Relative Efficacy of Internet-based and Face-to-face Behavioural Parent Training for Parents of Children with Attention-deficit/ hyperactivity disorder: a Non-randomised Controlled Trial.

Background/objective: Behavioural Parent Training (BPT) is an evidence-based psychosocial intervention for attention-deficit/hyperactivity disorder (ADHD) in children. The use of online technologies significantly increases the accessibility of these interventions. This study aimed to assess the relative efficacy of face-to-face and online training in the use of parenting strategies taught. We also explored the impact of parental ADHD symptom levels.

Method: A massive open online course (MOOC) version of a BPT program was designed and evaluated. A total of ninety parents of children diagnosed with ADHD were recruited. Randomisation was not employed; parents gave their preferences in choosing between face-to-face and online training formats. One month after the completion of the training and at a three-month follow-up, parents were queried regarding the implementation and frequency of use of the parenting strategies taught. The two groups were compared along these variables. The Adult ADHD Rating Scale (ASRS-A) was employed to screen parental ADHD symptoms, with the two groups (positively/negatively screened) subsequently compared in terms of their choice of training format and the use of the parenting strategies. The psychopathological symptoms of the child were evaluated using the Strengths and Difficulties Questionnaire (SDQ).

Results: Thirty parents elected to participate in the face- to-face training, while sixty parents registered for the online programme. The drop-out rate was high, data from 21 and 39 parents was included in the analysis from the two groups, respectively. The two groups did not differ in the ASRS-A screening outcome. The only difference was the implementation of the reward system, which was reported by more parents in the face-to-face group than in the online group. The only difference between the groups that screened positive and negative in the ASRS-A was found in the use of proactive parenting strategies. We found no significant differences between the two time points in the use of most parenting strategies.

Discussion: Our results suggest that the online format may be similarly effective in teaching parenting techniques as the face-to-face parenting training. The level of parental ADHD symptoms had little effect; the difficulties regarding proactive strategies may be due to deficits in executive functioning. Parent training delivered through telemedicine can significantly improve access and is cost-effective; therefore, we recommend its use in the treatment of ADHD in children. Nevertheless, this necessitates appropriate regulation and funding of telemedicine. (Neuropsychopharmacol Hung 2024; 26(4): 204-217)