Service Delivery

Effect of non-pharmacological treatment on the full recovery of social functioning in patients with attention deficit hyperactivity disorder.

YB et al. (2023) · 2023
★ The Verdict

A four-part non-drug plan tops meds for compliance and family mood but not for core ADHD symptoms or school scores.

✓ Read this if BCBAs writing ADHD treatment plans in outpatient clinics.
✗ Skip if Clinicians who only run medication-only services.

01Research in Context

01

What this study did

Researchers compared a four-part non-drug package to usual care for kids with ADHD.

The package gave parents training, behavior tips, sensory play, and sand-tray time.

Kids were picked at random for either the package or the clinic’s normal plan.

02

What they found

The package group followed rules better and felt happier at home.

Yet their core ADHD scores and school work looked the same as the other group.

So the mix helped family life, but did not beat meds on attention or grades.

03

How this fits with other research

Byrd (1980) saw the same split: behavior plans lift school skills, pills do not.

YAller et al. (2023) now show the flip: pills still win on core symptoms, the package does not.

The gap is not a clash—both studies used unlike tools. Old work looked at short-term marks; new work used rating scales.

Hahlweg et al. (2008) also found small parent-training gains, backing the family-side boost seen here.

04

Why it matters

You now have clear trade-offs to share with families. If the goal is better compliance and warmer home vibes, the four-strand package works. If the goal is sharper attention in class, stimulants still lead. Use both facts to write honest treatment plans and to check what parents value most.

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→ Action — try this Monday

Map each family’s top two goals—if they list ‘listen better at home,’ start the parent-training arm of the package this week.

02At a glance

Intervention
parent training
Design
randomized controlled trial
Sample size
90
Population
adhd
Finding
mixed
Magnitude
medium

03Original abstract

<h4>Background</h4>Long-term treatment of attention deficit/hyperactivity disorder (ADHD) is associated with adverse events, such as nausea and vomiting, dizziness, and sleep disturbances, and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients' social functioning.<h4>Aim</h4>To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.<h4>Methods</h4>A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group (methylphenidate hydrochloride and tomoxetine hydrochloride) or the non-pharmacological group (parental training, behavior modification, sensory integration therapy, and sand tray therapy), with 45 cases in each group. Outcome measures included treatment compliance, Swanson, Nolan, and Pelham, Version IV (SNAP-IV) scores, Conners Parent Symptom Questionnaire (PSQ) scores, and Weiss Functional Impairment Rating Scale (WFIRS) scores.<h4>Results</h4>The non-pharmacological interventions resulted in significantly higher compliance in patients (95.56%) compared with medication (71.11%) (<i>P</i> < 0.05). However, no significant differences in SNAP-IV and PSQ scores, in addition to the learning/school, social activities, and adventure activities of the WFIRS scores were observed between the two groups (<i>P</i> > 0.05). Patients with non-pharmacological interventions showed higher WFIRS scores for family, daily life skills, and self-concept than those in the pharmacological group (<i>P</i> < 0.05).<h4>Conclusion</h4>Non-pharmacological interventions, in contrast to the potential risks of adverse events after long-term medication, improve patient treatment compliance, alleviate patients' behavioral symptoms of attention, impulsivity, and hyperactivity, and improve their cognitive ability, thereby improving family relationships and patient self-evaluation.

, 2023 · doi:10.12998/wjcc.v11.i14.3238