Case Control Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2023; 11(18): 4267-4276
Published online Jun 26, 2023. doi: 10.12998/wjcc.v11.i18.4267
Multimodal integrated intervention for children with attention-deficit/hyperactivity disorder
Ying-Bo Lv, Wei Cheng, Meng-Hui Wang, Xiao-Min Wang, Yan-Li Hu, Lan-Qiu Lv
Ying-Bo Lv, Wei Cheng, Meng-Hui Wang, Xiao-Min Wang, Yan-Li Hu, Lan-Qiu Lv, Pediatric Health Care Section, Ningbo Women and Children's Hospital, Ningbo 315000, Zhejiang Province, China
Author contributions: Lv YB and Cheng W proposed the concept of this study; Wang MH and Lv LQ contributed to data collection; Lv YB, Wang XM, and Hu YL contributed to formal analysis; Lv YB and Lv LQ contributed to the survey; Lv YB, Lv LQ, and Wang XM contributed to the methods; Lv YB, Lv LQ, Hu YL, and Wang MH supervised the study; Lv LQ validated the study; Lv YB and Cheng W contributed to visualization of the study; Lv YB and Lv LQ wrote the initial draft of the manuscript; and Lv YB, Cheng W, Wang MH, and Wang XM reviewed and edited the manuscript.
Supported by Ningbo Medical Key Fostering Discipline Child Health Science, No. 2022-F26; Ningbo Science and Technology Plan Project Public Welfare Plan, No. 2019C50099.
Institutional review board statement: The authors declare that every effort has been made to comply with all local and international ethical standards and laws related to the study. This study was conducted in accordance with the Helsinki Declaration and approved by the Institutional Review Committee of Zhejiang Ningbo Women and Children's Hospital (No. NBFY2020093).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The author declares that there is no interest relationship.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lan-Qiu Lv, MD, Attending Doctor, Pediatric Health Care Section, Ningbo Women and Children's Hospital, No. 339 Liuting Street, Haishu District, Ningbo 315000, Zhejiang Province, China. lulanqiunb@sina.com
Received: April 11, 2023
Peer-review started: April 11, 2023
First decision: April 26, 2023
Revised: May 4, 2023
Accepted: May 19, 2023
Article in press: May 19, 2023
Published online: June 26, 2023
Processing time: 76 Days and 19.6 Hours
ARTICLE HIGHLIGHTS
Research background

In this study, the background discusses the prevalence of attention-deficit/hyperactivity disorder (ADHD) and the lack of effective treatments despite extensive research in the last decade or two. The concept of ADHD has also become broader and more heterogeneous, which adds to the challenge of diagnosis and treatment for clinicians. This sets the stage for the current research, which aims to investigate the effects of a multimodal integrated intervention for children with ADHD.

Research motivation

In this study, the motivation is to address the lack of effective treatments for ADHD despite extensive research and the broader and heterogeneous concept of ADHD that makes diagnosis and treatment challenging for clinicians. The study aims to investigate the effects of a multimodal integrated intervention that includes medication, parent training, behavior modification, sensory integration therapy, and sand tray therapy. The motivation behind the research is to find an effective intervention that can alleviate symptoms associated with ADHD in children and improve their memory and attention while ensuring high safety and parental satisfaction.

Research objectives

In this study, the primary objective is to investigate the effects of a multimodal integrated intervention on children with ADHD. More specifically, the study aims to compare the efficacy of a multidisciplinary intervention that includes medication, parent training, behavior modification, sensory integration therapy, and sand tray therapy vs medication alone in treating ADHD symptoms. The study also aims to assess and compare the compliance, family satisfaction, and incidence of adverse events between the two treatment groups. Ultimately, the research objectives are to identify an effective intervention to alleviate ADHD symptoms in children and improve their overall quality of life.

Research methods

A total of 100 children with ADHD were assessed for eligibility, and 49 patients were assigned to each group using a randomized number table. The medication group received methylphenidate hydrochloride extended-release tablets and atomoxetine hydrochloride tablets, while the multimodal integrated intervention group received medication, parent training, behavior modification, sensory integration therapy, and sand tray therapy. The clinical endpoint was the efficacy of the different intervention modalities, which was evaluated through various measures such as symptom questionnaires, functional impairment scales, and sensory integration scales. Compliance, family satisfaction, and incidence of adverse events were also assessed.

Research results

The study found that the multimodal integrated intervention had a significantly higher treatment efficacy than medication alone in alleviating ADHD symptoms in children. The group receiving the integrated intervention also showed lower scores on symptom questionnaires and functional impairment scales, higher scores on sensory integration scales, higher compliance rates, and greater family satisfaction with fewer adverse events. These results indicate that a multidisciplinary approach to ADHD treatment can be more effective than medication alone, and that integrating parent training, behavior modification, sensory integration therapy, and sand tray therapy can enhance the treatment outcomes in children with ADHD, improving their memory and attention while ensuring high safety and parental satisfaction.

Research conclusions

The study concludes that the multimodal integrated intervention, consisting of medication, parent training, behavior modification, sensory integration therapy, and sand tray therapy, is an effective treatment for children with ADHD. The research found a significantly higher treatment efficacy in the group receiving this multidisciplinary approach compared to the medication-alone group. The integrated intervention improved symptom relief, increased compliance rates, boosted family satisfaction, and resulted in fewer adverse events. This study supports the promotion of a comprehensive approach to treating ADHD, which can improve memory and attention, leading to better outcomes in children with the condition.

Research perspectives

The study's findings suggest that a multimodal integrated intervention can significantly improve the treatment outcomes in children with ADHD. Further research is needed to explore the long-term effects of this intervention and its impact on cognitive and academic performance. Future studies can also examine the applicability of this approach to other populations or age groups. In addition, more research is necessary to determine the optimal combination of interventions, dosages, and duration of treatment. Finally, efforts should be made to disseminate the results of this study and promote the adoption of a comprehensive approach to treating ADHD in clinical practice.