Preschool-age children with attention-deficit/hyperactivity disorder (ADHD) are at-risk for expulsion from preschool settings due to disruptive, noncompliant behavior. Removal from preschool limits the child's exposure to preacademic instruction, socialization opportunities, and the structure of classrooms. In this review, the authors evaluate the efficacy of pharmacological, parent training, and behavioral interventions designed to manage the disruptive behavior of preschool children with ADHD. Twenty-six experimental articles were reviewed. Pharmacological intervention, which has received the most attention, was found to be generally effective, although not without problems due to side effects. Parent-training methods were found to be effective in the home setting, but minimal information has been collected on the generalization of these findings to the school setting. Very little research has been devoted to the use of behavior management in the school setting, but results from those studies that have been done appear promising. Issues regarding future research and the use of these interventions to prepare the preschool-age child with ADHD for kindergarten are discussed.
Get full access to this article
View all access options for this article.
References
1.
Abikoff, H. (1985). Efficacy of cognitive training intervention in hyperactive children: A critical review. Clinical Psychology Review, 5, 479-512.
2.
Alessandri, S.M., & Schramm, K. (1991). Effects of dextroamphetamine on the cognitive and social play of a preschooler with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 768-772.
3.
Allen, K.E., Henke, L.B., Harris, F.R., Baer, D.M., & Reynolds, N.J. (1967). Control of hyperactivity by social reinforcement of attending behavior. Journal of Educational Psychology, 18, 231-237.
4.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author .
5.
Anastopoulos, A.D., Shelton, T.L., DuPaul, G.J., & Guevremont, D.C. (1993). Parent training for attention deficit hyperactivity disorder: Its impact on parent functioning. Journal of Abnormal Child Psychology, 21, 581-596.
6.
Barkley, R.A. (1988). The effects of methylphenidate on the interactions of preschool ADHD children with their mothers. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 336-341.
7.
Barkley, R.A. (1998). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment (2nd ed.). New York: Guilford.
8.
Barkley, R.A., DuPaul, G.J., & McMurray, M.B. (1991). Attention deficit disorder with and without hyperactivity: Clinical response to three dose levels of methylphenidate. Pediatrics, 87, 519-531.
9.
Barkley, R.A., Karlsson, J., Pollard, S., & Murphy, J.V. (1985). Developmental changes in the mother-child interactions of hyperactive boys: Effects of two dose levels of Ritalin. Journal of Child Psychology and Psychiatry, 26, 705-715.
10.
Barkley, R.A., Karlsson, J., Strzelecki, S., & Murphy, J.V. (1984). Effects of age and Ritalin dosage on the mother-child interactions of hyperactive children. Journal of Consulting and Clinical Psychology, 52, 750-758.
11.
Billings, D.C., & Wasik, B.H. (1985). Self-instructional training with preschoolers: An attempt to replicate. Journal of Applied Behavior Analysis , 18, 61-67.
12.
Binder, L.M., Dixon, M.R., & Ghezzi, P.M. (2000). A procedure to teach self-control to children with attention deficit hyperactivity disorder. Journal of Applied Behavior Analysis, 33, 233-237.
13.
Blackman, J.A., Westervelt, V.D., Stevenson, R., & Welch, A. (1991). Management of preschool children with attention deficithyperactivity disorder. Topics in Early Childhood Special Education, 11, 91-104.
14.
Bornstein, P.H., & Quevillon, R.P. (1976). The effects of a self-instructional package on overactive preschool boys. Journal of Applied Behavior Analysis, 9, 179-188.
15.
Bryant, L.E., & Budd, K.S. (1982). Self-instructional training to increase independent work performance in preschoolers. Journal of Applied Behavior Analysis, 15, 259-271.
16.
Bryant, D., Vizzard, L.H., Willoughby, M., & Kupersmidt, J. (1999). A review of interventions for preschoolers with aggressive and disruptive behavior. Early Education and Development, 10, 47-68.
17.
Byrne, J.M., Bawden, H.N., DeWolfe, N.A., & Beattie, T.L. (1998). Clinical assessment of psychopharmacological treatment of preschoolers with ADHD. Journal of Clinical and Experimental Neuropsychology, 20,613-627.
18.
Campbell, S.B. (1990). Behavior problems in preschool children: Clinical and developmental issues. New York: Guilford.
