Multimodal integrated intervention for children with attention-deficit/hyperactivity disorder

Abstract

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common disorders in child and adolescent psychiatry, with a prevalence of more than 5%. Despite extensive research on ADHD in the last 10 to 20 years, effective treat-ments are still lacking. Instead, the concept of ADHD seems to have become broader and more heterogeneous. Therefore, the diagnosis and treatment of ADHD remains challenging for clinicians.

AIM

To investigate the effects of a multimodal integrated intervention for children with ADHD.

METHODS

Between March 2019 and September 2020, a total of 100 children with ADHD who were diagnosed and treated at our hospital were assessed for eligibility, two of whom revoked their consent. A case-control study was conducted in which the children were equally assigned, using a randomized number table, to either a medication group (methylphenidate hydrochloride extended-release tablets and atomoxetine hydrochloride tablets) or a multimodal integrated intervention group (medication + parent training + behavior modification + sensory integration therapy + sand tray therapy), with 49 patients in each group. The clinical endpoint was the efficacy of the different intervention modalities.

RESULTS

The two groups of children with ADHD had comparable patient characteristics (P > 0.05). Multimodal integrated intervention resulted in a significantly higher treatment efficacy (91.84%) than medication alone (75.51%) (P < 0.05). Children who received the multimodal integrated intervention showed lower scores in the Conners Parent Symptom Questionnaire and the Weiss Functional Impairment Rating Scale than those treated with medication alone (P < 0.05). The Sensory Integration Scale scores of children in the multimodal integrated intervention group were higher than those of children in the medication group (P < 0.05). Children who received the multimodal integrated intervention had higher compliance and family satisfaction and a lower incidence of adverse events than those treated with medication alone (P < 0.05).

CONCLUSION

Multimodal integrated intervention effectively alleviated symptoms associated with ADHD in children. It enhanced their memory and attention with high safety and parental satisfaction, demonstrating good potential for clinical promotion.

Keywords: Attention-deficit/hyperactivity disorder; Multimodal integrated intervention; Medication; Behavior modification; Sensory integration therapy; Sand tray therapy

Core Tip: Multimodal integrated intervention, including medication, parent training, behavior modification, sensory integration therapy, and sand tray therapy, has been shown to effectively alleviate symptoms of attention-deficit/hyperactivity disorder (ADHD) in children. This intervention resulted in higher treatment efficacy compared to medication alone, with lower scores in symptom questionnaires and functional impairment scales. Children who received this approach also had higher compliance and family satisfaction and a lower incidence of adverse events. Such a multimodal integrated intervention shows promising potential for clinical promotion in ADHD treatment.