Pilot Effectiveness Trials of Interventions for Preschoolers with ADHD (R34 Clinical Trial Required)

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ADHD is a neurodevelopmental disorder with symptoms and impairments that emerge early and persist into adulthood for a substantial portion of affected individuals. While evidence-based treatments exist for school-age children and adolescents with ADHD, findings from longitudinal research suggests that children and adolescents who receive evidence-based interventions for ADHD remain significantly impaired relative to their non-ADHD peers over time. Early identification and intervention for young children with ADHD may be a necessary first step in normalizing symptoms across development and mitigating negative outcomes. The number of preschool children diagnosed with ADHD has been growing in recent years, more than doubling between 2007 and 2016 (Danielson et al., 2017). This increase may be due in part to the 2011 expansion of the American Academy of Pediatrics (AAP) ADHD Clinical Practice Guideline to include recommendations for children as young as 4-years-old (Wolraich et al., 2019). Behavioral interventions are recommended in the AAP Guideline as the first-line treatment for preschoolers with ADHD symptoms, due largely to parental preferences and data suggesting a higher rate of ADHD medication-related side effects and adverse events among younger children. Yet little research has been conducted to test the effectiveness of behavioral interventions in this population. A handful of completed NIMH-funded efficacy studies support the feasibility and promise of conducting interventions research in the preschool ADHD population. However, no preschool ADHD effectiveness trials designed to test service-ready, scalable approaches have been funded by NIMH to date, further highlighting the need for research in this area.

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