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Completed

NCT Number: NCT02518711

Effectiveness Study of a Behavioral Teacher Program Targeting ADHD Symptoms

The goal of this study was to investigate the effectiveness of a behavioral teacher program addressing symptoms of Attention-Deficit Hyperactivity Disorder (ADHD) in the classroom.

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Key information

Conditions

Attention Deficit Hyperactivity Disorder Attention Deficit Disorder with Hyperactivity Attention Deficit and Disruptive Behavior Disorders Mental Disorders Neurodevelopmental Disorders

Age range

6 year–13 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Background:

Most behavioral teacher programs involve intensive and expensive teacher trainings by health care specialists, which may limit successful large-scale implementation. This behavioral program, on the contrary, involves a self-containing manual that does not require expert training in order to increase the likelihood of successful implementation (if proven effective). The aim was to investigate the program's effects on behavioral, socio-emotional and school functioning in primary school children.

Methods:

Children with ADHD symptoms were randomly assigned at school level to the intervention condition (receiving the program during 18 weeks) or control group (not receiving the program but who were allowed to receive care as usual).

Measures to assess program's effectiveness:

  • Strengths and Weaknesses of ADHD-symptoms and Normal Behavior,
  • Strengths and Difficulties Questionnaire
  • Social Skills Rating Scale
  • Spence Children's Anxiety Scale
  • Classroom Observation Code
  • Actigraphy
  • Sociometric measures (peer nomination and peer rating)
  • Dutch arithmetic test (Tempo-Test-Rekenen)
  • reading test (Drie-Minuten-Toets) and writing test (PI-dictee).

Additional measures:

  • Wechsler Intelligence Scale for Children (Block Design and Vocabulary; used to estimate IQ);
  • Sensitivity to Punishment and Sensitivity to Reward Questionnaire and several neuropsychological computer tasks

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • sub-threshold or clinical level of ADHD symptoms as observed by participant's teacher through the Dutch version of the Disruptive Behavior Disorders Rating Scale (Pelham, Gnagy, Greenslade, & Milich, 1992)
  • at least one clinical and three sub-threshold ADHD symptoms as measured by the Teacher Telephone Interview (Holmes et al., 2004), a semi-structured interview which is based on the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000)

Exclusion criteria

  • (medication) treatment for ADHD at study entry or in preceding 6 months;
  • neurological or severe physical condition
  • IQ < 80 based on a short version of the Wechsler Intelligence Scale for Children (Block Design and Vocabulary; Legerstee, van der Reijden-Lakeman, Lechner-van der Noort, & Ferdinand, 2004; Hrabok, Brooks, Fay-McClymont, & Sherman, 2014)
  • participant enrolled in a daily contingency management program or other teacher program targeting behavior or social problems at study entry or in the preceding month
  • Maximum of 2 children per classroom and 5 classrooms per school (in order to limit teachers' burden and increase heterogeneity of teacher and classroom settings)

Treatment and study plan

Behavioral Teacher Program

Behavioral

This program was based on the evidence-based Summer Treatment Program (MTA Cooperative Group, 1999), involving psycho-education for the teacher and universal and individual behavioral techniques that focused on classroom structure and contingency management

Primary outcomes

  1. Change from Baseline in Strengths and Weaknesses of ADHD-symptoms and Normal Behavior Scale (SWAN; Young, Levi, Martin, & Hay, 2009)

    Time frame: 6 weeks and 18 weeks after baseline assessment

    The teacher and parent version of the SWAN were used

  2. Change from Baseline in Strengths and Difficulties Questionnaire (SDQ; Van Widenfelt, Goedhart, Treffers, & Goodman, 2003)

    Time frame: 6 weeks and 18 weeks after baseline assessment

    The teacher and parent-version of the SDQ were administered, using the following subscales: ADHD, Conduct Problems, Internalizing Behavior (combining Emotional Symptoms and Peer Problems), and Impact On Daily Functioning

  3. Change from Baseline in hyperactivity during school hours using Actigraphy (Cambridge Neurotechnology, 2008)

    Time frame: 6 weeks and 18 weeks after baseline assessment

    It concerned an actigraph worn on the wrist of the non-dominated hand during 5 school days

  4. Change from Baseline in Disruptive Classroom Behavior measured by the Classroom Observation Code (COC; Abikoff, Gittelman, & Klein, 1980)

    Time frame: 6 weeks and 18 weeks after baseline assessment

    The observation was performed by well-trained psychology students not involved in treatment delivery. Each participant was observed twice on the same school day for 8 minutes, using the average score as outcome measure

Secondary outcomes

  1. Change from Baseline in Social Skills Scale of the Social Skills Rating Scale (SSRS; Merrell & Popinga, 1994)

    Time frame: 6 weeks and 18 weeks after baseline assessment

    The teacher and parent version of the SSRS were used

  2. Change from Baseline in Spence Children's Anxiety Scale (SCAS)

    Time frame: 6 weeks and 18 weeks after baseline assessment

    SCAS is a self-report administered to the child

  3. Change from Baseline in Sociometric Measure (Bukowski, Cillessen, & Velasquez, 2012)

    Time frame: 6 weeks and 18 weeks after baseline assessment

    The sociometric measure includes both a peer nomination and a peer rating scale

  4. Change from Baseline in Performance on Dutch Reading Test (Drie-Minuten Toets; Verhoeven, 1995)

    Time frame: 6 weeks and 18 weeks after baseline assessment

  5. Change from Baseline in Performance on Dutch Writing Test (PI-dictee; Geelhoed & Reitsma, 2000)

    Time frame: 6 weeks and 18 weeks after baseline assessment

  6. Change from Baseline in Performance on Dutch Arithmetic Test (Tempo-Test Rekenen; De Vos, 1992)

    Time frame: 6 weeks and 18 weeks after baseline assessment

  7. Teacher's treatment fidelity averaged over 18 similar checklists (self-constructed), containing 13 items on a 3-point Likert scale regarding the use of each intervention element (0=not used or inadequate use, 1=adequate use, and 2=good use)

    Time frame: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, and 18 weeks after start of the intervention

    Only teachers in the intervention group needed to fill in this rating scale

Sponsors and collaborators

Lead sponsor

VU University of Amsterdam

Other

Collaborators

  • Nederlandse Stichting voor het Gehandicapte Kind, The Netherlands
  • Stichting Kinderpostzegels Nederland
  • Stichting Weeshuis der Doopsgezinden, The Netherlands
  • Stichting Zonnige Jeugd, The Netherlands

Registry information

Official study title

A Randomized Controlled Trial Into the Effectiveness of a Behavioral Teacher Program Targeting ADHD Symptoms

Important dates

Study start
2011
Primary completion
2014
Study completion
2014
First posted
Aug 10, 2015
Registry last updated
Aug 10, 2015

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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