New behavioral therapy to support Japanese mothers of children with ADHD

February 21, 2017
The New Forest Parenting Programme Japan (NFPP-Japan) provides support to Japanese mothers of children with ADHD to develop more effective parenting practices. This image is taken from a DVD made by OIST’s Human Development and Neurobiology Unit that accompanies NFPP-Japan. The role play between Shizuka-san and her nieces illustrates an effective way for a mother to engage the attention of a child with ADHD. Parental permission for the DVD was granted. Credit: Okinawa Institute of Science and Technology

OIST researchers have successfully adapted a parent-training program for ADHD for use with families in Japan, where ADHD-specific behavioral interventions are limited.

The results of the proof-of-concept of the new , the "New Forest Parenting Programme-Japan", published in Japanese Psychological Research, show reductions in children's ADHD symptoms and improvements in parent-child relationships, suggesting that the parent-training program might prove to be an effective mainstream behavioral treatment for ADHD in Japan.

International guidelines for the management of ADHD in children recommend approved medications and/or behavioral therapy. Compared with many western countries, Japan has fewer pharmacological and behavioral options. The availability of behavioral therapy is further limited by a shortage of trained specialists.

Researchers at the Okinawa Institute of Science and Technology Graduate University (OIST) first recruited Japanese of children with ADHD for a pilot study using standard behavioral strategies to see if Japanese parents would be comfortable with the program content, assessment strategies and group delivery of the program. Though the researchers did not specify the gender of the parents, only contacted the researchers to participate in the study and five mothers were recruited for the study. The mothers embraced the group setting, expressing the importance of interacting with other mothers who could understand the challenges of parenting a child with ADHD. However, they articulated a desire to have more information about the causes of ADHD as well as extra practice using behavioral strategies specifically targeting ADHD. In response, the OIST researchers adapted the New Forest Parenting Programme, with the support of the program originators, for use with Japanese parents.

"It is important that children with ADHD are rewarded with positive praise after engaging in appropriate behaviors," says Dr. Shizuka Shimabukuro from OIST's Human Development Neurobiology Unit, who is the driving force behind adapting the NFPP for Japanese families. "In general, Japanese parents praise their children more sparingly than Western parents. Overcoming this cultural norm can be challenging for many mothers."

Based on the feedback from the pilot study, researchers in OIST's Human Development Neurobiology Unit recruited mothers only for the proof-of-concept study. They modified the programme to replace four general parenting strategy sessions with six sessions that were specifically designed for parents of children with ADHD and also added five extra support sessions to the beginning of the training program to increase mothers' understanding of ADHD and increase their confidence in participating in the parenting program.

The researchers then conducted a proof-of-concept study with the new extended program, known as the NFPP-Japan, with 17 Japanese mothers, to assess the effects of the program on child behavior, mothers' well-being and parenting skills.

Mothers' reports before and after the program indicated significant reductions in children's ADHD symptoms, reductions in mothers' reactivity to their child's behavioral difficulties and reductions in the stress they experienced in their roles as parents.

"Because the results of the study are based on self-reports from the mothers, we cannot rule out that the positive results we saw are due to changes in mothers' perceptions of, or attitudes toward, their child's behavior," says Professor Gail Tripp, head of OIST's Human Development Neurobiology Unit. "Nevertheless, improving the parent-child relationship is an important step in managing ADHD."

Future studies of the NFPP-Japan will focus on using objective evaluations of child behavior and the parent child-relationship. A randomized control trial of the NFPP-Japan is currently underway. If the program proves successful, it might eventually become generally available in Japan as an effective treatment for managing symptoms of ADHD.

Explore further: New parenting program benefits ADHD children

More information: Shizuka Shimabukuro et al. Supporting Japanese Mothers of Children with ADHD: Cultural Adaptation of the New Forest Parent Training Programme, Japanese Psychological Research (2017). DOI: 10.1111/jpr.12140

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BubbaNicholson
1 / 5 (1) Feb 22, 2017
ADHD can be instantly cured by taking 250mg of healthy adult male (father) facial skin surface lipid "face grease" pheromone by mouth one single time. Collection and administration require only ordinary chewing gum. We use Wrigley's gum. The fresh, new, unchewed sticks of chewing gum are rubbed against a male donor's face to collect the skin surface pheromone. UV illumination diminishes infection risks. The collected pheromone emits an airborne pheromone that diminishes confidence, increases suspicion. Osculation partners within 40 days of dosage become jealous. Isolation of patients, administration of the pheromone to the ADHD sufferer under oscillating fans, and activated charcoal dunnage within hermetically sealed packaging for the collected pheromone diminish behavioral biohazard risks. Keep collected odorless, colorless, tasteless pheromone on gum under a fume hood. All staff should wear supplied air respirators when handling pheromone gum.

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