19.
Campbell, S.B. (1994). Behavior problems in preschool children: A review of recent research. Journal of Child Psychology and Psychiatry , 36, 113-149.
20.
Campbell, S.B., Endman, M.W., & Bernfield, G. (1977). A three year follow-up of hyperactive preschoolers into elementary school. Journal of Child Psychology and Psychiatry , 18, 239-249.
21.
Campbell, S.B., Ewing, L.J., Breaux, A.M., & Szumowski, E.K. (1986). Parent-referred problem three-year-olds: Follow-up at school entry. Journal of Child Psychology and Psychiatry, 27, 473-488.
22.
Cohen, M., Becker, M.G., & Campbell, R. (1990). Relationships among four methods of assessment of children with attention-deficit/hyperactivity disorder. Journal of School Psychology, 28, 189-202.
23.
Cunningham, C.E., Siegel, L.S., & Offord, D.R. (1985). A developmental dose-response analysis of the effects of methylphenidate on the peer interactions of attention deficit disordered boys. Journal of Child Psychology and Psychiatry and Allied Disciplines, 26, 955-971.
24.
Delong, R.G., & Aldershof, A.L. (1987). Long-term experience with lithium treatment in childhood: Correlation with clinical diagnosis. Journal of the American Academy of Child and Adolescent Psychiatry , 26, 389-394.
25.
Drash, P.W., Soloman, E.M., Long, K.L., & Stolberg, A.L. (1976, May). Hyperactivity in preschool children as non-compliance: A new conceptual basis for treatment . Paper presented at the 29th annual meeting of the Florida Psychological Association, Clear-water Beach, FL.
26.
DuPaul, G.J., & Eckert, T.L. (1997). The effects of school-based interventions for children with attention deficit hyperactivity disorder: A meta-analysis. School Psychology Review, 26, 5-27.
27.
DuPaul, G.J., & Rapport, M.D. (1993). Does methylphenidate normalize the classroom performance of children with attention deficit disorder?Journal of the American Academy of Child and Adolescent Psychiatry, 32, 190-198.
28.
Eckert, T.L., McGoey, K.M., & DuPaul, G.J. (1996, November). Preschool-aged children at-riskfor ADHD: A needs assessment of parents, service providers and experts. Paper presented at the annual meeting of the Association for the Advancement of Behavior Therapy, New York, NY
29.
Erhardt, D., & Baker, B.L. (1990). The effects of behavioral parent training on families with young hyperactive children. Journal of Behavior Therapy and Experimental Psychiatry, 21, 121-132.
30.
Firestone, P., Musten, L.M., Pisterman, S., Mercer, J., & Bennett, S. (1998). Short-term side effects of stimulant medication are increased in preschool children with ADHD: A double-blind placebo-controlled study. Journal of Child and Adolescent Psychopharmacology , 8, 13-25.
31.
Fiore, T.A., Becker, E.A., & Nero, R.C. (1993). Educational interventions for students with attention deficit disorder. Exceptional Children, 60, 163-173.
32.
Fischer, M., & Newby, R.F. (1991). Assessment of stimulant response in ADHD children using a refined multimethod clinical protocol. Journal of Clinical Child Psychology, 20, 232-244.
33.
Henry, G.K. (1987). Symbolic modeling and parent behavioral training: Effects on non-compliance of hyperactive children. Journal of Behavior Therapy and Experimental Psychiatry, 18, 105-113.
34.
Hinshaw, S.P. (1994). Attention deficits and hyperactivity in children . Thousand Oaks, CA: Sage.
35.
Johnston, C., Pelham, W.E., Hoza, J., & Sturges, J. (1988). Psychostimulant rebound in attention deficit disordered boys. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 719-723.
36.
Kyle, K.E., DuPaul, G.J.,Yugar, J.M., & Lutz, J.G. (1996). Hyperactivity, number of years in preschool and aggression: Predictors of future behavior disorders in a school setting. Atlanta: National Association of School Psychologists .
37.
Landau, S., & McAninch, C. (1993, May). Young children with attention deficits. Young Children, 49-55.
38.
