WWC Review of the Report "A Randomized Trial Examining the Effects of Aerobic Physical Activity on Attention-Deficit/Hyperactivity Disorder Symptoms in Young Children." What Works Clearinghouse Single Study Review PDF Download
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Author: What Works Clearinghouse (ED)
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Languages : en
Pages : 5
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For the 2014 study, "A Randomized Trial Examining the Effects of Aerobic Physical Activity on Attention-Deficit/Hyperactivity Disorder Symptoms in Young Children", researchers examined the effect of a daily before-school physical activity program on behavioral outcomes of students in grades K-2. The study sample included 202 students who either were identified as at risk for ADHD or showed typical development. The study authors randomly assigned students to receive either the physical activity intervention or a sedentary classroom-based program. The study authors then altered the random assignment of students in order to have more similar research groups and analyzed the student data based on the altered research conditions. The analysis included imputed outcomes for students with missing data. Because randomization was compromised, the study could not meet WWC group design standards without reservations. In addition, to meet WWC group design standards with reservations, the WWC requires that baseline equivalence of the analytic samples be demonstrated without imputed outcomes. The study did not demonstrate this baseline equivalence, so the study does not meet WWC group design standards. A glossary of terms is included. [The following study is the focus of this Single Study Review: Hoza, B., Smith, A. L., Shoulberg, E. K., Linnea, K. S., Dorsch, T. E., Blazo, J. A., Alerding, C. M., & McCabe, G. P. (2014). "A randomized trial examining the effects of aerobic physical activity on attention-deficit/hyperactivity disorder symptoms in young children". Journal of Abnormal Child Psychology. doi:10.1007/s10802-014-9929-y].
Author: What Works Clearinghouse (ED)
Publisher:
ISBN:
Category :
Languages : en
Pages : 5
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Book Description
For the 2014 study, "A Randomized Trial Examining the Effects of Aerobic Physical Activity on Attention-Deficit/Hyperactivity Disorder Symptoms in Young Children", researchers examined the effect of a daily before-school physical activity program on behavioral outcomes of students in grades K-2. The study sample included 202 students who either were identified as at risk for ADHD or showed typical development. The study authors randomly assigned students to receive either the physical activity intervention or a sedentary classroom-based program. The study authors then altered the random assignment of students in order to have more similar research groups and analyzed the student data based on the altered research conditions. The analysis included imputed outcomes for students with missing data. Because randomization was compromised, the study could not meet WWC group design standards without reservations. In addition, to meet WWC group design standards with reservations, the WWC requires that baseline equivalence of the analytic samples be demonstrated without imputed outcomes. The study did not demonstrate this baseline equivalence, so the study does not meet WWC group design standards. A glossary of terms is included. [The following study is the focus of this Single Study Review: Hoza, B., Smith, A. L., Shoulberg, E. K., Linnea, K. S., Dorsch, T. E., Blazo, J. A., Alerding, C. M., & McCabe, G. P. (2014). "A randomized trial examining the effects of aerobic physical activity on attention-deficit/hyperactivity disorder symptoms in young children". Journal of Abnormal Child Psychology. doi:10.1007/s10802-014-9929-y].
Author: What Works Clearinghouse (ED)
Publisher:
ISBN:
Category :
Languages : en
Pages : 10
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This study measured the impact of the "Fitness Improves Thinking in Kids" ("FITKids") afterschool program on the executive control (i.e., maintaining focus, performing multiple cognitive processes) and physical fitness of preadolescent students. The "FITKids" program was held at the University of Illinois' campus and included 2 hours of afterschool activities each day. Study authors randomly assigned 221 students ages 7-9 to either participate in "FITKids" or to be in a business-as-usual comparison group. Executive control was measured before and after the "FITKids" program by assessing students' response accuracy and response time on two tasks: (1) attentional inhibition (flanker task) which required students to resist distracting information; and (2) cognitive flexibility (switch task) which required students to perform multiple cognitive duties at the same time. Study authors also measured fitness levels of students both before and after the intervention using body mass index (BMI) and maximal oxygen consumption during aerobic activity. The study authors found that the "FITKids" program increased accuracy in the attentional inhibition task and accuracy in the more difficult portion of the cognitive flexibility task. However, the What Works Clearinghouse (WWC) did not confirm this finding to be statistically significant after adjusting for multiple comparisons. The study also showed a statistically significant positive impact for one subscale of the attentional inhibition task, and the WWC confirmed this finding to be statistically significant. Additionally, the study authors found that "FITKids" had a statistically significant positive effect on aerobic fitness. Moreover, BMI for students in "FITKids" increased by a smaller amount than for students not in the program, and this result was statistically significant. The WWC confirmed the findings for aerobic fitness and BMI. The research described in this report meets WWC group design standards without reservations. A glossary of terms is included. The following are appended: (1) Study details; (2) Outcome measures for each domain; (3) Study findings for each domain; and (4) Supplemental findings for the executive control domain (flanker task). [The following study is the focus of this "Single Study Review": Hillman, C. H., Pontifex, M. B., Castelli, D. M., Khan, N. A., Raine, L. B., Scudder, M. R., Drollette, E. S., Moore, R. D., Wu, C-T, & Kamijo, K. (2014). Effects of the "FITKids" randomized controlled trial on executive control and brain function. "Pediatrics," 134(4), 1062-1071.].
