"Our findings indicate that children with attention deficit hyperactivity disorder and their parents receiving standard community care that includes medication may benefit from a low-intensity and economical behavioral and social skill program," said lead author Steve Tutty, M.A.

The disorder, which affects 3 percent to 5 percent of U.S. school-aged children, is usually treated solely with stimulant medications. Few physicians routinely supplement patient medication with behavior therapy because the effectiveness of the combined approach has not been validated. The current study was designed to evaluate the effectiveness of such a combined approach.

Tutty and his American colleagues studied 100 children ages 5 to 12 years who had recently been diagnosed with the disorder and were receiving stimulant medication. More than half the children and their parents were assigned to an 8-week behavioral and social skill class, while the rest did not take a class. At 3 and 6 months after treatment began, an independent telephone interviewer spoke to the parents and the teachers of the children to determine the effectiveness of the class as part of the therapeutic regimen.

The class sessions, designed to help parents and children cope with the disorder, presented common case histories and included exercises on listening, self-esteem, and friendship building. The class leaders incorporated visual aids such as a "boiling-point thermometer" for assessing moods and a "star board" for assessing progress. The children also participated in writing exercises, such as completing open-ended statements ("I get angry whenever somebody ..."), to help them identify triggers for anger, while their parents received additional training in behavioral modification strategies.

Compared with parents not enrolled in the class, parents enrolled in the behavioral and social skill class reported significantly fewer symptoms of the disorder in their children and more consistent use of discipline practices with their children. The school teachers of the study participants reported no differences in symptoms between those enrolled and those not enrolled in the behavioral and social skill class.

The researchers suggest that teachers, in addition to parents, may benefit from participating in workshops that increase awareness of the disorder and management skills. Teachers who participate in such workshops "may become more sensitive in detecting their pupil's symptoms, while using specific tools for managing those challenges in the classroom," said Tutty.

"In addition, teachers could learn how to provide an [attention deficit hyperactivity disorder] weekly report card to parents about their child's challenges and accomplishments," he added.

The authors noted several study limitations, including the makeup of study group (mostly white and lower-to-middle class), that make it difficult to generalize findings to other socioeconomic and cultural groups. They also noted that the class may have taught parents to be more understanding of their child's disorder-related behaviors and this class side effect may have led parents to report reduced symptoms.