Comparing the Efficacy of In-person Versus Videoconference Parent Management Training for ADHD: A Randomized Clinical Trial

Abstract

Background: Parent management training (PMT) is a recognized intervention for managing attention deficit hyperactivity disorder (ADHD) in children. Objectives: The present study aims to bridge this gap by investigating the comparative effectiveness of in-person versus videoconference PMT. Methods: Ninety parents with diagnosed ADHD children participated in this parallel-design, randomized clinical trial. Parents were recruited from a community outpatient clinic and randomly assigned (block randomization) to either a videoconference or in-person PMT group. The ADHD children between the ages of 3 and 12 who met the diagnostic and statistical manual of mental disorders (DSM-5) standards for ADHD diagnosis were included, as long as the child did not have oppositional defiant disorder (ODD) or conduct problem. The primary outcome measure was parent-reported ADHD symptoms, assessed using the Conners' Parent Rating Scale (CPRS-48) at baseline, post-treatment, and 2-month follow-up. The Swanson, Nolan, and Pelham (SNAP-IV) Questionnaire was also used as a secondary outcome measure. Statistical analyses included Independent samples t-test and mixed ANOVA, with effect sizes reported as Cohen's d. Results: Both in-person and videoconference PMT significantly improved core ADHD symptoms (attention deficit, hyperactivity, and overall ADHD) (all P < 0.001 except videoconference PMT at follow-up for ADHD, P = 0.01) and conduct problems (P < 0.001). However, in-person PMT showed additional benefits for social and psychosomatic problems, with medium to large effect sizes. Specifically, the effect size for in-person PMT in improving conduct problems was 0.48, while the effect size for the superiority of in-person PMT over videoconference PMT in improving social problems was 0.55. These findings suggest that while both delivery methods are effective for core ADHD symptoms, in-person PMT may offer more comprehensive benefits, particularly in addressing social and psychosomatic issues. Conclusions: Videoconference PMT can be a viable alternative for improving core ADHD symptoms, particularly when in-person delivery is impractical. However, in-person PMT might be the preferred approach for addressing social and psychosomatic difficulties. These findings have implications for clinical practice and future research in expanding access to PMT.