Barkley's Parent Training Program, Working Memory Training and their Combination for Children with ADHD: Attention Deficit Hyperactivity Disorder


Objective: The aim of the current study was to examine the effectiveness of Barkley's parent training program, working memory training and the combination of these two interventions for children with Attention deficit hyperactivity disorder (ADHD).
Methods: In this study, 36 participants with ADHD (aged 6 to 12 years) were selected by convenience sampling. Revision of the Swanson, Nolan and Pelham (SNAP) questionnaire (SNAP–IV), Child Behavior Checklist (CBCL) and clinical interviews were employed to diagnose ADHD. Wechsler Intelligence Scale for Children-Fourth Edition was also implemented. The participants were randomly assigned to the three intervention groups of Barkley's parent training program, working memory training and the combined group. SNAP-IV and CBCL were used as pre-tests and post-tests across all three groups. Data were analyzed using MANCOVA (SPSS version18).
Results: There was a significant difference (p< 0.05) in the decline of attention deficit and hyperactivity /impulsivity symptoms betwe  n the combined treatment group and working memory training group and also between the combined treatment group and the parent training group in SNAP. In terms of attention problems (experience-based subscales) of CBCL, there was a significant difference (p< 0.001) between the combined treatment group and working memory training group. Furthermore, compared to the working memory training and parent training groups, the combined group demonstrated a significant decline (p< 0.01) in clinical symptoms of ADHD (based on DSM).
Conclusion: It was revealed that combined treatment in comparison with the other two methods suppressed the clinical symptoms of ADHD more significantly.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4 eds, text revision. Washington, DC: Author; 2000.

Barkley RA. Attention-deficit disorder: A handbook for diagnosis and treatment (3rded.). New York: Guilford Press; 2006.

Sadock BJ, Sadock VA. Kaplan & Sadok’s Synapsis of psychiatry: Behavioral science/clinical psychiatry, 10eds. Lippincott Williams & Wilkins; 2007.

Bell AS. A critical review of ADHD diagnostic criteria: What to address in the DSM-V. JAD 2011; 15: 3 –10.

Cunningham CE. A family centered approach to planning and measuring the outcome of interventions for children with attention-deficit/hyperactivity disorder. J Pediatr Psychol 2007; 32: 676-694.

Barnard-Brak L, Sulak TN, Fearon DD. Coexisting disorders and academic achievement among children with ADHD. JAD 2011; 15: 506 –515.

Pliszka SR. ADHD and Comorbid Disorders Psychosocial and Psychopharmacological Interventions. New York: The Guilford Press; 2009.

Stefanatos GA, Baron IS. Attention-deficit/hyperactivity disorder: A neuropsychological perspective towards DSM-V. Neuropsychol Rev 2007; 17: 5-38.

Pelham WE, Fabiano GA. Evidence-based psychological treatment for Attention-deficit hyperactivity disorder: An update. JCCAP 2008; 34: 449-476.

Millichap JG. Attention deficit hyperactivity disorder handbook: A physician’s guide to ADHD. New York: Springer; 2010.

Hoza B, Kaiser NM, Hurt E. Evidence-based treatments for attention-deficit/hyperactivity disorder (ADHD). In M. Roberts, D. Elkin, & R. Steele, eds. Handbook of evidence based therapies for childhood and adolescents. New York NY: Springer; 2008.

Neophytou K, Webber R. Attention deficit hyperactivity disorder: The family and social context. ASW 2005; 58: 313-325.

Musa RB, Shafiree Z. Depressive, anxiety and stress levels among mothers of ADHD children and their relationships to ADHD symptoms. AJP 2007; 8: 20-28.

Modesto-Lowe V, Danforth JS, Brooks D. ADHD: Does Parenting Style Matter? CLP 2008; 47: 865-872.

Hughes AA, Hedtke KA, Kendall PC. Family functioning in families of children with anxiety disorders. FamPsychol 2009; 22: 325-328.

