INTRODUCTION:Evidence-based assessments for ADHD include the collection of standardized ratings of Diagnostic and Statistical Manual of Mental Disorders symptoms. There is limited research on ADHD diagnostic procedures in Hispanic/Latino children and a growing concern that ADHD may be underdiagnosed due to language barriers that exist between parents and the standardized measures. To address this gap, we examined potential language related biases in the assessment of ADHD among Spanish-speaking parents. METHODS:The sample was 107 Hispanic/Latino, Spanish-speaking parents of children in kindergarten or first grade. The Spanish translated versions of the Disruptive Behavior Disorders Rating Scale (DBD-RS), Strength and Difficulties Questionnaire (SDQ), and Impairment Rating Scale (IRS) were administered to assess ADHD symptoms, concurrent validity, and the influence of time since arrival in the United States on parent ratings. RESULTS:The Spanish DBD-RS demonstrated strong internal consistency for both Inattention (α = .85) and Hyperactivity/Impulsivity (α = .85) subscales. Parent ADHD ratings were positively correlated with SDQ Hyperactivity/Inattention scores (r = .38, p < .001), supporting concurrent validity. In regression analyses, parent time in the U.S. significantly predicted IRS impairment scores beyond ADHD symptoms (ΔR2 = .036, p = .035). CONCLUSION:Despite limitations such as reliance on self-report measures and cultural heterogeneity in the sample, this research contributes to understanding ADHD assessment in an under-studied ethnic group. Our findings contribute to ongoing efforts to refine diagnostic tools and promote equitable access to ADHD evaluations that are culturally appropriate for Hispanic/Latino children.

BACKGROUND:Youth with attention-deficit/hyperactivity disorder (ADHD) are more likely to experience delays in obtaining their driver's license relative to their same-aged peers. However, despite these delays, there is no evidence of improved driving outcomes for these youth. Additionally, graduated driver's licensing laws typically terminate around the age of 18, giving some youth less structure prior to independently transitioning to the road. To date, no study has examined the cognitive and parenting factors that are related to delays in licensure for adolescents with ADHD within the context of an intervention (i.e., Supporting a Teen's Effective Entry to the Roadway; STEER). The current study utilized logistic regression analyses to determine if teen cognitive functioning, parenting, and the intervention were related to licensure status at 12-month follow-up. METHOD:Baseline cognition (i.e., reaction time variability, working memory, inhibitory control), baseline parental monitoring, baseline negative parenting, and licensure status were collected on 172 adolescents with ADHD enrolled in a randomized, controlled trial. RESULTS:There was a significant interaction between reaction time variability and the intervention on licensure status (p = .007), and a marginal interaction between negative parenting and the intervention on licensure status (p = .05). Those in the STEER group with more reaction time variability were more likely to be licensed at the 12-month follow-up. Although not statistically significant, those in the STEER group tended to have higher rates of licensure when negative parenting was lower. CONCLUSIONS:These findings indicate that the STEER intervention may have uniquely benefitted those adolescents who had more difficulties with reaction time prior to the intervention and, to some extent, provided additional support to parents that already had lower levels of negative parenting.

Children with ADHD have significant difficulties with social skill application (e.g., waiting turn, interpreting social cues). Behavioral treatments to promote social skills, such as the Summer Treatment Program (STP), incorporate daily social skills training with systematic opportunities to apply skills as part of peer group interactions. Recreational periods are particularly well-suited for examining these behaviors, as social skills are essential during game play. The current study examined undesirable behaviors during board games and explored underlying factors (e.g., inhibitory control, sensitivity to reinforcement) that may contribute to undesirable behaviors during play. Twenty-eight children with ADHD participated in the current cross-over design study. At baseline, children completed a task of inhibitory control and their parents rated their child's sensitivity to reinforcement. During the STP, children played competitive or cooperative board games, when taking either stimulant medication or placebo, in small groups of 3-4 children across 20 days. Undesirable behaviors were recorded during game play. Overall, medication use reduced rule violations, poor sportsmanship, and other behaviors. Only cooperative board games decreased teasing behavior. There was a reward x game interaction, such that those with higher reward sensitivity exhibited more poor sportsmanship during competitive games. Collectively, these findings suggest that stimulant medication attenuates undesirable peer interactions during board game play, cooperative board games may decrease teasing relative to competitive games, and the board game setting may be a potential avenue to better understand and address peer interactions in children with ADHD.

