A Comparison of Effectiveness of Parent Behavioral Management Training and Methylphenidate on Reduction of Symptomsof Attention Deficit Hyperactivity Disorder

  • Mohammad Reza Mohammadi Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Ali Akbar Soleimani Mail School of Humanities, University of Science and Culture, Tehran, Iran.
  • Nastaran Ahmadi Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Elham Davoodi Department of Psychology, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Attention deficit hyperactivity disorder (ADHD), Parent's behavioral management training (PBMT), Medication treatment, Methylphenidate


Attention deficit hyperactivity disorder (ADHD) is one of the most common psychological disorders of childhood. Methylphenidate is highly effective in the treatment of ADHD. This study aimed to determine the effectiveness of combined Parent behavioral management training (PBMT) and medication treatment (Methylphenidate) in reducing ADHD symptoms in 6-12-year-old children, using randomized sampling. A total of 50 children with ADHD were assigned into two groups: an experimental group of PBMT and a control group of medication treatment (Methylphenidate) without other interventions. Conners’ Parent Rating Scale (CPRS-48) was employed before and after interventions to determine the effects. Descriptive Statistics method (consisting of Mean and Standard deviation) and Statistical inference method, (including t-test and Levene's Test) were used for data analysis.  Findings revealed that the combined behavioral intervention of PBMT and methylphenidate treatment is more effective in reduction of ADHD in children. The difference of means between pre-test and post-test of CPRS in the experimental group was equal to 10.77, and it was equal to 1.88 in the control group. In addition, PBMT was more effective in the case of younger parents (P<0.025). However, parents’ education level did not affect the behavioral intervention (P<0.025).The findings suggest that combined intervention of PBMT and methylphenidate is effective in reducing the symptoms of ADHD in children.


Remschmidt H, Global ADHD Working Group. Global consensus on ADHD. Eur Child Adolesc Psychiatry 2005;14:127-37.

About kinds health. (Accessed in May 2016, 3, at http://www.aboutkidshealth.ca/IWK/ADHD/ADHD-and- Brain-Function.aspx?articleID=6897&categoryID=IWK _AD-nh1-04).

Goldstein S, Goldstein M, editors. Managing attention deficit hyperactivity disorder in children: A guide for practitioners.2nd ed. New York, NY: John Wiley and Sons Inc, 1998.

Diamond G, Siqueland L. Current status of family intervention science. Child Adolesc Psychiatry Clin N Am


Barkley RA. Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychol Bull 1997;121:65-94.

Kronenberger WG, Meyer RG, editors. The Child Clinician’s Handbook. 1st ed. Boston. USA: Allynand Bacon, 1996.

Goyette CH, Conners CK, Ulrich RF. Normative data on revised Conners Parent and Teacher Rating Scales. J Abnorm Child Psychol 1978;6:221-36.

Khushabi K, Pour-Etemad H, Mohammadi M, Mohammadkhani P. The prevalence of ADHD in primary school students in Tehran. MJIRI 2006;20:147-50.

Erhardt D, Baker BL. The effects of behavioral parent training of families with young hyperactive children. J Behav Ther Exp Psychiatry 1990;21:121-32.

Anstopoulos AD, KupaulGJ, Barkley RA. Stimulant medication and parent training therapies for ADHD. J Learn Disabil 1991;24:210-8.

Danforth JS, Anderson LP, Barkely RA, Stokes TF.Observations of parent-child interactions whit hyperactive children: Research and Clinical implications. Clin Psychol Rev 1991;11:703-27.

DeWolfe NA, Byrne M, Bawden HN. The ADHD children were off-task significantly more time than the non-ADHD children. J AttenDisord 2000;4:80-90.

Hinshaw SP, Owens EB, Wells KC, Kraemer HC, Abikoff HB, Arnold LE, et al. Family processes & treatment outcome in the MTA: negative/ineffective parenting practices on relation to multimodal treatment. J Abnorm Child Psychol 2000;28:555-68.

Carlson CL, Tamm L. Responsiveness of children with ADHD to reward and response cost: Differential impact on performance and motivation. J Consult Clin Psychol2000;68:73-83.

Reitman D, Hupp SD, O'Callaghan PM, Gulley V, Northup J. The influence of a token economy and methylphenidate on attentive and disruptive behavior during sports with ADHD-diagnosed children. Behav Modif 2001;25:305-23.

Lin YF, Chung HH. Parenting stress and parent’s willingness to accept treatment in relation to behavioral problems of children with ADHD. J Nurs Res 2002;10:43-56.

Weiss M, Weiss G. Attention deficit hyperactivity disorder. In: Lewis M, editor. Child and Adolescent Psychiatry a Comprehensive Textbook. 3rd ed. Philadelphia, Pa, USA: Lippincott Williams and Wilkins,


FrolichJ, Dopfner M, Berner W, Lehmkuhl G. Treatment effects of combined cognitive behavioral therapy with parent training in hyperkinetic syndrome. Prax Kinderpsychol Konderpsychiatr 2002;51:476-93.

Huang HL, Chao CC, Tu CC, Yang PC. Behavoiral parent training for Taiwanese parents of children with ADHD. Psychiatry Clin Neurosci 2003;57:275-81.

Klein RG, Abikoff H, Hechtman L, Weiss G. Design and rationale of controlled study of long-term methylphenidate and multimodal psychosocial treatment in children whit ADHD. J Am Acad Child Adolesc Psyciatry 2004;43:792-801.

