ABSTRACT
BACKGROUND: Despite well-established Evidence-Based Treatments (EBTs) for Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD), many low-resource settings lack EBT access. METHODS: We conducted a school-clustered randomized controlled pilot of CLS-FUERTE (a multicomponent behavioral EBT adapted for children in Mexico) with 58 students. We randomly assigned four schools to receive CLS-FUERTE and four to receive school services as usual. We compared groups post-treatment on parent- and teacher-rated ADHD/ODD symptoms and impairment. RESULTS: CLS-FUERTE fidelity, attendance, engagement, and acceptability was high and students receiving CLS-FUERTE showed greater improvement in teacher-rated ADHD, ODD, and impairment, as well as parent-rated ADHD and impairment, compared to students receiving usual services. CONCLUSIONS: Pilot results suggest that psychosocial EBTs can be successfully implemented by School Mental Health Providers in Mexico.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Mental Health , Adolescent , Attention Deficit Disorder with Hyperactivity/therapy , Attention Deficit and Disruptive Behavior Disorders , Child , Humans , Mexico , Pilot Projects , SchoolsABSTRACT
OBJECTIVE: The current study sought to establish psychometric properties of the ADHD-FX (a culturally sensitive measure designed to assess functional impairment related to ADHD) in a dual-site clinical sample. METHOD: We analyzed patient charts of 67 children (47 boys and 20 girls, ages 5 to 15 years) receiving comprehensive assessments from two university-based ADHD clinics. RESULTS: The parent and teacher ADHD-FX rating scales demonstrated good psychometric properties via adequate reliability (Cronbach's α > .70), convergent construct validity (significant correlations with majority of theoretically related measures), and divergent construct validity (insignificant correlations with majority of theoretically unrelated measures). CONCLUSION: Results extend upon previously published psychometric analyses to suggest that the ADHD-FX is a reliable and valid measure for parents and teachers to assess functional impairment related to ADHD (i.e., difficulties with academic achievement, social competence, and familial relationships) in community and clinical populations. Clinical implications and future directions are discussed.
Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Faculty , Parents , Psychiatric Status Rating Scales/standards , Psychometrics/statistics & numerical data , Academic Success , Adolescent , Adult , Attention Deficit Disorder with Hyperactivity/physiopathology , Child , Child, Preschool , Clinical Coding , Family Relations , Fathers , Female , Humans , Male , Mothers , Reproducibility of Results , Social SkillsABSTRACT
Conceptualizing and measuring functional impairment related to childhood ADHD, particularly within the rapidly growing, yet underserved, Latino population, is an important area of research that is in its infancy in the field of psychology. The functional impairments related to academic achievement, social competence, and familial relations experienced by children with ADHD lead to long-lasting and debilitating difficulties that adversely affect the individuals themselves, their families, and society. In addition, limited available research suggests that Latino children are at a great or greater risk for developing ADHD, although they are much less likely to be identified by their parents as displaying problematic behavior and subsequently are less likely to receive proper assessment and treatment due to several practical and cultural factors. Fortunately, initial evidence suggests that the construct of functional impairment may be a more universal notion than the potentially culturally biased measurement of symptomatology. Therefore, in order to provide the best possible outcomes for all children with ADHD, research needs to be expanded to include examination of functional impairment related to ADHD, particularly when working with Latino children and their families. Thus, the primary aim of the current review is to examine and critique how the field of psychology has understood and measured functional impairment in school-aged Latino children with ADHD to date. Based on information reviewed, suggestions for moving toward a culturally modified assessment of functional impairment related to ADHD in Latino children will be proposed. This work is a necessary step toward providing culturally appropriate services for a currently underserved, yet rapidly growing, Latino population in our country.