HEAT Research Projects
Enhancing behavioral parent training for parents and children affected by ADHD: Developing the Executive Functioning Enhanced Caregiver Training Skills (EFECTS) program
Funding Source: National Institutes of Health (NIH)/National Institutes of Mental Health (NIMH)
Grant Number: K23MH128536 (PI: Friedman)
Results from one of the most proven and widely used treatments for ADHD, Behavioral Parent Training (BPT), can be mixed. Up to 66% of individuals do not respond well to this intervention. A significant portion of these poor responders are families where parents themselves have ADHD. Given that almost half of all children with ADHD have a parent with ADHD, and even more parents experience symptoms that still affect their daily lives, improving BPT for such families may have a large public health impact.
In BPT programs, caregivers learn important skills that are implemented at home. The success of BPT depends on parents consistently using the skills they learned. However, studies show that parents don't use these skills often enough, which makes the treatment less effective. Parents with high levels of ADHD symptoms face these challenges more often and use the skills less. These difficulties are likely because of problems with executive function, which is linked to ADHD symptoms and related issues.
This project seeks to make BPT more effective by developing a program for parents with ADHD symptoms. The new program, called the Executive Function Enhanced Caregiver Training Skills (EFECTS), will have two improvements to tackle common skill use problems among parents with ADHD symptoms: (a) adult ADHD Cognitive and Behavioral Therapy (CBT) strategies, and (b) a smartphone app to provide personalized supports.
A Pilot Study to Inform the Development a Behavioral Parent Training Intervention for Parents and Children with ADHD
Funding Source: Institute for Social Science Research (ISSR)
PI: Friedman
In Behavioral Parent Training (BPT) programs for childhood ADHD, parents learn skills that are applied in their kids' daily lives. The goal of BPT is to reduce ADHD symptoms and improve day-to-day functioning. These programs are effective—improvements are seen across domains and are often of large magnitude. However, not all children benefit equally, and a large proportion of poor responders consist of families where parents also have ADHD. The success of BPT relies on parents consistently applying BPT skills, but studies show low rates of skill use, limiting treatment effects. Parents with high levels of ADHD symptoms face these challenges more often and use the skills less, but it remains unclear why parents with ADHD struggle to apply BPT skills at home. This project seeks to understand the factors that prevent parents with ADHD from using skills at home. The goal is to inform the design of more effective interventions for families affected by intergenerational ADHD, such as the EFECTS Treatment described above.
Assessing Parental ADHD-related Barriers to Behavioral Parent Training Skill Use: Developing the Parental ADHD and Executive Dysfunction Scale (PAEDS)
Funding Source: Institute for Mental Health Research (IMHR)
PI: Friedman
Our ISSR funded study (above) showed that parents with ADHD experience several barriers that prevent them from applying the BPT skills with their children. These include forgetting to use skills, poor planning, procrastination, lacking motivation, dealing with daily and other parenting stresses, having trouble paying attention, and not understanding the skills. These difficulties are likely because of problems with executive functions, which are linked to ADHD symptoms and related issues. Although parents often report these barriers, researchers lack a way of measuring or quantifying these barriers. Being able to quantify barriers is critical for the HEAT Lab’s goal to improve treatment for families affected by intergenerational ADHD. If we don’t have a way to measure barriers, we won’t know (a) if our new treatments are effectively reducing BPT skill use barriers for families or (b) whether reducing barriers actually improves outcomes. Therefore, the goal of this project is to develop such a measure. We will work with clinicians who deliver BPT and parents with ADHD symptoms who have completed BPT to develop and validate the Parental ADHD and Executive Dysfunction Scale (PAEDS)