Özlem GÜNDOĞDU YILDIZ, Fatma TAŞ VAROL, Esra ÖZYURT YILDIRIM, Funda DÖNDER, NURSU ÇAKIN MEMİK

Okul öncesi dönemde DEHB: Psikososyal tedavi yaklaşımlarının gözden geçirilmesi

Dikkat eksikliği hiperaktivite bozukluğu (DEHB) çocuk ve ergen psikiyatrisi alanında en sık tanı konan ve tedavi edilen bozukluklardan biridir. Alan çalışmaları etiyoloji, tedavi ve uzun dönem sonuçları üzerinde yoğunlaşmakta ve daha çok okul çağı-ergenlik dönemlerini ele almaktadır. Okul öncesi döneme özgü belirtiler, tanı ve tedavi yaklaşımları ile ilgili çalışmalar sınırlı sayıda olup son yayınlarda bu döneme ilginin arttığı görülmektedir. Bu derleme çalışmasında okul öncesi dönemde DEHB'nin tanı ve ayırıcı tanı zorlukları ve tedavi etkinliği kanıtlanmış anne-baba eğitim programlarının tanıtılması amaçlanmıştır. Çalışmanın ilk bölümünde okul öncesi DEHB'nin klinik özellikleri ve tanı aşamaları ele alınırken, ilerleyen bölümlerde etkinliği kanıtlanıp tedavi kılavuzlarına girmiş anne-baba eğitim programları ayrıntılı olarak tanıtılmaya çalışılmış, bu alanda çalışan klinisyenlere yeni bakış açıları sunabileceğine ilişkin sonuçlar sunulmuştur.

ADHD in preschool children: review of psychosocial interventions

Attention deficit hyperactivity disorder (ADHD) is one of the most diagnosed and treated disorders among child and adolescent psychiatry. Current studies focus on etiology, treatment, long-term results and mostly contain school age, adolescence and adulthood. Studies regarding symptoms, diagnosis and treatment of pre-school age are limited and interest on this issue has been increasing over the last years. Therefore, the purpose of present review is to give difficulties of diagnosis and differentiating diagnosis of pre-school ADHD and presentation of proven parent training programs. In the first section of the paper, clinical features and diagnosing stages of pre-school ADHD are presented. In the following parts parent training programs are attempted to be presented in a detailed way which may represent new perspectives to clinicians in the field.

