Lignes directrices pour les programmes d’éducation thérapeutique destinés aux enfants et adolescents présentant un trouble déficit de l’attention avec ou sans hyperactivité : les résultats d’une revue systématique de la littérature

Abstract

The National Strategy for Neurodevelopmental Disorders published in France in November 2023 underscores the importance of implementing therapeutic education programs for adolescents and adults with Attention Deficit Hyperactivity Disorder (ADHD). While these programs are integral to the knowledge component of the recommended multimodal approach for ADHD, specific guidelines regarding the content and structure of such programs remain undefined. This paper endeavors to bridge this gap by systematically reviewing literature to discern objectives and methodologies essential for incorporating into therapeutic education programs aimed at children and adolescents with ADHD. Given the sparse representation of therapeutic education in global literature, this systematic literature review (SLR) also considers studies focusing on psychoeducation and cognitive-behavioral learning strategies which demonstrate efficacy in individuals clinically diagnosed with ADHD aged 8 to 19 years. Professional databases such as PubMed, APA PsycINFO, and Psychology and Behavioral Sciences Collection were consulted during this review. Of the 604 identified articles, only 15 met inclusion criteria, allowing for the derivation of comprehensive guidelines and insights necessary for shaping future research and clinical practices in this domain. The current body of research on therapeutic education remains notably limited due to several factors, such as reliance on specific program evaluations, absence of replication, and lack of exploration into cultural nuances. Additionally, there is a shortage of research addressing the unique implications of gender differences in ADHD, particularly regarding hormonal influences on symptoms across the menstrual cycle in females. These gaps highlight the urgent need for a wider array of studies to develop more inclusive and adaptable therapeutic programs tailored to the individual needs of diverse populations. Moreover, determining the most effective format of interventions, whether delivered in group, individual, or hybrid settings, continues to present a challenge. The results of this SLR provide foundational themes to include in therapeutic programs, which should emphasize understanding ADHD symptomatology, developing organizational skills, enhancing time management, promoting self-autonomy, practicing emotional regulation, and fostering appropriate social communication skills. These programs should primarily employ cognitive-behavioral strategies and prioritize parental involvement to reinforce the generalization and retention of acquired skills. It is imperative to note that while these topics address ADHD management, they fail to adequately cover associated risks and comorbidities, such as anxiety, oppositional behaviors, substance abuse, or prolonged screen time. Therefore, future research should focus on a more comprehensive understanding of these factors to refine and extend the therapeutic education content. This paper also highlights the substantial contribution that therapeutic education can make in addressing ADHD, suggesting a multimodal approach to improve overall treatment adherence and outcomes. Nonetheless, significant work remains to tailor these programs to address individual variations and to explore their interactions with cultural, environmental, and gender-specific elements. Future investigations should also examine the inclusion of comorbidities to ensure that therapeutic education programs cater to the broad spectrum of needs displayed by individuals with ADHD. By refining these guidelines based on ongoing and future research, the potential to enhance the quality of life for those diagnosed with ADHD, alongside their families, can be realized.