Kaiser NM, McBurnett K, Pfiffner LJ. Child ADHD Severity and Positive and Negative Parenting as Predictors of Child Social Functioning: Evaluation of Three Theoretical Models. JAD 2011; 15: 193 –203.

McBurnett K, Pfifner L. Attention-deficit hyperactivity disorder: Concepts, controversies, new directions. New York: Information Healthcare USA; 2008.

Bo¨gels SM, Lehtonen A, Restifo K. Mindful parenting in mental health care. Mindfulness 2010; 1: 107–120.

Mikulincer M, Shaver PR, Pereg D. Attachment theory and affect regulation: Psychodynamics, development, and cognitive consequences of attachment related strategies. Motivation and Emotion 2003; 27: 77-102.

Rogers MA, Wiener J, Marton I, TannockR. . Parental involvement in children's learning: Comparing parents of children with and without Attention-Deficit/Hyperactivity Disorder (ADHD). Journal of School Psychology 2009; 47: 167–185.

Keown LJ, Woodward LJ. Early parent–child relations and family functioning of preschool boys with pervasive hyperactivity. JACP 2002; 30: 541–553.

Cunningham CE, Boyle MH. Preschoolers at risk for attention-deficit hyperactivity disorder and oppositional defiant disorder: Family, parenting, and behavioral correlates. JACP 2002; 30: 555–569.

Yousefi S, Soltanifar A, Abdollahian E. Parenting stress and parenting styles in mothers of ADHD with mothers of normal children. Social and Behavioral Sciences 2011; 30: 1666 – 1671.

Liffore KJ, Harold TG, Thapar A. Parent-child relationships and ADHD symptoms: A longitudinal analysis. JACP 2008; 36: 285-296 .

Sonuga-Barke EJS, Daley D,Thompson M, Laver-Bradbury C, Weeks A. Parent-based therapies for preschool ADHD: A randomized, controlled trial with a community sample. AACAP 2001; 40: 402-408.

Daly BP, Creed T, Xanthopoulos M. Brown RT. Psychosocial treatments for children with attention deficit/hyperactivity disorder. Neuropsychol Rev 2007; 17: 73–89.

Moharreri F, Shahrivar Z, Tehrani-doost M. Efficacy of the positive parenting program (Triple P) for Mothers on behavior problems of children with attention deficit/hyperactivity disorder. Journal of Mental Health 2008; 1: 31-40 .

Gerrard L, Anastopoulos AD. The relationship between AD/HD and mother–child attachment in early childhood. Paper presented at the annual meeting of the American Psychological Association; 2005.

Danfortha JS, Harvey E, Ulaszekc WR, Eberhardt McKee T. The outcome of group parent training for families of children with attention-deficit hyperactivity disorder and defiant/aggressive behavior. Journal of Behavior Therapy and Experimental Psychiatry 2006; 37: 188–205.

Barkley RA.ADHD and the nature of self-control.New York: Guilford Press; 2005.

Chan RC, K Shumb D, Toulopoulou T, Chen EYH. Assessment of executive functions: Review of instruments and identification of critical issues. Archives of Clinical Neuropsychology 2008; 23: 201–216.

Biederman J, Petty CR, Doyle AE, Spencer T, Henderson CS. MarionB. et al. Pediatric psychopharmacology program of the psychiatry department. Developmental Neuropsychological 2008; 33: 44–61.

Trani, MD, Casini MP, Capuzzo F, Gentil S, Bianco G, Menghini D, et al. Executive and intellectual functions in attention-deficit/hyperactivity disorder with and without comorbidity. Brain & Development 2001; 33: 462-469.

Rapport MD, Alderson RM, Kofler MJ, Sarver DE, Bolden J, Sims V. Working memory deficit in boys with attention-deficit/hyperactivity disorder (ADHD): the contribution of the central executive and subsystem processes. JACP 2008; 36: 825–837.

