Behavior Parent Education for ADHD in Pre-Kindergarteners

(PEAK Trial)

Recruiting in Palo Alto (17 mi)

Overseen by Lee Kern, Ph.D.

Age: < 18

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Lehigh University

No Placebo Group

Trial Summary

What is the purpose of this trial?

This trial tests a parent training program called PEAK for parents of young children with ADHD. The program teaches practical strategies to manage behavior and improve early academic skills through interactive sessions available both face-to-face and online.

Do I have to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the idea that Behavior Parent Education for ADHD in Pre-Kindergarteners is an effective treatment?

The available research shows that Behavior Parent Education (BPE) is effective for treating ADHD in pre-kindergarteners. One study found that group-based BPE is a cost-effective and time-efficient alternative to individual sessions, especially in low-resource settings, and it helps reduce ADHD severity in preschoolers. Another study highlighted that home-based BPE significantly improved ADHD symptoms and disruptive behaviors in children who had not fully responded to other treatments. These findings suggest that BPE is a beneficial treatment option for young children with ADHD. ^{1 2 3 4 5}

What safety data exists for Behavior Parent Education for ADHD in Pre-Kindergarteners?

The available research does not directly address safety data for Behavior Parent Education (BPE) specifically under the names Promoting Engagement with ADHD Pre-Kindergarteners (PEAK) or Promoting Engagement for ADHD pre-Kindergartners. However, Behavioral Parent Training (BPT), which is similar in approach, is recommended as a first-line treatment for preschool children with ADHD. Studies suggest that structured parent education programs, including BPT, can be effective in improving child behavior and parenting practices. These programs are generally considered safe and beneficial, but specific safety data for BPE under the mentioned names is not provided in the available research. ^{2 3 5 6 7}

Is the treatment Promoting Engagement with ADHD Pre-Kindergarteners (PEAK) a promising treatment for ADHD in young children?

Yes, the treatment Promoting Engagement with ADHD Pre-Kindergarteners (PEAK) is promising. Research shows that behavioral parent training, like PEAK, is effective in reducing ADHD symptoms such as inattention, hyperactivity, and impulsivity in young children. It also improves parenting practices and overall outcomes for children with ADHD. ^{2 3 5 7 8}

Research Team

George J DuPaul, Ph.D.

Principal Investigator

Lehigh University

Lee Kern, Ph.D.

Principal Investigator

Lehigh University

Eligibility Criteria

This trial is for children aged 3 to nearly 6 with ADHD symptoms, who meet the criteria for ADHD based on interviews and behavior ratings. They should be in preschool or daycare at least twice a week unless they can't due to behavioral issues or disabilities unrelated to ASD, intellectual disability, or significant physical impairments.

Inclusion Criteria

My child, aged 3-5 years, shows significant ADHD symptoms.

Children who have been diagnosed with ADHD by a doctor through clinical interview and have shown signs of ADHD at home and school according to their parents and teachers.

Exclusion Criteria

My child attends preschool or daycare at least 2 days a week, unless unable due to specific issues.

You have been diagnosed with autism spectrum disorder (ASD), intellectual disability, or significant physical or neurological impairments.

Treatment Details

Interventions

• Promoting Engagement with ADHD Pre-Kindergarteners (PEAK) (Behavioural Intervention)

Trial Overview Project PEAK tests how effective parent education programs are in managing child behavior problems related to ADHD. It compares two ways of delivering this training: face-to-face and online, against a wait-list control group. The study aims to see which method keeps parents more engaged and helps maintain improvements over time.

Participant Groups

Group I: Waitlist Control Experimental Treatment 1 Intervention

The comparison condition is a waitlist control group that will receive no intervention throughout the intervention timeframe. Instead, participants will receive wellness information about typical child development and constructs unrelated to the intervention content. Subsequent to the 12-month follow-up assessment, they will be provided access to the online version of the program. To encourage ongoing participation in the absence of services, parents will be informed that, at the end of the intervention timeframe, they will receive support (i.e., weekly contact to answer questions) while they complete the online program.

Group II: Online Treatment Experimental Treatment 1 Intervention

For the online version of the program, in addition to content regarding an overview of ADHD, the initial session consists of brief video clips demonstrating how to access PEAK sessions on the Internet, and an orientation to online content (e.g., handouts, interactive chat sessions, research team contact links). Prior to the session, parents are provided with password-protected individual access codes. Similar to the F2F program, check-ins are provided weekly via each parent's preferred mode of communication (i.e., text, internet, phone) to query strategies implemented, praise success, and troubleshoot alternative strategies. Parents in the online condition will also receive supplemental optimistic training to improve pessimistic thinking patterns about their child and parenting.

Group III: Face to Face Treatment Experimental Treatment 1 Intervention

The F2F version of PEAK contains 10 BPE sessions (1.5 hours each). Session content includes: 1) Introduction to ADHD, 2) Attending, Rewards and Ignoring, 3) General Behavior Management Strategies, 4) Problem-Solving Approach, 5) Preventive Intervention, 6) Instructive Interventions, 7) Response Strategies, 8) Extending What Works to Community Settings, 9) Promoting Early Reading and Math Skills, and 10) Effective Communication Strategies. Each session contains didactic instruction and activities designed to enhance engagement. Sessions include video examples and interactive activities. Weekly homework is assigned for strategy practice. At the start of the following session, the leader checks in with families on the use of the chosen strategy. The session leader praises successes and troubleshoots challenges. The intervention also includes optimistic training which aims to identify/improve pessimistic thinking patterns that parents have about their parenting and child's behaviors.