Hartmann RR, Stage SA, Webster-Stratton C. A growth curve analysis of parent training outcomes: examining the influence of child risk factors inattention, impulsivity hyperactivity problems), Parental and Family risk factors. J

Child Psychol Psychiatry 2003;44:388-98.

Chronis AM, Chacko A, Fabiano GA, Eymbs BT, Pelham WE Jr. Enhancements to the behavioral parent training paradigm for families of children with ADHD; review and future directiond. Clin Child Fam Psychol Rev 2004;7:1-27.

Barlow J, Coren E. Parent-Training Programs for improving maternal Psychosocial Health. Cochrance Database System Rev2004;1:CD002020.

Salbach NM, Mayo NE, Robichaud-Ekstrand S, Hanley JA, Richards CL, Wood-Dauphinee S. The effect of a task- oriented walking intervention on improving balance self- efficacy poststroke: a randomized, controlled trial. J Am GeriatrSoc 2005;53:576-82.

Ercan ES, Varan A, Deniz U. Effects of combined treatment of Turkish children diagnosed with ADHD: a preliminary report. J Child Adolesc Psychopharmacol 2005;15:203-19.

Zubrick SR, Ward KA, Silbum SR, Lawrence D, Williams AA, Blair E, et al. Prevention of child behavior problems through universal implementation of a group behavioral family intervention. Prev Sci2005;6:287-304.

Danforth JS, Harvey E, Ulaszek WR, McKee TE. The outcome of group parent training for families of children with attention-deficit/hyperactivity disorder and defiant/aggressive behavior. J Behav Ther Exp Psychiatry 2006;37:188-205.

NIMH Funds Research to Find Best Treatments for Children with Autism and ADHD Symptoms. NIH. (Accessed in May 2015, 3, at http://www.nimh.nih.gov/ science-news/2008/ nimh-funds-research-to-find-best- treatments-for-children-with-autism-and-adhd-symptoms. shtml).

Behavior Therapy for ADHD Children: More Carrot, Less Stick ADDITUDE. (Accessed in May 2015, 3, at http://www.additudemag.com/adhd/article/3577.html).

Sonuga-Barke EJ, Sergeant JA, Nigg J, Willcutt E.Executive Dysfunction and Delay Aversion in Attention Deficit Hyperactivity Disorder: Nosological and Diagnostic Implications. Child Adolesc Psychiatr Clin N Am 2008;17:367-84.

Fabiano GA, Chacko A, Pelham WE, Robb J, Walker KS, Wymbs F, et al. A comparison of behavioral parent training programs for fathers of children with attention- deficit/hyperactivity disorder. Behav Ther 009;40:190-

MTA Cooperative group. Moderators and mediators of treatment response for children with ADHD: the Mutlimedia Treatment Study of Children with Attention- defict/hyperactivity disorder. Arch Gen Psychiatry 1999;56:1088-96.

Green RW, Ablon JS. What does the MTA study tell us about effective psychosocial treatment for ADHD. J Clin Child Psychol 2001;30:114-21.

Swanson JM, Kraemer HC, Hinshaw SP, Arnold LE, Conners CK, Abikoff HB, et al. Clinical Relevance of the Primary Findings of the MTA: Success Rates Based on Severity of ADHD and ODD Symptoms at the End of Treatment. J Am Acad Child Adolesc Psychiatry 2001;40:168-79.

Montiel Nava C, Pena JA, Espina Maries G, Ferrer- Hernandez ME, López-Rubio A, Puertas-Sánchez S, et al. A pilot study of methylphenidate and parent training in the treatment of children with attention deficit hiperactivity disorder. Rev Neurol 2002;35:201-5.

Vogel EK, McCollough AW, Machizawa MG. Neural measures reveal individual differences in controlling access to visual working memory. Nature 2005;428:500-3.

Zargari Nejad Gh. The effect of parental education on reducing behavioral problems in children with attention deficit hyperactivity disorder [Dissertation]. Iran Univ Med Sci., 2004.

Keown LJ, Woodward LJ. Early ParentChild Relations and Family Functioning of Preschool Boys with Pervasive Hyperactivity. J Abnormal Child Psychol 2002;30:541-53.

Lundahl B, Risser HJ, Lovejoy MC. A meta-analysis of parent training: moderators and follow-up effects. Clin Psychol Rev 2005;26:86-104.

Klassen A, Miller A, Raina P, Lee SK, Olsen L. ADHD in children and youth: a quantitative systematic review of the efficacy of different management strategies. Can J Psychiatry 1999;44:1007-16.

Ialongo NS, Horn WF, Pascoe JM, Greenberg G, Packard T, Lopez M, et al. The effects of a multimodal intervention with attention-deficit hyperactivity disorder children: A 9- month follow-up. J Am Acad Child Adolesc Psychiatry 1993;32:182-9.

Learning Disabilties and the Risk of Psychiatric Disorders.Greenhill L, Osman BB, eds. Ritalin: Theory and practice.2nd ed. Larchomont, NY: Mary Ann Libert, 2000:223.

Fathi N. The effects of parent management training in reducing symptoms of ADHD: Master's thesis in clinical psychology [Dissertation]. Iran Univ Med Sci., 1995.

How to Cite
Mohammadi MR, Soleimani AA, Ahmadi N, Davoodi E. A Comparison of Effectiveness of Parent Behavioral Management Training and Methylphenidate on Reduction of Symptomsof Attention Deficit Hyperactivity Disorder. Acta Med Iran. 54(8):503-509.