Longitudinal Impact of a Randomized Clinical Trial to Improve Family Function, Reduce Maternal Stress and Improve Child Outcomes in Families of Children with ADHD

Shervin S. Churchill, Michael C. Leo, Eileen M. Brennan, Claudia Sellmaier, Judy Kendall, Gail Houck

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective Evaluate the efficacy of a 12 month nursing case-management intervention over a period of 18 months, 6 months after the end of intervention, for families of children attention deficit hyperactivity disorder (ADHD). Methods Mother and child dyads were enrolled to participate in a randomized controlled clinical trial. Children were 4–18 years old. Data were collected at baseline, 6, 12, and 18 months or 6 months after the termination of direct intervention. Longitudinal analyses, using generalized estimating equations, were conducted to assess change in study outcomes relating to family function, maternal stress, and child behavior over the 18 month period. Results Compared to control families, some family function outcomes were moderately improved in the intervention group. In particular, intervention families demonstrated substantial improvement in implementing family behavior controls (p value = 0.038) and improvement in family satisfaction (not statistically significant p = 0.062). Although there was improvement in the overall family function measure there was not a statistically significant difference between groups. Maternal stress and child behavior outcomes were not significantly different between control and intervention groups by the end of the intervention. Conclusions for Practice Addressing ADHD is complex and requires the assessment of comorbidities that might exacerbate negative behavior. Our findings support the latest American Academy of Pediatrics guidelines to use behavioral therapy as the first line of treatment in young children. Nursing case-management interventions that provide direct family education and improve family function, especially with respect to providing structure and behavior control, may complement and facilitate behavioral therapy for treatment of ADHD and improving child behavior.

Original languageEnglish (US)
Pages (from-to)1172-1182
Number of pages11
JournalMaternal and Child Health Journal
Volume22
Issue number8
DOIs
StatePublished - Aug 1 2018
Externally publishedYes

Fingerprint

Attention Deficit Disorder with Hyperactivity
Randomized Controlled Trials
Mothers
Child Behavior
Maternal Behavior
Behavior Control
Case Management
Nursing
Therapeutics
Comorbidity
Outcome Assessment (Health Care)
Guidelines
Pediatrics
Education
Control Groups

Keywords

  • ADHA
  • Child outcomes
  • Family function
  • Maternal stress

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health

Cite this

Longitudinal Impact of a Randomized Clinical Trial to Improve Family Function, Reduce Maternal Stress and Improve Child Outcomes in Families of Children with ADHD. / Churchill, Shervin S.; Leo, Michael C.; Brennan, Eileen M.; Sellmaier, Claudia; Kendall, Judy; Houck, Gail.

In: Maternal and Child Health Journal, Vol. 22, No. 8, 01.08.2018, p. 1172-1182.

Research output: Contribution to journalArticle

Churchill, Shervin S. ; Leo, Michael C. ; Brennan, Eileen M. ; Sellmaier, Claudia ; Kendall, Judy ; Houck, Gail. / Longitudinal Impact of a Randomized Clinical Trial to Improve Family Function, Reduce Maternal Stress and Improve Child Outcomes in Families of Children with ADHD. In: Maternal and Child Health Journal. 2018 ; Vol. 22, No. 8. pp. 1172-1182.
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