BACKGROUND:Understanding the mechanisms of change and between-family differences in behavioural parenting interventions for children with attention-deficit/hyperactivity disorder (ADHD) may help personalise interventions. Therefore, we examined whether improvements in parenting are associated with changes in child behaviour and functional outcomes, and how these associations vary based on parents' baseline parenting levels. METHODS:We collected individual participant data including 19 randomised controlled trials focusing on children with ADHD (n = 1,720). Immediate post-intervention measures of child ADHD and oppositional behaviour severity, reported by parents and functional impairment reported by either the parent or probably masked clinicians, were treated as outcomes. We estimated pathways from intervention (vs. control) to child outcomes, via immediate post-intervention parent reports of constructive parenting (e.g. praise), non-constructive parenting (e.g. physical punishment) and parent-child affection (e.g. warmth), while controlling for baseline values of both child outcomes and parenting levels. Baseline values of each parenting variable were used as moderators of the mediated pathways. RESULTS:Improvements in parenting behaviours and parent-child affection immediately following the intervention jointly explained concurrent improvements in children's ADHD severity, oppositional behaviour and functional impairment. Furthermore, when reversing the direction of the pathways, improvements in all child outcomes jointly explained improvements in each aspect of parenting. Improvements in non-constructive parenting and parent-child affection uniquely accounted for intervention effects on functional impairment, especially for families with higher baseline levels of non-constructive parenting. CONCLUSIONS:Our findings might indicate that improvements in both the behavioural and affective aspects of parenting are associated with concurrent reductions in child behaviour problems and functional impairment. However, more research is necessary to explore the potential causal directionality between parenting and child outcomes. Nonetheless, supporting families with poorer parenting skills may be especially important, as reductions in non-constructive parenting in these families are linked to stronger treatment effects on child functional impairment.

General parenting interventions without an explicit focus on weight-related constructs have demonstrated lasting effects on child weight outcomes. However, well-established parenting interventions are time and resource intensive, which has limited their ability to transition to real-world delivery. This exploratory study examined whether Play With Me, a pilot at-home play-based general parenting intervention, affected weight outcomes in middle childhood. The intervention provided evidence-based parenting guidance that parents implemented in shared activities with their four-to-five-year-old children. Two years following the intervention, a follow-up survey was sent to families who had participated (N = 31), and parents (n = 27) reported child height and weight when children were 6.9 ± 0.6 years old. Children in the intervention group had a lower body mass index (BMI) in middle childhood, adjusting for baseline BMI, age, and sex (d = 0.52). Results were similar when examining BMI z-scores, percentiles, and overweight status, with children in the intervention group being less likely to meet clinical criteria for overweight at middle childhood follow-up than children in the control group (9.10 % intervention, 37.50 % control, V = 0.32). These exploratory findings add to the evidence supporting causal links between general parenting and child weight, extend this evidence to an interactive at-home intervention delivery model, and indicate that future rigorous, well-powered trials are needed to test whether results replicate and elucidate mechanisms through which general parenting may promote healthy child growth trajectories.

OBJECTIVE:Daily report cards (DRC) are an effective approach for improving behavior in children with attention-deficit/hyperactivity disorder (ADHD). Recently, they have been used to address behavioral goals that are commonly documented in individualized education programs for children with ADHD receiving special education supports. METHOD:The present study evaluated a DRC, established and supported by research study consultants, based on special education (i.e., individualized education program [IEP]) goals and objectives. The sample included 213 students (grades kindergarten to seventh) with ADHD enrolled in a randomized, controlled trial that compared the DRC with school as usual. RESULTS:Results indicated that children with ADHD who had the DRC intervention significantly reduced the frequency of classroom rule violations, and teachers rated reductions in ADHD symptoms and in functional impairment. There were no significant differences between groups for the teacher ratings of academic performance or improvement in meeting special education goals. IEP quality (i.e., alignment between identified needs and goals) was a significant moderator of outcomes, with children who had lower quality IEPs being better supported by the DRC intervention. CONCLUSIONS:Overall, the DRC appears to be a viable approach for positively supporting children with ADHD who are receiving special education supports in schools, particularly for improving behavior in the classroom. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

