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ROAR-Early Childhood: Pilot Testing a Brief Telemedicine Parent Training Program for Rural Children Diagnosed with
James T Craig1,2, Michael T Sanders3, Christina C Moore1,2
1Dartmouth Health, Lebanon, NH, USA.
Insights
A new telemedicine program, ROAR-EC, shows promise for treating young children with Attention Deficit/Hyperactivity Disorder (ADHD) in rural areas. The program was feasible, acceptable, and improved family empowerment and child behavior.
Area of Science:
- Child Psychology
- Telemedicine Interventions
- Neurodevelopmental Disorders
Background:
- Attention Deficit/Hyperactivity Disorder (ADHD) affects 2-4% of preschoolers and 9% of all children, significantly impairing development.
- Behavioral Parent Training (BPT) is effective but faces access barriers in rural and underserved communities.
- Telemedicine offers a potential solution to improve treatment accessibility for ADHD in young children.
Purpose of the Study:
- To test the feasibility, acceptability, and effectiveness of the Rural Outreach and ADHD Research-Early Childhood (ROAR-EC) program.
- The ROAR-EC program is a brief, clinician-led, 7-session telemedicine intervention for young children with ADHD.
- To compare the ROAR-EC program with treatment as usual in a predominantly rural population.
Main Methods:
- A pilot randomized controlled trial (RCT) involving 44 children (ages 3-7) diagnosed with ADHD.
- Families were randomized to either the ROAR-EC program or treatment as usual for 24 weeks.
- Feasibility, acceptability, parenting practices, caregiver empowerment, disruptive behaviors, and ADHD symptoms were assessed.
Main Results:
- The ROAR-EC program was found to be feasible to implement and acceptable to caregivers.
- Significant improvements were observed in the ROAR-EC group compared to the control group for family empowerment and parenting practices.
- The ROAR-EC program also led to reductions in total behavior problems, impairment, and inattentive symptoms.
Conclusions:
- Brief telemedicine programs like ROAR-EC are a promising alternative to traditional BPTs for young children with ADHD.
- The study highlights the potential of telemedicine to reach underserved populations in rural areas.
- ROAR-EC demonstrates feasibility, acceptability, and likely benefits for children with ADHD and their families.
Objective:
Attention Deficit/Hyperactivity Disorder (ADHD) is a chronic and impairing neurodevelopmental disorder diagnosed in approximately 2% to 4% of preschool-age children and 9% of all children. Behavioral parent training (BPT) and high-quality education are effective treatments for young children with ADHD; however, poor rates of treatment access and participation limit the reach of BPTs to rural and underserved communities. In this study, we tested the newly developed Rural Outreach and ADHD Research-Early Childhood (ROAR-EC) program, a clinician-led, 7-session education and parent training program designed for delivery over telemedicine.
Method:
We conducted a pilot RCT to assess the feasibility, acceptability, engagement of mechanism, and exploratory group × time effects of the ROAR-EC program compared to a control group in a sample of 44 children diagnosed with ADHD from a predominantly rural area (ages 3-7; Mage = 4.8; 62% male; 96% White; 89% non-Hispanic/Latinx). Families were randomized into either ROAR-EC or treatment as usual through developmental pediatrics and followed for 24 weeks. Assessed were metrics of feasibility, acceptability, parenting practices, caregiver empowerment, disruptive behaviors, and ADHD symptoms.
Results:
Results indicated that ROAR-EC was feasible to implement and acceptable to caregivers. Repeated measures ANOVAs found significant group × time interaction effects in favor of the treatment group compared to control for family empowerment, parenting practices, total behavior problems, impairment, and inattentive symptoms.
Conclusions:
This study demonstrated the promise of brief telemedicine programs as feasible, acceptable, and likely beneficial alternatives to traditional BPTs for young children with ADHD in rural and low-resource areas.
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