Who Is Running the Clinical Trial?

Lehigh University

Lead Sponsor

Trials

24

Recruited

6,800+

Institute of Education Sciences

Collaborator

Trials

10

Recruited

3,200+

Institute of Education Sciences (IES)

Collaborator

Trials

2

Recruited

800+

Findings from Research

Integrating behavioral parent training (BPT) into pediatric primary care settings is a promising approach to increase access for families, especially in low-income, predominantly Black communities.

The adaptations made to the BPT program were found to be feasible and acceptable, successfully engaging families and transforming the practices of primary care providers, which can help reduce behavioral health disparities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adapting a preschool disruptive behavior group for the underserved in pediatric primary care practice. Raglin Bignall, WJ., Herbst, RB., McClure, JM., et al.[2023]

A randomized controlled trial involving 56 preschool children with ADHD showed that group-based behavioral parent training (BPT) is as effective as individual BPT in reducing ADHD severity over 12 weeks.

Both group and individual BPT significantly reduced parental stress and improved coping strategies, indicating that group BPT is a feasible and effective treatment option in low-resource settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of brief group behavioural parent training with individual parent training for preschool children with attention deficit hyperactivity disorder: A randomized feasibility study. Vaidyanathan, S., Chandrasekaran, V., Kandasamy, P.[2023]

A psychoeducation program for families of children with ADHD significantly reduced total ADHD symptoms and inattention/cognition issues, with medium-large effect sizes, based on parent reports from a study involving 69 participants.

The positive effects of the psychoeducation program persisted for at least 6 months after the intervention, suggesting it is an effective and valid approach to managing ADHD symptoms alongside standard treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Trial Evaluating the Efficacy of a Psychoeducation Program for Families of Children and Adolescents With ADHD in the United Kingdom: Results After a 6-Month Follow-Up. Ferrin, M., Perez-Ayala, V., El-Abd, S., et al.[2021]

In a study of 73 children with ADHD and disruptive behaviors, home-based behavioral parent training significantly reduced the severity of disruptive behaviors and ADHD symptoms compared to a waiting list and standard care, with effect sizes indicating moderate to large improvements.

The training was particularly effective in addressing oppositional-defiant disorder symptoms, suggesting that it can be a valuable intervention for children who continue to struggle after traditional treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home-based parent training for school-aged children with attention-deficit/hyperactivity disorder and behavior problems with remaining impairing disruptive behaviors after routine treatment: a randomized controlled trial. Nobel, E., Hoekstra, PJ., Agnes Brunnekreef, J., et al.[2022]

Parent training (PT) is recommended as the first-line treatment for preschool children with ADHD, highlighting its importance in managing this prevalent neuro-developmental disorder.

The review evaluates three different PT programs in Denmark that have been assessed through randomized controlled trials (RCTs), providing evidence for their effectiveness in addressing ADHD symptoms in young children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[ADHD in preschoolers and early parent training interventions]. Lange, AM., Thomsen, PH.[2020]

A systematic review of 16 studies found that group-based parent education programs can effectively improve behavior problems in children aged 3 to 10, leading to positive changes in both parental perceptions and children's behavior.

Despite the promising results, the review highlighted significant variability in the interventions and populations studied, suggesting that more controlled studies are needed before broadly applying these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavior problems and group-based parent education programs. Barlow, J., Stewart-Brown, S.[2019]

Behavioral Parent Training (BPT) is an effective first-line treatment for children with ADHD under six years old and a recommended combination treatment for older children, showing significant improvements in problem behaviors like inattention and hyperactivity.

The study demonstrated that BPT significantly improved parenting practices, as evidenced by changes in Parenting Scale scores, indicating that it can reduce negative parenting behaviors and enhance outcomes for children with ADHD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does a Behavioral Parent Training Program for Parents of ADHD Children Improve Outcomes? A Pilot Project. Morgan, TC., O'Keefe, LC.[2021]

A randomized controlled trial involving 164 preschool children with ADHD showed that a structured parent training program significantly improved parent-reported ADHD symptoms compared to usual care, with effects lasting up to 36 weeks after treatment.

The parent training program also enhanced parenting self-efficacy and reduced family strain, but did not show any impact on teacher ratings, direct observations of ADHD symptoms, or child conduct problems.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parent Training for Preschool ADHD in Routine, Specialist Care: A Randomized Controlled Trial. Lange, AM., Daley, D., Frydenberg, M., et al.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

Adapting a preschool disruptive behavior group for the underserved in pediatric primary care practice. [2023]

2. Australia pubmed.ncbi.nlm.nih.gov

Comparison of brief group behavioural parent training with individual parent training for preschool children with attention deficit hyperactivity disorder: A randomized feasibility study. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Trial Evaluating the Efficacy of a Psychoeducation Program for Families of Children and Adolescents With ADHD in the United Kingdom: Results After a 6-Month Follow-Up. [2021]

4. Germany pubmed.ncbi.nlm.nih.gov

Home-based parent training for school-aged children with attention-deficit/hyperactivity disorder and behavior problems with remaining impairing disruptive behaviors after routine treatment: a randomized controlled trial. [2022]

5. Denmark pubmed.ncbi.nlm.nih.gov

[ADHD in preschoolers and early parent training interventions]. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

Behavior problems and group-based parent education programs. [2019]

7. England pubmed.ncbi.nlm.nih.gov

Does a Behavioral Parent Training Program for Parents of ADHD Children Improve Outcomes? A Pilot Project. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Parent Training for Preschool ADHD in Routine, Specialist Care: A Randomized Controlled Trial. [2019]