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Yildiz Oc O, Agaoglu B, Sen Berk F, Komsuoglu S, Karakaya I, Coskun A. Evaluation of the effect of methylphenidate by computed tomography, electroencephalography, neuropsychological tests, and clinical symptoms in children with Attention-Deficit/Hyperactivity Disorder: a prospective cohort study. Curr Ther Res 2007; 68:432-449.
Yildiz O, Sismanlar SG, Cakin Memik N, Karakaya I, Agaoglu B. Atomoxetine and methylphenidate treatment in children with ADHD: the efficacy, tolerability and effects on executive functions. Child Psychiatry Hum Dev 2011; 42(3):257-269.
Pineda DA, Lopera F, Palacio JD, Ramirez D, Henao GC. Prevalence estimations of attentiondeficit/hyperactivity disorder: differential diagnoses and comorbidities in a Colombian sample. Int J Neurosci 2003; 113(1):49-71.
Egger HL, Kondo D, Angold A. The epidemiology and diagnostic issues in preschool attention-deficit/hyperactivity disorder: A review. Infants and Jung Children 2006; 19:109-122.
Wichstrom L, Berg-Nielsen TS, Angold A, Egger HL, Solheim E, Sveen TH. Prevalence of psychiatric disorders in preschoolers. J Child Psychol Psychiatry 2012; 53(6):695-705.
Bauer NS, Gilbert AL, Carroll AE, Downs SM. Associations between early exposure to intimate partner violence, parental depression and subsequent mental health outcomes. JAMA Pediatr 2013; 167(4):341-347.
Willoughby MT, Curran PJ, Costello EJ, Angold A. Implications of early versus late onset of attentiondeficit/hyperactivity disorder symptoms. J Am Acad Child Adolsc Psychiatry 2000; 39(12):1512- 1519.
Berg-Nielsen TS, Solheim E, Belsky J, Wichstrom L. Preschoolers' psychosocial problems: in the eyes of the beholder? Adding teacher characteristics as determinants of discrepant parent-teacher reports. Child Psychiatry Hum Dev 2012; 43(3):393-413.
Garstein MA, Bridgett DJ, Dishion TJ, Kaufman NK. Depressed mood and maternal report of child behavior problems: another look at the depression-distortion hypothesis. J Appl Dev Psychol 2009; 30(2):149-160.
Ghuman JK, Ghuman HS. Pharmacologic intervention for attention-deficit hyperactivity disorder in preschoolers: is it justified? Paediatr Drugs 2013; 15(1):1-8.
Murray DW. Treatment of preschoolers with attention-deficit/hyperactivity disorder. Curr Psychiatry Rep 2010; 12(5):374-381.
Youngwirth SD, Harvey EA, Gates EC, Hashim RL, Friedman-Weieneth JL. Neuropsychological abilities of preschool-aged children who display hyperactivity and/or oppositional-defiant behavior problems. Child Neuropsychol 2007; 13(5):422- 443.
McGoey KE, DuPaul GJ, Haley E ve ark. Parent and teacher ratings of attention deficit /hyperactivity disorder in preschool: The ADHD Rating Scale-IV Preschool Version. J Psychopathol Behav Assess 2007; 29:269-276.
Gadow KD, Sprafkin J, Nolan EE. DSM-IV Symptoms in community and clinic preschool children. J Am Acad Child Adolesc Psychiatry 2001; 40:1383-1392.
Achenbach TM, Rescorla LA. Manual for ASEBA prechool forms and profiles. Burlington VT: University of Vermont, Research Center for Children, Youth and Families, 2000.
Conners CK. Conners Early Childhood. North Tonawanda, NY: Multi-Health Systems, 2009. 17. Sprafkin J, Gadow KD. Early Childhood Symptom Inventories. Stoney Brook, NY: Checkmate Plus, 1996.
Lucas CP, Fisher P, Luby JL. Young Child DISCIV Research Draft: Diagnostic Interview Schedule for Children. New York, NY: Columbia University, Division of Children Psychiatry, Joy and William Ruane Center to Identify and Treat Mood Disorders, 1998.
Brimaher B, Ehmann M, Axelson DA, Goldstein BI, Monk K, Kalas C, et al. Schedule for affective disorders and schizophrenia for school-age children (K-SADS-PL) for the assessment of preschool children-a preliminary psychometric study. J Psychiatr Res 2009; 43:680-686.
Egger H, Angold A. The Preschool Age Psychiatric Assessment (PAPA): a structured parent interview for diagnosing psychiatric disorders in preschool children. R DelCarmen-Wiggins, A Carter (Eds.), Handbook of Infant, toddler, and Preschool Mental Health Assessment, New York: Oxford University Press, 2004, p.223-246.
Yıldız Ö, Çakın Memik N, Kara B, Ağaoğlu B. Çocukluk çağı serebral tip adrenolökodistrofi'de tanı ve ayırıcı tanı zorlukları: bir olgu sunumu. Nöropsikiyatri Arşivi 2011; 48:261-264.
Ghuman JK, Riddle MA, Vitiello B, Greenhill LL, Chuang SZ, Wigal SB. Comorbidity moderates response to methylphenidate in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS). J Child Adolesc Psychopharmacol 2007; 17(5):563-580.
Sanders MR, Markie-Dadds C, Turner KMT. Theoretical, scientific and clinical foundations of the Triple P - Positive Parenting Program: A population approach to the promotion of parenting competence. Parent Res Practice Monograph, 2003; 1:1-21.
Lahey BB, Pelham WE, Loney J, Kipp H, Ehrhardt A, Lee SS. Three-year predictive validity of DSMIV attention deficit hyperactivity disorder in children diagnosed at 4-6 years of age. Am J Psychiatry 2004; 161(11):2014-2020.
Wolraich M, Brown L, Brown RT, Du Paul G, Earls M, Feldman HM, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics 2011; 128(5):1007-1022.
Patterson GR, Forgatch MS, Degarmo DS. Cascading effects following intervention. Dev Psychopathol 2010; 22(4):949-970.
