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Acceptance and Commitment Therapy-Based Parenting Program in Children With Co-Occurring Asthma and ADHD: A Randomized
Yuen Yu Chong1, Wai Tong Chien1, Kenneth P Fung2
1The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
JAMA Pediatrics
|June 2, 2025
Summary
This study found that an Acceptance and Commitment Therapy-based Parenting Program (ACT-PAM) significantly reduced healthcare visits and improved asthma control and ADHD symptoms in children. ACT-PAM offers a holistic approach for managing comorbid asthma and ADHD.
Area of Science:
- Pediatric Pulmonology
- Child Psychiatry
- Behavioral Health
Background:
- Co-occurring asthma and ADHD in children present unique caregiving challenges and increase healthcare utilization.
- Holistic interventions are needed to address the complexities of managing both conditions simultaneously in pediatric populations.
Purpose of the Study:
- To evaluate the 12-month efficacy of an Acceptance and Commitment Therapy-based Parenting Program (ACT-PAM) on health outcomes for children with asthma and ADHD, and their parents.
- To assess the impact of ACT-PAM on healthcare use, asthma control, ADHD symptoms, parental psychological inflexibility, and self-efficacy.
Main Methods:
- An assessor-blinded randomized clinical trial enrolled 118 parents of children with asthma and comorbid ADHD.
- Participants were randomized to receive either ACT-PAM plus standard asthma care (TAU) or TAU alone.
- Intervention involved six ACT-PAM group sessions focusing on acceptance, mindfulness, values-based parenting, and asthma management.
Main Results:
- ACT-PAM plus TAU significantly reduced unscheduled healthcare visits for asthma exacerbations compared to TAU alone (aMD -0.8 visits).
- Asthma control (C-ACT scores) improved significantly (aMD 4.4), and parent-rated ADHD symptoms (SWAN scores) decreased (aMD -0.5).
- Parental psychological inflexibility decreased (aMD -10.0), and asthma management self-efficacy increased (aMD 0.8) in the ACT-PAM group.
Conclusions:
- ACT-PAM is an effective intervention for managing pediatric asthma with comorbid ADHD.
- The program demonstrates significant improvements in healthcare use, asthma control, ADHD symptom severity, and parental well-being.
- This study highlights the relevance of ACT-PAM in providing a comprehensive approach for families facing these dual diagnoses.
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