Lavigne, J.V., Gibbons, R.D., Christoffel, K.K., Arend, R., Rosenbaum, D., Binns, H., Dawson, N., Sobel, H., & Isaacs, C. (1996). Prevalence rates and correlates of psychiatric disorders among preschool children. Journal of the American Academy of Child Adolescent Psychiatry, 35, 204-214.
39.
Mayes, S.D., Crites, D.L., Bixler, E.O., Humphrey, F.J., & Mattison, R.E. (1994). Methylphenidate and ADHD: Influences on age, IQ, and neurodevelopmental status. Developmental Medicine and Child Neurology, 36, 1099-1107.
40.
McCain, A.P., & Kelley, M.L. (1993). Managing the classroom behavior of an ADHD preschooler: The efficacy of a school-home note intervention. Child and Family Behavior Therapy, 15, 33-44.
41.
McGoey, K.E., & DuPaul, G.J. (2000). Token reinforcement and response cost procedures: Reducing the disruptive behavior of preschool children with ADHD. School Psychology Quarterly, 15, 330-343.
42.
Medical Economics Data Production Co. (1995 ). Physicians' desk reference (49th ed.). Montvale, NJ: Author.
43.
Musten, L.M., Firestone, P., Pisterman, S., Bennett, S., & Mercer, J. (1997). Effects of methylphenidate on preschool children with ADHD: Cognitive and behavioral functions. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1407-1415.
44.
Olsen, S.L., & Hoza, B. (1993). Preschool developmental antecedents of conduct problems in children beginning school. Journal of Clinical Child Psychology, 22, 60-67.
45.
Pelham W.E., Greenslade, K.E., Vodde-Hamilton, M., Murphy, D.A., Greenstein, J.J., Gnagy, E.M., & Dahl, R.E. (1990). Relative efficacy of long-acting stimulants on children with attention deficithyperactivity disorder: A comparison of standard methylphenidate, sustained release methylphenidate, sustained-release dextroamphetamine, and pemoline. Pediatrics, 86, 226-237.
46.
Pisterman, S., McGrath, P., Firestone, P., Goodman, J.T., Webster, I., & Malory, R. (1989). Outcome of parent-mediated treatment of preschoolers with attention deficit disorder with hyperactivity. Journal of Consulting and Clinical Psychology, 57, 628-635.
47.
Pollard, S., Ward, E.M., & Barkley, R.A. (1983). The effects of parent training and Ritalin on the parent-child interaction of hyperactive boys. Child and Family Behavior Therapy, 5, 51-69.
48.
Power, T.J., Atkins, M.S., Osborne, M.L., & Blum, N.J. (1994) .The school psychologist as manager of programming for ADHD. School Psychology Review, 23, 279-291.
49.
Rapport, M.D., Denney, C., DuPaul, G.J., & Gardner, M.J. (1994). Attention deficit disorder and methylphenidate: Normalization rates, clinical effectiveness, and response prediction in 76 children. Journal of the American Academy of Child andAdolescent Psychiatry, 33, 882-893.
50.
Resnick, R. J., & McEvoy, K. (Eds.). (1994). Bibliographies in psychology, number 14: Attention-deficitlhyperactivity disorder. Washington, DC: American Psychological Association.
51.
Schliefer, M., Weiss, G., Cohen, N., El-man, M., Cvejic, C., & Kruger, E. (1975). Hyperactivity in preschoolers and the effect of methylphenidate. American Journal of Orthopsychiatry, 45, 38-50.
52.
Stage, S.A., & Quiroz, D.R. (1997). A meta-analysis of interventions to decrease disruptive behavior in public school settings. School Psychology Review , 26, 333-368.
53.
Strayhorn, J.M., & Weidman, C.S. (1989). Reduction of attention deficit and internalizing symptoms through parent-child interaction training. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 888-896.
54.
Strayhorn, J.M., & Weidman, C.S. (1991). Follow-up one year after parent-child interaction training: Effects on behavior of preschool children. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 138-143.
55.
Workman, E.A., Helton, G.B., & Watson, P.J. (1982). Self-monitoring effects in a four-year-old child: An ecological behavior analysis. Journal of School Psychology , 20, 57-64.
56.
Zito, J.M., Safer, D.J., dosReis, S., Gardner, J.F., Boles, M., & Lynch, F. (2000). Trends in the prescribing of psychotropic medications to preschoolers. Journal of the American Medical Association , 283, 1025-1030.