Author: What Works Clearinghouse (ED)
Publisher:
ISBN:
Category :
Languages : en
Pages : 8
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The study examined in this review analyzed whether a full two-year "Learning Experiences and Alternative Program for Preschoolers and Their Parents" ("LEAP") training and support model for teachers was superior in improving outcomes of preschool children with Autism Spectrum Disorder (ASD), as compared to a limited "LEAP" model in which no professional development support was provided. Fifty preschool classrooms from 16 districts and seven states across the United States were randomly assigned to either intervention or comparison conditions. Teachers in classrooms assigned to the intervention group received written "LEAP" materials, skill area presentations and demonstrations by "LEAP" trainers, onsite training and support, and maintenance checks. Comparison classroom teachers received written "LEAP" materials and videos, but no in-person training or ongoing support. In total, there were 177 children with ASD in the full "LEAP" training classrooms and 117 children with ASD in the comparison classrooms. The study found a positive impact after two years of the full "LEAP" training and support model on the average classroom-level measures of behavior, communication, intellectual outcomes, and social outcomes of preschool children. The average effect sizes for all four domains are statistically significant. The research described in this report meets What Works Clearinghouse (WWC) evidence standards without reservations. This study is a well-implemented randomized controlled trial. Three appendices include: (1) Study details; (2) Outcome measures for each domain; and (3) Study findings for each domain. A glossary of terms is provided. [The following study is the focus of this "Single Study Review": Strain, P. S., & Bovey II, E. H. (2011). Randomized, controlled trial of the LEAP model of early intervention for young children with autism spectrum disorders. "Topics in Early Childhood Special Education," 31(3), 133-154 (EJ942105).].
Author:
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Languages : en
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OBJECTIVES: (1) Compare effectiveness and adverse events of interventions (pharmacological, psychosocial, or behavioral, and the combination of pharmacological and psychosocial or behavioral interventions) for preschoolers at high risk for attention deficit hyperactivity disorder (ADHD); (2) compare long-term effectiveness and adverse events of interventions for ADHD among persons of all ages; and (3) describe how identification and treatment for ADHD vary by geography, time period, provider type, and sociodemographic characteristics, compared with endemic prevalence. DATA SOURCES: MEDLINE(r), Cochrane CENTRAL, EMBASE, PsycInfo, and ERIC (Education Resources Information Center) were searched from 1980 to May 31, 2010. Reference lists of included studies and gray literature were searched manually. REVIEW METHODS: Reviewers applied preset criteria to screen all citations. Decisions required agreement between two independent reviewers, with disagreements regarding inclusion or exclusion resolved by a third. The Effective Public Health Practice Project (EPHPP) process was used to evaluate internal validity of publications regarding interventions for preschoolers at high risk of ADHD and long-term outcomes following interventions for ADHD in persons of all ages. Overall strength of the evidence (SOE) was assessed using the GRADE approach, accounting for risk of bias and study design, consistency of results, directness of evidence, and degree of certainty regarding outcomes of interest. RESULTS: Of included studies, only a subset could be pooled statistically using meta-analytic techniques. For the first objective, we rated as "good" quality eight studies of parent behavior training (PBT) with 424 participants. These demonstrated high SOE for improving child behavior (standardized mean difference [SMD] = 0.68; 95-percent confidence interval [CI], 0.88 to 0.47). A single "good" quality study of methylphenidate (MPH) with 114 preschool children provided low SOE for improving child behavior (SMD = -0.83; 95-percent CI, -1.21 to -0.44). Adverse effects were present for preschool children treated with MPH; adverse effects were not mentioned for PBT. For the second objective, the majority of studies were open extension trials without continuation of untreated comparison groups. Evidence from the single "good" quality study of MPH demonstrated low SOE for reduction of symptoms, with SMD = 0.54 (95-percent CI, 0.79 to 0.29). Evidence from the single "good" quality study of atomoxetine demonstrated low SOE for reduction of symptoms, with SMD = 0.40 (95-percent CI, 0.61 to 0.18). Evidence from the single "good" quality study of combined psychostimulant medication with behavioral/psychosocial interventions provided low SOE, with SMD = 0.70 (95-percent CI, 0.95 to 0.46). Safety reports for pharmacological interventions derived from observational studies on uncontrolled extensions of clinical trials, as well as from administrative databases, provided inconclusive evidence for growth, cerebrovascular, and cardiac adverse effects. Evidence that psychostimulant use in childhood improves long-term outcomes was inconclusive. For the third objective, a discussion of contextual issues and factors relating to underlying prevalence and rates of diagnosis and treatment was included. Population-based data were relatively scarce and lacked uniform methods and settings, which interfered with interpretation. The available evidence suggested that underlying prevalence of ADHD varies less than rates of diagnosis and treatment. Patterns of diagnosis and treatment appeared to be associated with such factors as locale, time period, and patient or provider characteristics. CONCLUSIONS: The SOE for PBT as the first-line intervention for improved behavior among preschoolers at risk for ADHD was high, while the SOE for methylphenidate for improved behavior among preschoolers was low. Evidence regarding long-term outcomes following interventions for ADHD was sparse among persons of all ages, and therefore inconclusive, with one exception. Primary school-age children, mostly boys with ADHD combined type, showed improvements in symptomatic behavior maintained for 12 to 14 months using pharmacological agents, specifically methylphenidate medication management or atomoxetine. Other subgroups, interventions, and long-term outcomes were under-researched. Evidence regarding large-scale patterns of diagnosis and treatment compared with endemic rates of disorder was inconclusive.
