Strongest Families (Formerly Family Help Program): Pediatric Attention Deficit/Hyperactivity Disorder (FHPADHD)

• Alabama Parenting Questionnaire [ Time Frame: baseline, 120, 240 and 365 day follow-up ] [ Designated as safety issue: No ]
• Revised Disruptive Disorder Rating Scale [ Time Frame: baseline, 120, 240 and 365 day follow-up ] [ Designated as safety issue: No ]
• Connors rating scale\ [ Time Frame: baseline, 120, 240 and 365 day follow-up ] [ Designated as safety issue: No ]
• Disability Measure; [ Time Frame: Weekly during treatment; baseline, 120, 240 and 365 day follow-up ] [ Designated as safety issue: No ]
• Child Health Questionnaire [ Time Frame: baseline, 120, 240 and 365 day follow-up ] [ Designated as safety issue: No ]
• Economic Outcome assessment [ Time Frame: baseline, 120, 240 and 365 day follow-up ] [ Designated as safety issue: No ]

• Specific Behavioural Measures:
• Alabama Parenting Questionnaire
• Revised Disruptive Disorder Rating Scale
• Connors rating scale\
• Other:
• Disability Measure;
• Child Health Questionnaire
• Economic Outcome assessment
• gathered at baseline, 120, 240 and 365 day follow-up.

The purpose of the Strongest Families (formerly Family Help Program)is to evaluate the effectiveness of the Strongest Families distance intervention compared to usual or standard care that is typically provided to children with mild to moderate Attention Deficit/Hyperactivity Disorder. This is a single-centre trial based at the IWK Health Centre. The primary outcome is change in diagnosis.

The purpose of the Strongest Families (formerly Family Help Program): is to deliver, primary care mental health services to children and their families in the comfort and privacy of their own home. Approximately 60 children (8-12 years of age)suffering from mild to moderate (but clinically significant) symptoms of pediatric Attention Deficit/Hyperactivity Disorder will be randomized.

The intervention is delivered from a distance, using educational materials (manuals, video-tapes, audio-tapes) and telephone consultation with a trained paraprofessional "coach" who is supervised by a licensed health care professional. The telephone coach delivers consistent care based on written protocols, with on-going evaluation by a professional team.

Fifty percent of the eligible participants will receive Strongest Families (formerly Family Help Program): telephone-based treatment and 50% will be referred back to their family physician to receive standard care as determined by that physician. Those receiving standard care will be evaluated for outcome results and then compared to the Strongest Families treated participants. It is anticipated that Strongest Families treatment will be proven to be as or more effective than standard care.

• Behavioral: FHPADHD
  Evidence-based psychological and behavioural distance intervention
  Other Name: Strongest Families (formerly Family Help Program):
• Behavioral: ADHD Standard Care

• Experimental: Treatment
  FHPADHD 50% randomized to receive Strongest Families (formerly Family Help Program): behavioural distance intervention
  Intervention: Behavioral: FHPADHD
• Active Comparator: Control
  ADHD Standard Care 50% randomized to receive standard/usual care for ADHD
  Intervention: Behavioral: ADHD Standard Care

• Lingley-Pottie P, McGrath PJ. A paediatric therapeutic alliance occurs with distance intervention. J Telemed Telecare. 2008;14(5):236-40.
• Lingley-Pottie P, Janz T, McGrath PJ, Cunningham C, MacLean C. Outcome progress letter types: parent and physician preferences for letters from pediatric mental health services. Can Fam Physician. 2011 Dec;57(12):e473-81.
• McGrath PJ, Lingley-Pottie P, Thurston C, MacLean C, Cunningham C, Waschbusch DA, Watters C, Stewart S, Bagnell A, Santor D, Chaplin W. Telephone-based mental health interventions for child disruptive behavior or anxiety disorders: randomized trials and overall analysis. J Am Acad Child Adolesc Psychiatry. 2011 Nov;50(11):1162-72. Epub 2011 Sep 3.
• Lingely-Pottie P, McGrath PJ. A therapeutic alliance can exist without face-to-face contact. J Telemed Telecare. 2006;12(8):396-9.
• McGrath PJ, Lingley-Pottie P, Emberly DJ, Thurston C, McLean C. Integrated knowledge translation in mental health: family help as an example. J Can Acad Child Adolesc Psychiatry. 2009 Feb;18(1):30-7.
• Lingley-Pottie P, McGrath PJ. Distance therapeutic alliance: the participant's experience. ANS Adv Nurs Sci. 2007 Oct-Dec;30(4):353-66.
• Lingley-Pottie P, McGrath PJ. Telehealth: a child and family-friendly approach to mental health-care reform. J Telemed Telecare. 2008;14(5):225-6.

Inclusion Criteria:

• child 3 to 7 years of age
• child had behavioural problems for 6 months or longer
• access to a telephone in the home
• speak and write english
• mild to moderate attention deficit/hyperactivity symptomology

Exclusion Criteria:

• severe attention deficit/hyperactivity symptomology
• received similar intervention within past 6 months
• Autism or Schizophrenia
• child has intellectual impairment