Liotti M, Pliszka SR, Higgins K, Perez III R Semrud-Clikeman M. Evidence for specificity of ERP abnormalities during response inhibition in ADHD children: A comparison with reading disorder children without ADHD. Brain and Cognition 2010; 72: 228–237.

Baddeley AD. Working memory, thought and action. Oxford: Oxford University Press; 2007.

Rapport MD, Bolden J.Kofler MJ, Sarver DE, Raiker JS. Alderson RM. Hyperactivity in boys with attention-deficit/hyperactivity disorder: A ubiquitous core symptoms or manifestation of working memory deficit. JACP 2009; 29: 555-568.

Mashhadi A, Teimouri S, Soltanifar A, Hossein zadeh Maleki Z. (Visual-spatial working memory in children with attention deficit disorder / hyperactivity (ADHD) in Benton visual retention test (Persian)). First Conference of the Cognitive Science in Education 2011; Mashhad, Iran.

Brocki, KC, Randall KD, Bohlin G, Kerns KA. Working memory in school-aged children with attention-deficit/hyperactivity disorder combined type: Are deficits modality specific and are they independent of impaired inhibitory control. JCEN 2008; 4: 1–11.

Söderqvist S, McNab F, Peyrard-Janvid M, Matsson H, Humphreys K, Kere J, et al. The SNAP25 gene is linked to working memory capacity and maturation of the Sadock BJ. Sadock VA. Kaplan &Sadok’s Synapsis of psychiatry: Behavioral science/clinical psychiatry, 10th eds. Lippincott Williams & Wilkins; 2010.

Westerberg H, Hirvikoski T, Forssberg H, Klingberg T. Visuo-Spatial working memory span: A sensitive measure of cognitive deficits in children with ADHD. Child Neuropsychol 2004; 10: 155–161.

Klingber T. Training and plasticity of working memory. Trends in Cognitive Sciences 2010; 14: 317–324.

Martinussen R, Hayden J, Hogg-Johnson S, Tannock R. A meta analysis of working memory impairments in children attention-deficit /hyperactivity disorder JAACAP 2005; 44: 377-384.

Willcutt EG, Doyle AE., igg JT, FaraoneSV, Pennington BF. Validity ofthe executive function theory of attention-deficit/hyperactivity disorder: A meta-analyticreview. Biological Psychiatry 2005; 57: 1336–1346.

Mashhadi A, Hosseinzadeh Maleki z. (Role of executive functions in neural development disorders ADHA and ASD (Persian)). First Conference of the Cognitive Science in Education 2011; Mashhad, Iran.

KlingbergT, Forssberg H, Wassenberg H. Training of working memory in children with ADHD. JCEN 2002; 24: 781-791.

Klingberg T, Fernell E, Olesen P, Johnson M, Gustafsson P, Dahlstr¨om K, et al. Computerized training of working memory in childrenwith ADHD- A randomized, controlled trial. JAACAP 2005; 44: 177–186.

Duarte NA, Woods SP, Rooney A, Atkinson JH, Grant I. The Translational Methamphetamine AIDS Research Center (TMARC) Group. Working memory deficits affect risky decision-making in methamphetamine users with attention-deficit/hyperactivity disorder. Journal of Psychiatric Research 2012; 46: 492-499.

Olesen PJ, Westerberg H, Klingberg T. Increased prefrontal and parietal activity after training of working memory. Nature Neuroscience 2004; 7: 75–79.

Westerberg H, Klingberg T. Changes in cortical activity after training of working memory: a single-subject analysis. Physiology and Behavior 2007; 92: 186–192.

Klingberg T. The overflowing brain: information overload and limits of working. New York: Oxford University Press; 2009.

Holmes J, Gathercole SS, Dunning DL. Adaptive training leads to sustained enhancement of poor working memory in children. Developmental Science 2009; 12: 9–15.

Shipstead Z, Redick TS, Engle RW. Is Working Memory Training Effective? Psychological Bulletin 2012; 10: 1037.