William ("Bill") E. Pelham Jr. was a renowned clinical child psychologist who specialized in the assessment and treatment of children with attention-deficit/hyperactivity disorder (ADHD). Bill was born in 1948 in Atlanta, Georgia, to William E. Pelham Sr. and Kittie Copeland Kay, the eldest of four brothers. Bill is most well-known for the development, study, and advocacy of psychosocial treatments for children with ADHD. While at Florida State University in the 1980s, he developed a comprehensive summer treatment program designed to improve family and classroom functioning, strengthen peer relationships, and boost academic achievement. Bill built the case for the behavioral treatment of ADHD over nearly 50 years of programmatic research. Bill was a leader in the field of clinical child psychology. Bill passed away on October 21, 2023, after a brief illness. He is survived by his wife of 33 years Maureen, son William E. Pelham III, and daughter Caroline. His legacy will live on in their work to support children with ADHD and their families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This pilot randomized controlled trial evaluated impacts of a novel shared activities intervention designed to promote positive parent-child interactions, which may function as an alternative reinforcer to food. The 4-week, at-home Play With Me intervention combines didactic parenting videos and play kits with materials for parent-child activities to practice skills. Aims of the present study were to examine the intervention’s acceptability and its effects on parenting and the relative reinforcing value (RRV) of food versus parent-child activity at post-intervention. Thirty-two parents of 4-to-5-year-old children at risk for obesity were randomly assigned to the intervention or a waitlist control group. The intervention was well-liked by parents and feasible. Intervention parents reported more parenting structure and demonstrated higher observed sensitive parenting than controls at post; the latter finding was driven by greater parent positive mood, warmth, positive reinforcement, and relationship quality, with large effect sizes. There were no effects on the RRV of food. Inconsistent with hypotheses, there were trends toward control group parents reporting more parenting satisfaction and efficacy at post. Possible explanations are discussed. Results suggest Play With Me shows promise as an effective and acceptable intervention to promote positive parenting. Further research is needed to examine these effects and their implications for socioemotional development and health in a larger, more diverse sample over a longer time frame.

The long-term academic outcomes for many students with attention-deficit/hyperactivity disorder (ADHD) are strikingly poor. It has been decades since students with ADHD were specifically recognized as eligible for special education through the Other Health Impaired category under the Education for all Handicapped Children Act of 1975, and similarly, eligible for academic accommodations through Section 504 of the 1973 Rehabilitation Act. It is time to acknowledge that these school-policies have been insufficient for supporting the academic, social, and behavioral outcomes for students with ADHD. Numerous reasons for the unsuccessful outcomes include a lack of evidence-based interventions embedded into school approaches, minimizing the importance of the general education setting for promoting effective behavioral supports, and an over-reliance on assessment and classification at the expense of intervention. Contemporary behavioral support approaches in schools are situated in multi-tiered systems of support (MTSS); within this article we argue that forward-looking school policies should situate ADHD screening, intervention, and maintenance of interventions within MTSS in general education settings and reserve special education eligibility solely for students who require more intensive intervention. An initial model of intervention is presented for addressing ADHD within schools in a manner that should provide stronger interventions, more quickly, and therefore more effectively.

The impact of attention-deficit/hyperactivity (ADHD) disorder results in significant challenges in academic, behavioral, and social domains, necessitating targeted interventions. Although a substantial number of students with ADHD receive individualized education programs (IEPs), little is known about the most common accommodations and interventions included, and there is a dearth of research examining the alignment of these programs with the student's specific areas of functional deficit. This current mixed-method study analyzes IEPs of 209 students with ADHD in kindergarten through seventh grade, revealing strong alignment in goals and support for academic areas. However, significant gaps existed in addressing social, emotional, and behavioral difficulties, with fewer than half of the students having measurable goals for these areas. Regional and grade level differences in IEP content underscore the need for standardized approaches.Impact StatementThis study sheds light on the content and alignment of IEPs for students with ADHD, revealing strengths in academic goal alignment but gaps in addressing social, emotional, and behavioral needs. It calls for improved alignment between present levels of performance and annual goals/supportive accommodations and interventions for students with ADHD. These findings underscore the need for comprehensive support systems to address the diverse needs of students with ADHD and promote their long-term success.

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent, chronic, and impairing mental health disorder of childhood. Decades of empirical research has established a strong evidence-based intervention armamentarium for ADHD; however, limitations exist in regards to efficacy and effectiveness of these interventions. We provide an overview of select evidence-based interventions for children and adolescents, highlighting potential approaches to further improving the efficacy and effectiveness of these interventions. We conclude with broader recommendations for interventions, including considerations to moderators and under-explored intervention target areas as well as avenues to improve access and availability of evidence-based interventions through leveraging underutilized workforces and leveraging technology.

