Integrating Behavioral Sleep Medicine with Behavioral Parent Training for Preschool ADHD: Stakeholder Insights for an Early Childhood Intervention.

IF 3.2 3区 医学 Q2 PSYCHIATRY
Jessica R Lunsford-Avery, Matthew J Gibson, Brian Eichner, John T Mitchell, Naomi O Davis
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引用次数: 0

Abstract

Objectives: Behavioral Parenting Training (BPT), the gold-standard treatment for preschool attention-deficit/hyperactivity disorder (ADHD), does not consistently improve core symptoms of inattention and hyperactivity/impulsivity. Pairing BPT with complementary preventative therapies targeting biological mechanisms, such as sleep dysregulation, may improve treatment outcomes. This qualitative study with key stakeholders aims to inform the development of parent-based interventions that incorporate behavioral sleep medicine (BSM) strategies to improve ADHD-related outcomes in preschoolers.

Method: Three stakeholder groups participated in two rounds of semi-structured focus group sessions: parents/caregivers of preschoolers with elevated ADHD symptoms (n = 8), pediatricians (n = 9), and pediatric behavioral health providers (n = 6). Each session included a review of a potential integrated BPT-BSM treatment. Participants provided iterative feedback on its helpfulness, appeal, and accessibility and recommended changes. Group session transcripts were coded and thematically analyzed using inductive and deductive approaches.

Results: Dominant themes across stakeholders concerned treatment content, structure, process, materials, and individualization. Stakeholders highlighted the importance of a 24-hr approach for improving preschool ADHD symptoms and emphasized needs for specific, practical, and developmentally-appropriate strategies; appropriate session pacing/time for troubleshooting skill use; sufficient support for caregiver skill implementation; validation of caregivers' experiences; easy-to-use handouts; digital materials; and treatment tailored to family culture, structure, and household environment.

Conclusions: Stakeholder input is essential for developing acceptable, feasible, and effective preschool ADHD interventions that incorporate BSM strategies and are adapted for real-world settings. Future research should evaluate whether the identified themes contribute to increased feasibility, scalability, and effectiveness of parent-based sleep treatments for improving sleep, ADHD, and functional outcomes among preschoolers at-risk for ADHD.

将行为睡眠医学与行为父母训练结合起来治疗学龄前多动症:利益相关者对早期儿童干预的见解。
目的:行为父母训练(BPT),学龄前儿童注意力缺陷/多动障碍(ADHD)的金标准治疗方法,并不能持续改善注意力不集中和多动/冲动的核心症状。将BPT与针对生物学机制(如睡眠失调)的补充预防性治疗相结合,可能会改善治疗效果。这项与主要利益相关者进行的定性研究旨在为基于父母的干预措施的发展提供信息,这些干预措施包括行为睡眠医学(BSM)策略,以改善学龄前儿童adhd相关的结果。方法:三个利益相关者小组参加了两轮半结构化的焦点小组会议:ADHD症状升高的学龄前儿童的父母/照顾者(n = 8),儿科医生(n = 9)和儿科行为健康提供者(n = 6)。每次会议都包括对潜在的BPT-BSM综合治疗的回顾。参与者提供了关于其有用性、吸引力和可访问性的迭代反馈,并建议进行更改。小组会议记录编码和主题分析使用归纳和演绎的方法。结果:利益相关者的主要主题涉及治疗内容、结构、过程、材料和个性化。利益相关者强调了24小时方法改善学龄前ADHD症状的重要性,并强调需要具体、实用和适合发展的策略;适当的会话节奏/时间用于故障排除技能的使用;对护理人员技能实施的充分支持;看护者经验的验证;易于使用的救济;数字材料;以及针对家庭文化、结构和家庭环境量身定制的治疗。结论:利益相关者的意见对于制定可接受的、可行的和有效的学龄前ADHD干预措施至关重要,这些干预措施包括BSM策略,并适应现实环境。未来的研究应评估确定的主题是否有助于提高以父母为基础的睡眠治疗的可行性、可扩展性和有效性,以改善有ADHD风险的学龄前儿童的睡眠、ADHD和功能结局。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.60
自引率
6.70%
发文量
71
审稿时长
6-12 weeks
期刊介绍: Journal of Attention Disorders (JAD) focuses on basic and applied science concerning attention and related functions in children, adolescents, and adults. JAD publishes articles on diagnosis, comorbidity, neuropsychological functioning, psychopharmacology, and psychosocial issues. The journal also addresses practice, policy, and theory, as well as review articles, commentaries, in-depth analyses, empirical research articles, and case presentations or program evaluations.
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