Nonpharmacological treatments for ADHD: a meta-analytic review

Abstract

Objective: The authors replicated and expanded on Fabiano et al.’s meta-analysis of behavioral treatments for ADHD, systematically comparing the efficacy of 7 nonpharmacological interventions. Method: A total of 14 controlled treatment studies conducted post-1994—evaluating behavior modification, neurofeedback therapy, multimodal psychosocial treatment, school-based programs, working memory training, parent training, and self-monitoring—were identified, primarily by searching electronic English-language databases. The results were meta-analyzed: mean-weighted effect sizes for the treatment outcomes of 625 participants (382 treatment, 243 controls) were calculated, and moderator analyses examined contributions of gender, ADHD subtype, and treatment “dosage” to outcome. Results: Behavior modification and neurofeedback treatments were most supported by this evidence. Interventions were generally more efficacious for girls, and least efficacious for the “combined” ADHD subtype. The authors found no dose or age effects. Conclusion: Based on the small, published literature, this study supports some nonpharmacological interventions for ADHD, and indicates directions for more evaluation research into psychological treatments.