|
| Study | Peer component | Parent component | Teacher component | Skills | Medication |
|
Frankel et al. [55]
QES | Children were didactically presented social skills and required to rehearse behaviours between each other. Participants were also taught conversational techniques and rehearsed them in the context of introductions to other class members | (i) Parent sessions
(ii) Parent ratings of social skills
(iii) Child socialisation homework | (i) Teacher ratings of antisocial, prosocial, and aggressive behaviour | (i) Conversation
(ii) Techniques
(iii) Playing together/getting along
(iv) Giving compliments & criticism | All ADHD participants were required to take medication (incl. methylphenidate, dextroamphetamine, pemoline, other psychotropic medication) |
|
Guli et al. [56]
QES | The sessions included activities that focus on establishing social skills through several improvisations or process dramas, through which they practice perspective taking and cognitive flexibility with their peers. | (i) Parent ratings of social skills
(ii) Parents encouraged home challenges | (i) None | (i) Group cohesion
(ii) Emotional knowledge
(iii) Focusing attention
(iv) Facial expression
(v) Body language
(vi) Vocal cues
(vii) Nonverbal cues | 51.3% of participants were reported to take prescription medication. Treatment: 12 medication & 6 no medication; Control: 4 medication & 12 no medication |
|
| Haas et al. [57] | Counsellor-led questions prompted a discussion of the social skills by encouraging children to provide a description of the social skills (e.g., definition, examples) and to model and role-play good and bad examples of how to use the social skill. | (i) Parent ratings of ADHD, ODD, and CD symptoms
(ii) Parent ratings of callous/unemotional traits | (i) None | Social skills:
(i) Validation
(ii) Cooperation
(iii) Communication
(iv) Participation | All ADHD participants were either not taking medication or prescribed a placebo assignment. However, some children were on medication for some (but not all) days during the summer treatment program |
|
Hantson et al. [59]
QES | The therapist first described how to perform the skills in an appropriate manner. The children were then paired and asked to role-play the new skill in front of the group. Following this, children were asked to role-play the skills from the other’s perspective in an effort to understand situations from other person’s point of view. | (i) Parent psychoeducation and training
(ii) Parent ratings of function, behaviour, and ADHD symptoms | (i) None | Social skills:
(i) Introducing self
(ii) Joining in
(iii) Knowing your feelings
(iv) Dealing with anger
(v) Self-control
(vi) Responding to teasing
(vii) Staying out of fights | Participants who were on medication stayed on medication; those who were not on medication remained so. Treatment: 20 medication & 13 no medication; control: 9 medication & 6 no medication |
|
Huang et al. [60]
QES | Children were taught various social skill modules via didactic instructions, modelling, role-play activities and behavioural rehearsals
Positive social behaviour was reinforced via a token system. | (i) Weekly parent sessions to educate on ADHD
(ii) Parent ratings of social skills | Teacher ratings of attention, hyperactivity, impulsivity, oppositional, cooperative behaviour, self-assertion, self-control and conflict coping | (i) Conversation
(ii) Playing together/getting along
(iii) Giving compliments & criticism | All ADHD participants received methylphenidate with drug compliance controlled |
|
Kolko et al. [62]
QES | Cotherapists and children engaged in several role-plays. The group discussed each role-play and provided constructive performance feedback. Inadequate role-plays were rehearsed a second time to promote mastery. | (i) None | (i) One-year follow-up teacher ratings of social skills and outcome measures | (i) Social involvement
(ii) Gaze
(iii) Physical space
(iv) Voice volume/inflection Openers/compliments
(v) Positive assertion
(vi) Negative assertion
(vii) Appropriate nonaggressive play or sharing | Comparable percentages of children in SCST and SA groups received methylphenidate (22% versus 20%), imipramine (11% versus 10%), lithium (8% versus 5%), or other medications (7% versus 5%) |
|
Abikoff et al. [53]
RCT | Peers role-played and modelled appropriate and inappropriate social behaviours in groups of four. | (i) Parent training
(ii) Parent ratings of social skills | (i) Teacher ratings of socially rejected and accepted children
(ii) Reinforcement strategies, daily school report card | (i) Basic interaction skills
(ii) Getting along with others
(iii) Contacts with adults at home and school
(iv) Conversation skills
(v) Problem situations | All participants were prescribed methylphenidate after a 5-week clinical methylphenidate trial and placebo substitution to determine positive response to medication prior to treatment |
|
Choi and Lee [54]
