PROJECT PEAK: Promoting Engagement with ADHD Pre-Kindergarteners

What is the Intervention?

This intervention is an early intervention parent education program for parents of preschoolers showing signs of ADHD. PEAK aimed at teaching behavior management and support strategies to parents via a face-to-face or online platform.

Who is it for?

Children, ages 3 to 5 years old, exhibiting symptoms of attention-deficit/hyperactivity disorder (ADHD), including frequent inattention, acting without thinking, distractibility, and high levels of activity.

Purpose

The primary purpose of Project PEAK was to develop and refine a parent education program that supports parent engagement with early intervention for young children with ADHD. A secondary purpose was to develop an alternative delivery format (online or web-based) to increase parent accessibility to and engagement with parent education. Thus, the overall objective was to develop an effective behavioral parent training program for preschoolers with or at-risk for ADHD that results in high levels of parent engagement.

Background Information
Young children with ADHD are at high risk for experiencing major problems in behavioral, social, and academic functioning. If untreated, these difficulties can lead to adverse outcomes throughout childhood and into adulthood. Parent education is an effective and relatively cost efficient approach to reducing child behavior problems; however, research suggests that low attendance at parent education sessions is associated with limited intervention effects. By creating an online platform, PEAK increased access to and engagement with treatment while not compromising intervention impact on parent knowledge of and fidelity with prescribed behavioral strategies or effects on child behavior outcomes.

The 10 PEAK sessions covered introductory material (e.g., What is ADHD?) and progressed through intervention strategies typically included in behavioral parent training programs (e.g., praise) as well as an emphasis on parents using proactive problem-solving including prevention, instruction, and response strategies. Additionally, parents are taught strategies promoting early numeracy and literacy skills.

Sample Session Materials (See Attached Examples)

• Prioritizing Your Child’s Behaviors
• Some Starters For Giving Positive Feedback and Encouragement
• Dialogic Reading Method
• Resources for Caregivers of Young Children with ADHD

Steps to Using Intervention Materials

• Prioritizing Your Child’s Behavior
  • Problem behavior can vary…
  • Some of the behaviors can be very minor. For example, your child taps their foot on the table impulsively while eating dinner. These are annoying and distracting behaviors but are not very severe.
  • Some other behaviors can become disruptive, like ripping papers in the preschool classroom when the teacher is trying to have class color. This behavior is distracting and may make the child stand out from other peers. This is more than just annoying, but not yet dangerous.
  • Then there are behaviors that are destructive. Examples of destructive behaviors include hitting others or themselves, biting self or others, throwing objects at others. These behaviors should be at the top of your list for what are important to intervene on.
  • Your child may have many behaviors that you might think are very challenging, but if you think about them based on their severity, it might make it easier to know what behaviors to prioritize your focus on.
  • It is recommended that you prioritize destructive behaviors first, followed by disruptive behaviors, and then distracting behaviors. This attachment is a good visual reminder for how to prioritize behaviors.
• Some Starters For Giving Positive Feedback and Encouragement
  • One of the most powerful ways for you to support your child is to give positive attention when your child behaves in desirable ways. Positive feedback and encouragement lets children know they are supported and the child is then more likely to continue to behave in an acceptable way.
  • Instead of the typical interaction you have with your child when they are demonstrating challenging behaviors that might include yelling or pointing out what the challenging or problem behavior is, it is important to shift your focus to what they can do! Using praise is a way you can support your child and put that positive aspect back in your relationship if you feel like you are always at odds or in a battle with your child. This allows you to focus on the positive and catch them being good!
  • Praise and encouragement teaches your child what to expect. The environment around a child might not always communicate what the expectations are for that child or what is coming next. As adults, we can pick up and infer a lot about what appropriate behavior is in different settings, but as a child, if things are not explicit, a child may not know what is coming next. This is especially true for children with ADHD, who may have difficulties with attention or may be impulsive.
  • This attachment provides greater examples of starters for giving your child praise and positive feedback.
• Dialogic Reading Method
  • This is a simple and easy strategy for reading to your child in a way that helps improve your child’s literacy skills.
  • This attachment goes through the steps to necessary steps to encourage your child to be an active reader while simultaneously reminding you, as the parent, to be a listener and questioner.
• Resources for Caregivers of Young Children with ADHD
  • This attachment lists helpful books and websites for parents with children with or at risk for ADHD.