A paradigm shift in intervention approaches for children with attention-deficits/ hyperactivity disorders: A systematic review of psycho-behavioral interventions

Objectives: This systematic review examines the literature of psycho-behavioural interventions for individuals diagnosed with AD/HD between 2005 and 2015 in order to answer the following research questions: (1) What are the underlying theoretical perspectives of AD/HD in the intervention design? (2) What are the measures used to assess the various AD/HD interventional approaches? (3) How effective are the identified AD/HD interventions? Method: 18 studies involving approximately 1200 participants met the selection criteria under the psycho-behavioural framework and went through the systematic review procedures. Results: Three approaches to intervention are identified, namely, ability-specific training focusing on enhancing working memory and attention, skills-building intervention aiming at improving organizational and social skills, and, interaction oriented programs targeting at mediating relationships between parents and their children. The interaction-oriented interventions tend to demonstrate the highest efficacy in improving the psycho-behavioural performance of individuals with AD/ HD. Conclusion: Different intervention approaches are founded on different underlying theoretical perspectives of the psycho-behavioural performance in AD/HD. There has been a paradigm shift from the management of dysfunction to the acquisition of functions based on the behavioural management theories and pharmaceutical knowledge-base to those of an ability-specific approach and skill-building approach to interventions for individuals with AD/HD with the dominance of the theory of executive functioning in the last decades. It is speculated that the trend of AD/HD intervention will continue to shift from that of a uni-directional childcentred approach to those of a multi-directional ecological systems perspective. This implication calls for more efforts in developing valid assessment measures to evaluate the new constructs assessing the inter-personal relationships within the AD/HD individual's ecological systems. Copyright © 2016 iMedPub.