RCT | EMT: children undertook activities that covered four major behavioural characteristics: (1) identification and labelling of emotional words; (2) emotional recognition and expression; (3) emotional understanding; and (4) emotional regulation in social situations
SST: children were taught various social skills to improve their interactions with peers and teachers by using prompts, role-play and reinforcement | (i) Parent ratings on emotional and behavioural problems in children | Interacted with children as part of the SST and EMT programs | (i) Basic interaction skills
(ii) Regulating emotions within a group
(iii) Problem-solving skills
(iv) Conversation skills
(v) Listening skills
(vi) Reaction to rejection, negotiation, being teased and criticised | All participants were prescribed with medication during the course of the study although not controlled |
|
Hannesdottir et al. [58]
RCT | Therapists lead discussions amongst groups of three children to aid solving problems presented at a number of “stations.” Stations included the Emotion Station, Friendship Station, Stopping Station, and Problem-Solving Station. In addition, there was a Brain Training Station, at which children practiced computer-based executive function tasks. | (i) Parent ratings of social skills
(ii) Parent training (one meeting) | None | (i) Identifying facial expressions
(ii) Hiding feelings
(iii) Relaxation and anger management techniques
(iv) Interpreting ambiguous situations
(v) Meeting new peers
(vi) Reading nonverbal messages
(vii) Compromising
(viii) Working memory
(ix) Thinking before acting/speaking
(x) Problem solving everyday problems | 100% of participants in treatment group were on medication for the duration of the study. There were 12 participants on medication in the control group (85.7%) at study commencement, dropping to 11 participants at the end of the study (78.6%) |
|
Jensen et al. [61]
RCT | Sessions include instruction, modelling, role-playing and practice in key social concepts such as communication, as well as more specific skills. In addition to these sessions, the children engaged in a daily cooperative group task that is designed to promote cooperation and contribute to cohesive peer relationships. A buddy system was employed to help children develop individual friendships that may “buffer” them from the possible negative effects of being unpopular. This was accomplished by assigning each child a buddy with whom their goal is to form a close friendship. The children engage in a variety of activities with their buddies and meet regularly with adult “buddy coaches” who assist them in working out relationship problems. | (i) Parent training
(ii) Parent ratings of ADHD, internalizing, oppositional, and aggressive symptoms, and social skills | School-based treatment:
(i) Teacher consultation focused on behaviour management strategies
(ii) Paraprofessional aid
(iii) Teacher ratings of ADHD, internalizing, oppositional, and aggressive symptoms and social skills | (i) Social skills effective for peer group functioning | 71% of combined treatment and medication management participants were using medication at high levels compared to 62% and 45% of community care and behavioural treatment participants, respectively. Average medication doses differed across all groups |
|
Mikami, Griggs [63]
RCT | Peers were trained to be more socially inclusive in the MOSAIC treatment condition. Teachers assigned children to work in teams for collaborative activities where children had to work together in order to succeed. | (i) None | (i) Summer program teacher ratings of problem behaviours | (i) Social skills
(ii) Social inclusion
(iii) Peer group functioning | 10 out of 24 children with ADHD were medicated with psychotropic medication, and some were taking additional medications for comorbid conditions. All medicated children stayed on a consistent regimen during the summer program |
|
The MTA Cooperative Group [64]
RCT | Sessions included instruction, modelling, role-playing, and practice in key social concepts such as communication, as well as more specific skills. In addition to these sessions, the children engaged in a daily cooperative group task that was designed to promote cooperation and contribute to cohesive peer relationships. A Buddy System was employed to help children develop individual friendships that may “buffer” them from the possible negative effects of being unpopular. This was accomplished by assigning each child a buddy with whom their goal is to form a close friendship. The children engaged in a variety of activities with their buddies and met regularly with adult “buddy coaches” who assisted them in working out relationship problems. | (i) Parent training
(ii) Parent ratings of ADHD, internalizing, oppositional, and aggressive symptoms, and social skills | School-based treatment:
(i) Teacher consultation focused on behaviour management strategies
(ii) Paraprofessional aid
