ADHD Treatment: Three New Approaches to Intervention
Given the chronic and pervasive impairments associated with Attention Deficit Hyperactivity Disorder (ADHD), high rates of child comorbidity, and heightened problems in child social interactions and relationships, [1] children with ADHD are at risk for poor outcomes [2] and require intensive interventions. Despite substantial success in clinical interventions, long-term adherence can be challenging. As children with ADHD become adolescents, they often receive less frequent treatment and support for their challenges in spite of the fact that they face increasingly difficult situations in academic and social settings. Recent research has shown that adolescents with persistent ADHD are more likely to engage in serious risk behaviors, including underage drinking, reckless driving, and illegal drug use. [3]
What can we do to help support adolescents with ADHD so that they don’t engage in these risky behaviors? Research has shown that self-regulation is a robust predictor of positive outcomes in adulthood and that early adolescence is a critical period for promoting self-regulation to prevent life-altering mistakes, which often have their roots in the high school years. [4] Intervention to promote self-regulation in adolescents with ADHD could have a profound impact on their middle school and high school experience as well as adult outcomes.
We are developing and investigating innovative new treatment approaches to help build and support self-regulation in children and adolescents with ADHD.
Here are a few highlights from our clinical research:
Individualized Intervention For Adolescents With ADHD – We are exploring ways to use smartwatches and smartphones to customize, enhance, and sustain treatment for adolescents with ADHD. I am very excited to announce that on September 18, 2018, we received a grant (R21HS026058: Dr. Lakes, Principal Investigator) from AHRQ to develop a health information technology intervention for adolescents with ADHD. I’ll be working closely with two colleagues: Dr. Gillian Hayes and Dr. Sabrina Schuck. We will involve kids, parents, teachers, and clinicians in the design process. Once we have completed the design, we plan to test the app in a group of kids who will use smartphones and smartwatches for 16 weeks. We’ll collect clinical data at four time points to evaluate the impact of the system on self-regulation and other health outcomes. Stay tuned for results!
Enhancing Treatment for ADHD by Including Therapy Dogs – Recently, my colleague, Dr. Sabrina Schuck published the main outcomes for a recent study funded by the National Institutes of Health. She has found that among children with ADHD the response to treatment is faster when dogs are integrated into therapy. Her findings have been getting a lot of press! See below for article links.
Using Health Information Technology to Support Parents of Children and Adolescents with ADHD – Our team is also working on several new interventions for parents of children and adolescents with ADHD. We have several projects underway looking at how to design a system for parents that is built on smartphones and smartwatches, providing ongoing support in an easily accessible and sustainable way. You can read about one of our proposals to OC Health Innovations here. If you are interested in the results of these studies and/or potentially accessing these interventions in the future, follow me on Twitter and stay tuned on the blog, as I’ll be posting information as it becomes available.
REFERENCES
1. Lahey, B.B. & Waldman, I.D. (2003). A developmental propensity model of the origins of conduct problems during childhood and adolescence. In B.B. Lahey, T.E. Moffitt, & A. Caspi (Eds.), Causes of Conduct Disorder and Juvenile Delinquency. New York: Guilford Press.
2. Chronis, A. M., Jones, H. A., & Raggi, V. L. (2006). Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Clinical Psychology Review, 26(4), 486-502. Chronis, A. M., Lahey, B. B., Pelham, W. E., Williams, S.H., Baumann, B.L., Kipp, H., Jones, H.A., & Rathouz, P.J. (2007). Maternal depression and early positive parenting predict future conduct problems in young children with attention-deficit/hyperactivity disorder. Development Psychology, 43, 70–82.
3. Lily Hechtman, James M. Swanson, Margaret H. Sibley, Annamarie Stehli, Elizabeth B. Owens, John T. Mitchell, L. Eugene Arnold, Brooke S.G. Molina, Stephen P. Hinshaw, Peter S. Jensen, Howard B. Abikoff, Guillermo Perez Algorta, Andrea L. Howard, Betsy Hoza, Joy Etcovitch, Sylviane Houssais, Kimberley D. Lakes, J. Quyen Nichols. (2016). Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results, Journal of the American Academy of Child & Adolescent Psychiatry, Volume 55, Issue 11, 2016, Pages 945-952.e2, ISSN 0890-8567.
4. Moffit, T. E., Arseneault, L., Belsky, D., Dickson, N., Hancox, R., Harrington, H., Houts, R., Poulton, R., Roberts, B. W., Ross, S., Sears, M. R., Thomson, W. M., & Caspi, A. (2011). A gradient of childhood self-control predicts health, wealth, and public safety. Proceedings of the National Academy of Sciences, 108, 2693-2698.