Witt M, School based working memory training: Preliminary finding of improvement in children’s mathematical performance. Advance cognitive psychology 2011; 7: 7-15.

Vance A, Winther J, Rennie K. Management of attention-deficit/hyperactivity disorder: the importance of psychosocial and medication treatments. JPCH 2012; 48: 33-7.

Esmaeili T, Bahrainis A, Hashemian P. Effects of methylphenidate with or without behavioral therapy in children with attention deficit hyperactivity disorder in (Persian). Journal of Research in Medical Sciences (Journal of the Faculty of Medicine) 2005; 29: 135-140.

Khushabi K, Ghadiri F, Jazayeri A. (Parent Management Training Group fits Iranian culture in reducing symptoms of attention deficit disorder / hyperactivity Comparison with pharmacotherapy (Persian)). Family Research 2006; 2: 269-283.

Mashhadi A, Rasoulzadeh-Tabatabaie K, Azadfallah P, Soltanifar A. (The Comparison of Response Inhibition and Interference Control in ADHD and Normal Children (Persian)) Journal of Clinical Psychology 2009; 1: 37 – 50.

Simpson HAJung L, Murphy TK. Update on attention-deficit/hyperactivity disorder and tic disorders: A review of the current literature. Current Psychiatry Reports 2011; 13: 351-356.

Swanson JM, Schuck S.Mann M, Carlson C, Hartman K, Sergeant J, et al. Categorical and dimensional definitions and evaluations of symptoms of ADHD: The SNAP and the SWAN rating Scales [Draft]. Available at: www. Adhd. Net/SNAP- SWAN.pdf/. 2005.

Bussing R, Fernandez M, Harwood M, Hou H.Garvan CW, Eyberg SM, et al. Parent and teacher SNAP–IV rating of attention deficit hyperactivity disorder symptoms: Psychometric properties and normative ratings from school district sample. Assessment 2008; 15: 317-328 .

Sadrosadat J, Hoshyari Z, Zamani R, Sadrosadat L. Determine the psychometric properties of SNAP –IV (Persian)]. Rehabilitation 2007; 8: 59-65.

Achenbach TM, Rescorla LA. Multicultural Understanding of Child and Adolescent Psychopathology: Implications for Mental Health Assessment. New York: Guilford Press; 2007.

Minaee A. Adaptation of Child Behavior Inventory Questionnaire, self and teacher report (Persian) Research on Exceptional Children 2006; 19: 529-558.

Anastopoulos AD, Shelton TL. Assessing attention deficit/hyperactivity disorder. New York: Kluwer Academic Publisher; 2002.

Lezak MD, Howieson DB, Loring DW, Hannay HJ. Neuropsychological Assessment, 4th eds. New York: Oxford University Press, 2004.

Khodadadi M, Mashhadi A, Amani H. [Working memory training software, Sinai Research Institute for the Behavioral Sciences (Persian)]; 2009.

Abedi M, Sadeghi A, Rabiee M. (Wechsler Intelligence Scale Fourth Edition) WISC-IV) performance and scoring guide (Persian)) Esfahan: Neveshteh; 2011.

Sadeghi A, Rabiee M, Abedi M. (Reliability and Validation of Wechsler Intelligence Scale for Children Fourth Edition) WISC-IV). Developmental Psychology (Persian)): Journal of Iranian Psychologists 2009; 7: 377-86.

Meyerrs LS, Gamst G, Guarino AJ. Applied multivariate research: Design and interpretation. Sage Publication: London; 2006.

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Attention deficit hyperactivity disorder (ADHD) Combined treatment Parent training program Working memory training

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Hosainzadeh Maleki Z, Mashhadi A, Soltanifar A, Moharreri F, Ghanaei Ghamanabad A. Barkley’s Parent Training Program, Working Memory Training and their Combination for Children with ADHD: Attention Deficit Hyperactivity Disorder. Iran J Psychiatry. 9(2):47-54.