What are the best school-based interventions for Attention-Deficit/Hyperactivity Disorder (ADHD)? New research led by the University of Exeter Medical School, in collaboration with Kings College London and Hong Kong Institute of Education, finds that many strategies exist for supporting children with ADHD at school, but that existing research has not lead to a definitive answer. The researchers conclude that non-drug interventions at school may be effective for improving academic outcomes. They call for more research into school-based interventions for ADHD.
The researchers reviewed 54 studies about school-based interventions for children with or at risk of ADHD. The studies—39 randomized controlled trials and 15 non-randomized—investigated methods of supporting ADHD children in school, including daily report cards that teachers and parents complete, study skills training, and others. The researchers focused on: cost-effectiveness and overall effectiveness of interventions; attitudes and experiences of children, teachers, and parents; and experiences of students, teachers, and parents related to ADHD.
It was not possible for the researchers to identify which treatments were the most effective because the studies used different combinations of treatments and research methodologies. The research team was not able to measure the impact of any single strategy. However, some trends emerged from their analysis:
- There were no studies about the cost-effectiveness of school-based interventions.
- Differences in beliefs about ADHD can create tension between teachers, students, and parents, which limits the effectiveness of interventions.
- Educating the staff and the public about ADHD can help remove stigma and encourage people to think beyond stereotypes.
- Interventions are more or less effective depending on the classroom culture and individualized support.
“There is strong evidence for the effectiveness of drugs for children with ADHD, but not all children can tolerate them or want to take them. ADHD can be disruptive to affected children as well as the classroom overall, but our study shows that effective psychological and behavioral management may make a significant improvement to children’s ability to cope with school,” explained study leader Professor Tamsin Ford of the University of Exeter Medical School.
The researchers suggest that rigorous evaluation is required to demonstrate what interventions work and in which contexts.
This research is published in the journal Health Technology Assessment.
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