Paper
Saturday, July 16, 2005
An Adaption of INSIGHTS for Children With Attention Deficit With Hyperactivity Disorder
Sandra G. McClowry, PhD, RN, FAAN, Division of Nursing, New York University, New York, NY, USA and Marie Foley, PhD, RN, Department of Nursing, Kean University, Umon, NJ, USA.
| Learning Objective #1: Explain how an efficacious intervention can be adapted for a new population |
| Learning Objective #2: Describe how INSIGHTS Into Children is being adapted for children with attention deficit with hyperactivity disorder |
A recent dramatic increase in the diagnosis of children with Attention Deficit Hyperactivity Disorder (ADHD) has caused controversy concerning over-diagnosis and treatment. Few behavioral interventions have shown effectiveness in reducing the problem behaviors associated with this disorder. The purpose of this secondary analysis was to test whether children who participated in the INSIGHTS into Children's Temperament intervention and who were at diagnosable levels for ADHD would exhibit fewer child behavior problems at home as reported by their primary caregiver compared to children in a Read Aloud control group. The participants were 139 inner-city first and second grade children and their caregivers. At baseline, attention deficit with hyperactivity was assessed on the parent version of the Diagnostic Interview Schedule for Children (DISC). During the intervention phase, a telephone interview using the Parent Daily Report was conducted five times. A secondary analysis of data that supported the overall effectiveness of INSIGHTS was conducted to see whether the results remained significant when only those children who were positive on the DISC for ADHD were compared to those who were not positive for the diagnosis. A repeated measures multivariate analysis of variance was used to test the efficacy of INSIGHTS as compared to the Read Aloud program. The Time X Treatment Interaction was significant. Children participating in INSIGHTS showed a significantly greater decline in reported problem behaviors over the five time periods than the children in the Read Aloud program. When a test of the differential effectiveness for children diagnosed versus not diagnosed for ADHD was conducted, the three-way interaction approached significance. Additional analyses were conducted in preparation for adapting INSIGHTS as a prevention program for kindergarten children who are low in task persistence. High correlations were found between child temperament and ADHD measures. The clinical implications of these data will be discussed.