Proactive new UK research has discovered that modifications to the classroom can improve academic outcomes for children with attention deficit hyperactivity disorder (ADHD) potentially reducing the need for medications.
Medications are often used for children with ADHD as they are typically restless, act without thinking, and struggle to concentrate — the actions causes particular problems for them and for others in school.
A systematic review was led by the University of Exeter Medical School with experts concluding that non-drug interventions in schools may be effective in improving academic outcomes measured by performance in standardized tests for children with ADHD.
The team found 54 studies (39 randomized controlled trials and 15 non randomized studies) that tested many different ways of supporting these children.
Researchers found several strategies can be used to help support an ADHD child. For one, the use of daily report cards — completed by teachers and parents — help provide the child consistent and regular feedback. Another method is to provide study and organizational skills training which can help children achieve better attainment levels, reduce hyperactive behavior, and increase attention.
Remarkably the research, published in the journal Health Technology Assessment, found so many different types of strategies, and so many different combination of approaches, that it was impossible to clearly identify what works best.
As a result, the researchers have called for more standardized assessment to make future research outcomes more meaningful.
The systematic review, which involved collaborators at Kings College London and the Hong Kong Institute of Education, looked at all available and relevant research published between 1980 and 2013.
They examined the following different areas that are important to supporting children with ADHD in schools:
- The effectiveness and cost-effectiveness of school-based interventions for children with or at risk of ADHD;
- The attitudes and experiences of children, teachers, parents and others using ADHD interventions in school settings;
- The experience or culture of dealing with ADHD in school among pupils, their parents and teachers.
From the review, researchers did not discover studies of cost-effectiveness — an area that needs to be addressed in the future. They did find studies of attitudes and experience that suggest differences in beliefs about ADHD can create tensions in relationships between teachers, pupils and parents that may be significant barriers to its effective treatment.
In conclusion, the review suggests that education of school staff as well as the public around ADHD would help to break down preconceptions and stigma, and that classroom / school culture as well as individualized support for children with ADHD may make the support offered more or less effective.
Professor Tamsin Ford, from the University of Exeter Medical School, led the study, which involved collaborators from Kings College London and the Hong Kong Institute for Education.
She said: “There is strong evidence for the effectiveness of drugs for children with ADHD, but not all children can tolerate them or want to take them. ADHD can be disruptive to affected children as well as the classroom overall, but our study shows that effective psychological and behavioral management may make a significant improvement to children’s ability to cope with school.
“While this is encouraging, it’s not possible to give definitive guidance on what works because of variations between the strategies tested, and the design and analysis of the studies that we found. We now need more rigorous evaluation, with a focus on what works, for whom and in which contexts.
“Gaps in current research present opportunities to develop and test standardized interventions and research tools, and agree on gold standard outcome measure to provide answers to both schools and families.
Source: University of Exeter