Barkley RA. Hyperactive Children: A handbook for diagnosis and treatment. New York: Guildford Press, 1981.
Reitman D, McMahon RJ. The Mentor and the Model. Cognitive and Behavioral Practice, 2012.
Dreyer AS, O'Laughlin L, Moore J, Milam Z. Parental adherence to clinical recommendations in an ADHD evaluation clinic. J Clin Psychol 2010; 66(10):1101-1120.
Barkley RA, Shelton TL, Crosswait C, Moorehouse M, Fletcher K, Barrett S, et al. Multi-method psycho-educational intervention for preschool children with disruptive behavior: preliminary results at post-treatment. J Child Psychol Psychiatry 2000; 41(3):319-332.
Werba BE, Eyberg SM, Boggs SR, Algina J. Predicting outcome in parent-child interaction therapy: success and attrition. Behav Modif 2006; 30(5):618-646.
Eyberg SM, Bussing R. Parent child interaction therapy for preschool children with conduct problems. RC Murrihy, AD Kidman, TH Ollendick (Eds.), A Clinician's Handbook for the Assessment and Treatment of Conduct Problems in Youth, New York: Springer Press, 2011, p.139- 162.
Charach A, Dashti B, Carson P, Booker L, Lim CG, Lillie E, et al. Attention Deficit Hyperactivity Disorder: Effectiveness of Treatment in At-Risk Preschoolers; Long-Term Effectiveness in All Ages; and Variability in Prevalence, Diagnosis, and Treatment Agency for Healthcare Research and Quality (US). AHRQ Comparative Effectiveness Reviews 2011 Oct. Report No. 12-EHC003- EF.
Menting AT, Orobio de Castro B, Matthys W. Effectiveness of the Incredible Years parent training to modify disruptive and prosocial child behavior: a meta-analytic review. Clin Psychol Rev 2013; 33(8):901-913.
Webster-Stratton C, Reid MJ, Hammond M. Treating children with early-onset conduct problems: intervention outcomes for parent, child, and teacher training. J Clin Child Adolesc Psychol 2004; 33(1):105-124.
Webster-Stratton CH, Reid MJ, Beauchaine T. Combining parent and child training for young children with ADHD. J Clin Child Adolesc Psychol 2011; 40(2):191-203.
Webster-Stratton C. Wally's Detective Book for Solving Problems at Home. Seattle, WA: Incredible Years, 1998.
Mullett J. Triple P Community Implementation Report. Victoria, BC: Action Research Consulting. Report Prepared for the Vancouver Island Health Authority, 2007.
Sanders MR, Ralph A, Sofronoff K, Gardiner P, Thompson R, Dwyer S, et al. Every Family: A population approach to reducing behavioral and emotional problems in children making the transition to school. J Prim Prev 2008; 29: 197-222.
Sanders MR. Triple P - Positive Parenting Program: A population approach to promoting competent parenting Australian e-Journal for the Advancement of Mental Health 2003; http://www.researchgate.net/publication/4347167 6.
Sanders MR. Triple P-Positive Parenting Program: Towards an empirically validated multilevel parenting and support strategy for the prevention of behavior and emotional problems in children. Clin Child Fam Psychol Rev 1999; 2:71-90.
Sanders M, Calam R, Durand M, Liversidge T, Carmont SA. Does self-directed and web-based support for parents enhance the effects of viewing a reality television series based on the Triple PPositive Parenting Programme? J Child Psychol Psychiatr 2008; 49:924-932.
Turner KMT, Richards M, Sanders MR. Randomised Clinical Trial of a Group Parent Education Programme for Australian Indigenous Families. J Pediatr Child Health 2007; 43:429-437.
Sanders MR, Ralph A. Facilitator's Manual for Group Teen Triple P. Milton, QLD, Australia: Triple P International Publishing, 2009.
Sanders MR, Markie-Dadds C, Tully LA, Bor V. The Triple P-Positive Parenting Program: A comparison of enhanced, standard and selfdirected behavioral family intervention for parents of children with early onset conduct problem. J Consult Clin Psychol 2000; 68:624-640.
Bor W, Sanders MR, Markie-Dadds C. The effects of the Triple P-Positive Parenting Program on preschool children with co-occuring disruptive behavior and attentional/hyperactive difficulties. J Abnorm Child Psychol 2002; 30:571-587.
Leung C, Sanders MR, Leung S, Mak L, Lau J. An outcome evaluation of the implementation of the Triple P Positive Parenting Program in Hong Kong. Fam Process 2003; 42: 531-544.
de Graff I, Speetjens P, Smit de Wolff M, Tavecchio L. Effectiveness of the TripleP Positive Parenting Program on behavioral problems in children: a meta-analysis. Behav Modif 2008; 32:714-735.
Reese RJ, Slone NC, Soares N, Sprang N. Telehealth for underserved families: An evidencebased parenting program. Psychol Serv 2012; 9:320-322.
Aghebati A, Gharraee B, Shoshtari MH, Gohari MR. TripleP-Positive Parenting Program for mothers of ADHD Children. Iran J Psychiatry Behav Sci 2014; 8:59-65.
Öztürk Y. Triple P Olumlu Annebabalık Eğitimi'nin Dikkat Eksikliği Hiperaktivite Bozukluğu Olan 7-12 Yaş Arası Çocuklarda Dikkat Eksikliği Hiperaktivite Bozukluğu Belirtileri Üzerine Etkilerinin Araş- tırıldığı Randomize Kontrollü Bir Çalışma. Yayınlanmamış Uzmanlık Tezi, Dokuz Eylül Üniversitesi, İzmir, 2013.
Daley D, Jones K, Hutchings J, Thompson M. Attention deficit hyperactivity disorder in preschool children: current findings, recommended interventions and future directions. Child Care Health Dev 2009; 35:754-766.