Author: N. Steiner
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Languages : en
Pages : 12
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Clinically significant attention problems among children present a significant obstacle to increasing student achievement. Computer-based attention training holds great promise as a way for schools to address this problem. The aim of this project is to evaluate the efficacy of two computer-based attention training systems in schools. One program uses neurofeedback (NFB) to train children with Attention-Deficit/Hyperactivity Disorder (ADHD) to focus on a task, and the other uses a Standard Computer Format (SCF) for cognitive retraining. The authors hypothesize that 1) both treatments will result in improvement in ADHD symptoms compared to a control condition; and 2) both treatments will result in improvement in academic outcomes compared to a control condition. This research is on-going and takes place in 19 elementary schools that accepted to participate in the project. The schools are part of two school systems in the greater Boston area. The authors' preliminary data from this four-year study evaluating the efficacy of two computer-based attention training systems in schools shows significant results as well as promising trends. As this is a preliminary analysis of preliminary data they have not addressed all of the study's aims and have not yet compared data between the three intervention groups. Teacher report of ADHD symptoms, math achievement by students, and objective classroom observations for their first wave were analyzed. The authors' preliminary data on these outcome measures suggest that computer-based attention training programs offered in an elementary school setting may be effective in reducing symptoms of ADHD and improved math achievement. (Contains 1 figure and 4 tables.).
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Languages : en
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Attention-Deficit Hyperactivity Disorder (ADHD) is described by the broadly defined symptoms, attention-deficit, hyperactivity and impulsivity. Characterized as the most common diagnosed developmental disorder in childhood, pharmacological interventions have been the most studied and used forms of treatment. Given that the alleviating effects of medication are not universal. researchers have considered other adjuvant therapies. Physical activity is one intervention that has received limited attention. but has been suggested. The purpose of this study was to extend the limited research by the following: (1) provide evidence for the prevalence of physical activity in ADHD children, as well as determine the prevalence of physical activity therapeutic practices, (2) explore the relationship between physical activity and ADHD symptoms, and determine which specific ADHD symptom(s) physical activity may affect most, and (3) identify any moderators of the physical activity and ADHD symptom relationship. Participants included 101 parents, mostly from Canada, who currently have a child with diagnosed ADHD and were recruited through collaboration with the Learning Disabilities Association - South Vancouver Island Chapter by mail and through ADHD online internet parent forums. Participants were asked to complete a questionnaire pertaining to their child's medical history, behavioral symptoms, physical activity behaviors and practices, and parent socio-demographics. Results indicate that 76% of the sample did not meet Canadian national recommended physical activity guidelines, and 52% of the sample does not use physical activity as a therapy.
Author: Nikander Jonté
Publisher:
ISBN:
Category : Attention-deficit hyperactivity disorder
Languages : en
Pages : 26
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BACKGROUND: ADHD is brain disorder described by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. One in every 20 children is affected by ADHD. PURPOSE: To examine the effect between physical activity participation and externalizing behaviors (conduct and hyperactivity) among children with and without ADHD. METHODS: The Growing Up in Ireland National Data set was used for analysis, only children with a diagnosis of ADHD were included (n = 77), and a gender-matched, random sample of children without ADHD for comparison purposes (n= 77). A Factorial ANOVA was conducted to compare the main effects of physical activity and the interaction effect between an ADHD diagnosis and physical activity on externalizing behaviors. The interaction effect (ADHD diagnosis X physical activity) was not significant, F(1,138) = .011, p = .918, demonstrating that the effect of physical activity on behavior did not significantly differ depending on the child having a diagnosis of ADHD or not. DISCUSSION: The findings of this study were consistent with other research.
