased stress levels for parents. While medication is the single most effective intervention for the symptoms of ADHD, it has not yet been demonstrated to have long-term benefits, has adverse side effects for some children and does not address the associated comorbid disorders that often accompany ADHD. The combination of medication and parent training may result in better long-term outcomes for children and their parents. The aim of this research was to assess the effectiveness of 'The Incredible Years Parent Training Series' on the functioning of families of children with ADHD. The program is an empirically based parent training intervention that uses group discussion, videotape modelling, role plays and rehearsal, along with facilitator input and guidance. A multiple baseline across participants design was employed with four research participants in a group of parents attending a 2-hour treatment session weekly for 20 weeks. Participants were referred from the Child and Adolescent Mental Health Specialist Service at Tauranga Hospital and were all solo mothers with sons between 5 and 10 years of age who met the DSM IV criteria for ADHD. Family functioning was assessed from a pre-treatment interview schedule, measures of child behaviour (CBCL, Conners, Strengths and Difficulties Questionnaire, daily ratings of child behaviour), and parental and family functioning (BDI- II, Parental Stress Index, weekly ratings on specific areas of family functioning, group goals). Participants also completed programme satisfaction and evaluation measures. Results showed (a) improvement in teacher reports of child behaviour but generally not in parent psychometric reports, (b) improved targeted family functioning problems, (c) high number of goals achieved related to child behaviours, (d) reduced stress and depression levels for most participants (e) reports of better parent-child relationships, and (f) increased parental confidence. Additionally, participants were highly satisfied with the programme. Findings support the use of the Incredible Years Parent Training Series as an effective low cost intervention to improve the functioning of families of ADHD children.