Components of Behavioral Parent Training for Children With Attention-Deficit/Hyperactivity Disorder: A Series of Replicated Single-Case Experiments
Extra praise and ignore added no measurable benefit to antecedent-only parent training for school-age, medicated kids with ADHD.
01Research in Context
What this study did
The team worked with six 8- to young learners children who had ADHD and took daily meds.
Each family got two kinds of parent training in random order: antecedent-only (clear rules, visual cues) and antecedent plus consequent (add praise and ignore).
Parents recorded child problem behavior at home. Researchers used randomization tests to see if the extra consequent pieces helped.
What they found
Charts showed most kids improved under both setups.
Yet the stats said adding praise and ignore did not beat antecedent-only training.
The consequent package looked helpful, but the gain was too small to call real.
How this fits with other research
Pilowsky et al. (1998) found that partial reinforcement actually hurts ADHD kids’ persistence. Their lab result fits the null home result here: lean or weak consequent schedules may do little or backfire.
Rasing et al. (1992) asked the same additive question in classrooms. Response-cost alone worked; tacking on extra coaching gave no clear bonus. The two studies echo each other across home and school.
Douma et al. (2006) show exercise can powerfully reinforce calm attending in a preschooler with ADHD. That single-case extends the current work by proving some consequent events do work—just not the praise-and-ignore mix tested here.
Why it matters
If you run parent training for medicated late-elementary kids with ADHD, start with strong antecedents—clear rules, visuals, posted schedules. Do not rush to layer on praise and ignore unless data show a need. Save session time for teaching parents to spot naturally occurring reinforcers (like brief active play) that pack more punch than generic social praise.
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02At a glance
03Original abstract
Behavioral parent training (BPT) is an evidence-based treatment for children with attention-deficit/hyperactivity disorder (ADHD). Stimulus control techniques (antecedent-based techniques, e.g., clear rules, instructions) and contingency management techniques (consequent-based techniques, e.g., praise, ignore) are the most common ones that are being taught to parents in BPT. However, research into the additive effects of these techniques is scarce. In this replicated single-case experimental ABC phase design, including six children on stable medication for ADHD (8–11 years) and their parents, the added efficacy of consequent-based techniques on top of antecedent-based techniques was evaluated. After a baseline period (phase A), we randomized the commencement time of two sessions parent training in antecedent-based techniques and two sessions parent training in consequent-based techniques for each child. Children’s behaviors were assessed by daily parent ratings of selected problem behaviors and an overall behavior rating. Although visual inspection showed that behavior improved for most children in both phases, randomization tests did not demonstrate the added efficacy of the consequent-based techniques on top of the antecedent-based techniques. Limitations of the study and recommendations for future single-case experiments in this population are discussed.
Behavior Modification, 2023 · doi:10.1177/01454455231162003