(iii) Teacher ratings of ADHD, internalizing, oppositional, and aggressive symptoms, and social skills | (i) Social skills effective for peer group functioning | All participants in the treatment groups were prescribed medication, however 3.1% of the combined treatment and medication management subjects were on no medication |
|
MTA Cooperative Group [65]
RCT | Sessions included instruction, modelling, role-playing, and practice in key social concepts such as communication, as well as more specific skills. In addition to these sessions, the children engaged in a daily cooperative group task that was designed to promote cooperation and contribute to cohesive peer relationships. A Buddy System was employed to help children develop individual friendships that may “buffer” them from the possible negative effects of being unpopular. This was accomplished by assigning each child a buddy with whom their goal is to form a close friendship. The children engaged in a variety of activities with their buddies and met regularly with adult “buddy coaches” who assisted them in working out relationship problems. | (i) Parent training
(ii) Parent ratings of ADHD, internalizing, oppositional, and aggressive symptoms, and social skills | School-based treatment:
(i) Teacher consultation focused on behaviour management strategies
(ii) Paraprofessional aid
(iii) Teacher ratings of ADHD, internalizing, oppositional, and aggressive symptoms, and social skills | (i) Social skills effective for peer group functioning | 70% of combined treatment and 72% of medication management participants were using medication at high levels compared to 62% and 38% of community care and behavioural treatment, respectively |
|
Pfiffner et al. [66]
RCT | Children role-played the positive use of a skill, using brief scripts of common problem situations with peers or siblings (e.g., entering a game, getting out during a game, and being teased). Children evaluated each other’s performance of the social skills immediately after each role-play and were called on to give specific reasons for their ratings. | (i) Parent training
(ii) Parent ratings of inattention and sluggish cognitive tempo symptoms, social skills, organizational skills, and overall improvement | (i) Teacher consultation
(ii) School-home daily report card
(iii) Teacher ratings of inattention and sluggish cognitive tempo symptoms, social skills, organizational skills, and overall improvement | (i) Social competence
(ii) Academic
(iii) Study
(iv) Organization
(v) Self-care
(vi) Daily living skills | Children were excluded if they changed medication status during the course of the study. Only two subjects (both in CLAS program group) began the study taking medication (atomoxetine); they continued medication at posttreatment and follow-up. Two children in the control group began medication at posttreatment, and one did so at follow-up |
|
Shechtman and Katz [67]
RCT | The expressive-supportive modality uses an integrative theoretical approach in therapy, with a strong emphasis on self-expressiveness and group support. Activities and therapeutic games are consistently used to help participants function in the group process. | (i) None | (i) None | (i) Initiation
(ii) Emotional support
(iii) Negative assertion
(iv) Disclosure
(v) Coping with conflicts
(vi) Intimacy in friendship | No mention of whether participants were medicated or nonmedicated |
|
Storebø et al. [68]
RCT | Different methods of teaching the children were used. These include didactic instructions, work with symbols (e.g., dolls), role-play, creative techniques, physical exercises, music, story reading, games, and movies. Each session had a theme of a particular aspect of social skills training. | (i) Parent training
(ii) Parent educational group
(iii) Parental screen for adult ADHD symptoms | (i) Teacher ratings of academic and behavioural performance, social problems, peer relations and emotional regulation | (i) Self-worth
(ii) Nonverbal communication
(iii) Feelings
(iv) Impulse control
(v) Aggression management
(vi) Conflict resolution
(vii) Problem solving
(viii) Social cues | All participants were prescribed medication. Treatment started with the first choice: methylphenidate; the second choice: dexamphetamine; and atomoxetine if significant anxiety component change or suspicion of dexamphetamine abuse |
|
Waxmonsky et al. [69]
RCT | Each session began with a brief description of the social skills of the day, which was presented to the child didactically and through modelling and role-playing. | (i) Parent training
(ii) Parent ratings of ADHD, ODD, CD, and depression symptoms, social skills, problem levels, adverse emotional events | (i) Teacher implemented daily report card
(ii) Teacher ratings of academic and behavioural performance, and adverse emotional events | (i) Cooperation
(ii) Participation
(iii) Validation
(iv) Communication
(v) Following rules
(vi) Completing assignments
(vii) Complying with adults
(viii) Teasing | All participants were prescribed atomoxetine
If a subject was already taking ADHD medication other than atomoxetine, the other medication was stopped for at least 48 hours prior to screening |
|
