The Interventions for Sleep Disorders in Children with Attention Deficit and Hyperactivity Disorder: A Narrative Review

BACKGROUND: Attention deficit and hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. Children with ADHD have more frequent comorbid sleep disorders than healthy children. The current methods of treating sleep disorders in ADHD children are still focused on pharmacological interventions which in fact only provide little benefit. AIM: This study aims to identify existing studies regarding the types of nonpharmacological and complementary interventions for sleep disorders in children with ADHD using a narrative review approach. METHODS: This was a narrative review. Inclusion criteria included articles in English and Bahasa, full-text articles, primary studies, and children with ADHD aged 18 years with or without comorbidities as the research sample, and the article having been published in the last 10 years. Searches were performed in several databases: PubMed, Springer, Web of Science, and Google Scholar. RESULTS: The result showed that programs for managing sleep disorder in ADHD are behavioral therapy, behavioral parent training (BPT), behavioral sleep intervention, neurofeedback, mind-body therapy, L-theanine supplementation, horse milk supplementation, and play therapy. The programs are found to be effective in improving sleep. CONCLUSION: The program most comprehensive with a high level of ease of implementation was BPT.

Developing the Technology-based Parenting Young Children Check-Up Intervention for Disruptive Behavior Problems in Early Childhood

Behavioral parent training programs show clear efficacy/effectiveness in response to young children’s disruptive behavior problems, but limitations in engagement and accessibility prevent many families from benefiting from these programs. The Parenting Young Children Check-up (PYCC) is a technology-based program being created to overcome these barriers and increase the reach of behavioral parent training. Developed for use in pediatric healthcare settings, the PYCC includes three parts: 1) an initial check-up designed to motivate program involvement; 2) text messages; and 3) a parent training website involving interactive video-based content to teach parenting skills. Following an established intervention development framework, this report details initial steps to refine PYCC intervention materials. Seventeen mothers and 17 primary care physicians (pediatricians or family medicine physicians) participated in this mixed methods data collection across three iterations. During semi-structured interviews, participants provided feedback regarding early drafts of the three parts of the PYCC; participants also completed a feedback questionnaire. Refinements were made to the PYCC materials after iterations 1 and 2. A third iteration of data collection revealed saturation of qualitative input, positive qualitative feedback, and positive quantitative ratings on the feedback questionnaire. This project represents an example of using mixed method input to refine and create a technology-based, behavioral intervention. Project completion led to a full version of the PYCC, which will be tested in a proof-of-concept trial and a subsequent pilot randomized clinical trial.

Meta-Analysis of Parent Training Programs Utilizing Behavior Intervention Technologies

Behavioral Parent Training (BPT) traditionally occurs in face-to-face (FTF BPT). Recently, Behavioral Intervention Technology (BIT) has been developed to deliver BPT in lieu of or as an adjunct to FTF BPT using websites, computer software, smartphone applications, podcasts, pre-recorded sessions, and teletherapy. The present meta-analysis reviews BIT BPT randomized control and comparison studies to determine the overall efficacy of BITs, if the level of human support significantly effects BIT BPT treatment outcomes, and which populations BIT BPT are effective for, by analyzing the following study variables: socioeconomic status, race, and clinical population. The analyses indicated that, overall, BIT BPT is an effective treatment (g = 0.62), and did not indicate a significant difference between levels of human support (?2 (3) = 4.94, p = 0.18). Analysis did indicate a significant difference between studies that used waitlist or education control groups, compared to studies that used active treatment controls (?2 (1) = 12.90, p = 0.00). The analyses did not indicate a significant difference between clinical population, low socioeconomic status, and racial minority studies. These findings provide preliminary evidence that BIT BPT is effective for treating child and adolescent externalizing behavior in a variety of populations.