Background:The Summer Treatment Program (STP) includes an emphasis on teaching children sports skills and it embeds effective contingency management within recreational sports activities. It also includes a weekly parent training group. Due to clinical observations of infrequent male caregiver attendance in STP parent training group meetings, the clinical team developed the Coaching Our Acting-Out Children: Heightening Essential Skills (COACHES) program. Objective:Describe the evolution of the COACHES program and how STP methods informed the approach. Method:Using a narrative and systematic review approach, the adaptation of the STP procedures to be embedded within a parenting program aimed at supporting male caregivers is described. Treatment outcome studies evaluating the impact of the COACHES program will be identified and described to demonstrate the promise of this approach as a clinical intervention. Results:Initial program development included pilot testing in the STP, focus group feedback elicited from potential participants, and a series of studies that evaluated the efficacy of the COACHES program. As a stand-alone extension of the STP, the COACHES program demonstrates improvements in caregiver parenting behaviors and child-focused outcomes. Five treatment outcome papers are reviewed. Conclusions:There is evidence in support of the COACHES program as an effective approach for teaching male caregivers parenting strategies to support children with ADHD. Future directions include continued evaluation of the COACHES program, including extensions to other developmental levels and embedded activities.

Demographic data from nearly 50 years of treatment research for children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are synthesized. Comprehensive search identified ADHD treatment studies that were between-group designs, included a psychosocial, evidence-based treatment, and were conducted in the United States. One hundred and twenty-six studies that included 10,604 youth were examined. Reporting of demographics varied with 48% of studies (k = 61) reporting ethnicity, 73% (k = 92) reporting race, 80% (k = 101) reporting age (M age = 8.81, SD = 2.82), and 88% (k = 111) reporting gender. Most participants identified as non-Hispanic/Latine (15.99% Hispanic/Latine), White (62.54%), and boys (74.39%; 24.47% girls). Since the 1970s, zero youth in ADHD treatment studies identified as Middle Eastern/North African, 0.1% were American Indian/Alaskan Native or Native Hawaiian Pacific Islander, 1.77% were Asian, 15.10% were Black, and 3.14% were Multiracial. Based on publication year, the proportions of girls, racially minoritized youth, and Hispanic/Latine youth included in ADHD treatment research have increased over time. Girls, non-binary and non-cisgender youth, young children, adolescents, Hispanic/Latine youth, and youth from all racial groups other than White are underrepresented in ADHD treatment research. Research gaps are discussed, and recommendations for comprehensive demographic reporting in child and adolescent psychological research are provided.

Children with ADHD may be treated in school settings with positive behavior supports, academic accommodations (eg, extra time on assignments), or pharmacologic interventions; however, little is known about how these approaches are combined in common practice, and whether there are any candidate moderators of treatment use that should be explored in further research. The present study explored whether perceived psychosocial impairment impacted likelihood of medication treatment use, a decision of particular interest because it is typically made outside the direct purview of the school. Participants (N = 214) were enrolled in a larger clinical trial comparing a behavioral intervention to business as usual for students with ADHD in special education. The present study focuses on baseline ratings completed by parents and teachers prior to the initiation of the clinical trial activities. Parents and teachers completed the Impairment Rating Scale ( IRS; Fabiano et al, 2006 ) to reflect impaired functioning across major life domains, as well as overall, and parents also reported current information on medication use for ADHD. In the present analysis, the overall item completed by the parent and teacher was used. Results indicated that there was no significant difference in teacher ratings on the IRS for children receiving medication treatment (M = 4.25; SD = 1.54) and those who were not (M = 4.31; SD = 1.47) (p > .05). In contrast, there was a significant difference on parent IRS ratings for children receiving medication for ADHD (M = 4.50; SD = 1.47) and those who were not (M = 3.83; SD = 1.52) (p < .05). These results suggest that it is possible that parent perceptions of the severity of a child’s academic impairment may be a contributor to the decision to add pharmacological treatment. Due to the exploratory nature of these results, and the inability to infer causality, future research in this area is warranted.

Behavioral treatment, stimulants, and their combination are the recommended treatments for childhood attention-deficit/hyperactivity disorder (ADHD). The current study utilizes within-subjects manipulations of multiple doses of methylphenidate (placebo, 0.15, 0.30, and 0.60 mg/kg/dose t.i.d.) and intensities of behavioral modification (no, low, and high intensity) in the summer treatment program (STP) and home settings. Outcomes are evaluated in the home setting. Participants were 153 children (ages 5–12) diagnosed with ADHD. In alignment with experimental conditions implemented during the STP day, parents implemented behavioral modification levels in three-week intervals, child medication status varied daily, and the orders were randomized. Parents provided daily reports of child behavior, impairment, and symptoms and self-reported parenting stress and self-efficacy. At the end of the study, parents reported treatment preferences. Stimulant medication led to significant improvements across all outcome variables with higher doses resulting in greater improvement. Behavioral treatment significantly improved child individualized goal attainment, symptoms, and impairment in the home setting and parenting stress and self-efficacy. Effect sizes indicate that behavioral treatment combined with a low-medium dose (0.15 or 0.30 mg/kg/dose) of medication results in equivalent or superior outcomes compared to a higher dose (0.60 mg/kg/dose) of medication alone. This pattern was seen across outcomes. Parents overwhelmingly reported preferring treatment with a behavioral component as a first-choice treatment (99