Author: Nicole Eleanor Irene Smith
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Category :
Languages : en
Pages :
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Attention-Deficit Hyperactivity Disorder (ADHD) is described by the broadly defined symptoms, attention-deficit, hyperactivity and impulsivity. Characterized as the most common diagnosed developmental disorder in childhood, pharmacological interventions have been the most studied and used forms of treatment. Given that the alleviating effects of medication are not universal. researchers have considered other adjuvant therapies. Physical activity is one intervention that has received limited attention. but has been suggested. The purpose of this study was to extend the limited research by the following: (1) provide evidence for the prevalence of physical activity in ADHD children, as well as determine the prevalence of physical activity therapeutic practices, (2) explore the relationship between physical activity and ADHD symptoms, and determine which specific ADHD symptom(s) physical activity may affect most, and (3) identify any moderators of the physical activity and ADHD symptom relationship. Participants included 101 parents, mostly from Canada, who currently have a child with diagnosed ADHD and were recruited through collaboration with the Learning Disabilities Association - South Vancouver Island Chapter by mail and through ADHD online internet parent forums. Participants were asked to complete a questionnaire pertaining to their child's medical history, behavioral symptoms, physical activity behaviors and practices, and parent socio-demographics. Results indicate that 76% of the sample did not meet Canadian national recommended physical activity guidelines, and 52% of the sample does not use physical activity as a therapy.
Author: U. S. Department of Health and Human Services
Publisher: CreateSpace
ISBN: 9781484032954
Category : Medical
Languages : en
Pages : 72
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This Future Research Needs (FRN) report is based on a draft Agency for Healthcare Research and Quality (AHRQ) comparative effectiveness review, “Attention Deficit Hyperactivity Disorder: Effectiveness of Treatment in At-risk Preschoolers; Long-Term Effectiveness in All Ages; and Variability in Prevalence, Diagnosis, and Treatment.” The Key Questions (KQs) were: KQ 1: Among children less than 6 years of age with Attention Deficit Hyperactivity Disorder or Disruptive Behavior Disorder, what are the effectiveness and adverse event outcomes following treatment? KQ 2: Among people ages 6 years or older with Attention Deficit Hyperactivity Disorder, what are the effectiveness and adverse event outcomes following 12 months or more of any combination of followup or treatment, including, but not limited to, 12 months or more of continuous treatment? KQ 3: How do (a) underlying prevalence of ADHD, and (b) rates of diagnosis (clinical identification) and treatment for ADHD vary by geography, time period, provider type, and sociodemographic characteristics? Findings in the draft review for KQ 1 supported the use of parent behavior training in preschoolers both for oppositional behaviors and for ADHD symptoms, with no adverse events reported. For preschoolers, psychostimulant medications are also generally safe and efficacious for improving behavior and can provide benefits in addition to parent training. However, adverse events, especially irritability and moodiness, can lead to discontinuation, and use for several months to a year slightly affects growth rate. For KQ 2, long-term effectiveness and safety studies of several psychostimulants in children over the age of 6 years and adolescents found they are efficacious for control of inattention and overactivity for extended periods of time. Few serious adverse events were noted. Publications from the Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (MTA) study provide the best data for long-term outcomes. By 3 years, no single intervention group showed superior benefit, which is likely because of individuals obtaining a complex range of interventions in the community. The findings for KQ 3 included results from a systematic review and meta-regression that estimated the prevalence of ADHD among those ages 18 or younger at 5.29 percent, with more boys than girls identified and the highest rates of disorder occurring in 5- to 10-year-olds. Primary sources of variability were identified as methodological rather than geographic. Fewer studies are available that document prevalence in adult, adolescent, or preschool age groups. In this project, we worked with a group of stakeholders to refine 29 identified research gaps and transform them into eight highest-priority research needs in the field of ADHD. These highest-level needs included a broad range of issues cutting across age range (above and below 6 years of age), key clinical issues, and epidemiological and measurement concerns. Within this group of eight, clear themes emerged: the need for improved measurement tools, more generalizable study populations and settings, longer follow-up periods, more understanding of patient-level predictors of response, and more comparative evaluation of psychopharmacologic, psychosocial, and combination interventions across age ranges. PICOTS construction aided our consideration of study design issues and our sample power analyses demonstrated the clear pragmatic barriers that many of the potential designs will present. Advanced secondary data analysis methods may allow some of these complex questions to be addressed in a more cost effective manner but will not be able to fully replace the need for new large, long-term trials to evaluate these complex research needs in ADHD.
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