In recent years, the prevalence rates of children's mental health disorders have increased with current estimates identifying that as many as 15-20% of children meet criteria for a mental health disorder. Unfortunately, the same robust parenting interventions which have long targeted some of the most common and the most treatable child concerns (e.g., externalizing, disruptive behavior, and aggression) have also shown consistently low rates of father engagement. This persistent issue of engagement comes in the wake of an increasingly large body of literature which highlights the unique positive contributions fathers make to children and families when they are engaged in parenting interventions. As the role fathers play in families shifts to become more inclusive of childcare responsibilities and less narrowly defined by financial contributions, it becomes increasingly important to understand how best to engage fathers in interventions that aim to enhance parenting efficacy and family outcomes such as coparenting. The current review examined intervention (e.g., format and setting) and implementation characteristics (e.g., training and agency-level changes) associated with father engagement. Particular attention is paid to studies which described father-specific engagement strategies (e.g., inviting fathers directly, father-only groups, and adapting intervention to incorporate father preferences). A total of 26 articles met inclusion criteria after screening and full-text review. Results indicate that father engagement (i.e., initiating treatment) remains low with 58% of studies either not reporting father engagement or having engagement rates below 50%. More than two-thirds of studies did not include specific father engagement strategies. Those that did focused on changes to treatment format (e.g., including recreational activities), physical treatment setting (e.g., in-home and school), and reducing the number of sessions required for father participation as the most common father-specific engagement strategies. Some studies reported efforts to target racially and ethnically diverse fathers, but review results indicated most participants identified as Non-Hispanic White. Interventions were largely standard behavioral parent training programs (e.g., PCIT and PMT) with few exceptions (e.g., COACHES and cultural adaptations), and very few agencies or programs are systematically making adjustments (e.g., extended clinic hours and changes to treatment format) to engage fathers. Recommendations for future directions of research are discussed including the impact of differential motivation on initial father engagement in treatment, the importance of continuing to support diverse groups of fathers, and the potential for telehealth to address barriers to father engagement.

During the COVID-19 pandemic, schools rapidly changed from in-class instruction to remote learning. Parent involvement and management of the home learning situation was greatly emphasized, and this presented challenges and opportunities for parents of children with attention-deficit/hyperactivity disorder (ADHD). There was an urgent need for effective parent support in the home learning situation, particularly for parents of youth with ADHD. The current study implemented a behavioral parent training (BPT) program, an evidence-based intervention for childhood ADHD, modified to target home learning and be delivered via telehealth. The intervention was evaluated in a multiple baseline trial across families of youth with ADHD (n = 3). The primary outcome was daily, parent-reported academic engagement during home learning. Parents also completed daily ratings of their child’s respectful and disruptive behavior, and remote, home observations of academic tasks were recorded at baseline and post-treatment. Based on visual analysis of baseline, treatment and post-treatment daily ratings, two of the three participants had a positive response to treatment indicated by improved academic engagement. These findings provide preliminary support for the home-learning, telehealth-delivered BPT program in supporting families during the COVID pandemic.

Early childhood educators are expected to provide the children in their centers high-quality care and preparation for later school success. At the same time, nearly a third of children enter early care and education settings displaying challenging behaviors, which in turn impacts educators’ stress levels and wellbeing. It is then unsurprising that classroom management and providing behavioral supports are consistently identified as areas where educators require further training upon entering the workforce. The purpose of this study is to conduct a systematic review of the empirical literature on professional development (PD) approaches targeting these areas for early childhood professionals. Forty-two studies were identified as meeting inclusion criteria and were coded for strategies targeted, the context and characteristics of the PD series, and the research design and outcomes utilized. Findings revealed that studies were highly variable in terms of targeted strategies, format of administration, training dose, research design, educator and child samples, and reporting practices. The majority of studies were conducted with educators from Head Start and public preschools and utilized research staff in the administration of the PD approaches. This indicates a need for more high-quality empirical evidence on PD approaches that cater to the larger early childhood workforce and centers’ needs. Implications for researchers and early childhood mental health professionals and administrators are discussed.