Short summary

The aim of this project is to validate the TEAMS treatment program. The acronym TEAMS is short for Training Executive Attention and Motor Skills and it is a non-pharmacological intervention program developed by Professor Jeffrey Halperin at City University of New York. The program is based on physical activity and play and targeted for pre-school children with ADHD difficulties; the efficiency evaluation from the original research project shows significant improvement of the children's functional ability after participation in the program.

Rationale

The validation of the TEAMS treatment program is set to investigate whether or not the effort significantly lowers the ADHD symptoms and/or increases the functionality level for the participants compared to before the intervention, furthermore we wish to examine whether or not the effect last one, tree and six month after the intervention and compare this to a control group. If the intervention is proved to have a positive effect, the goal is to develop the existing practice with TEAMS treatment as a supplement. Idealistically an early intervention will improve the child's cognitive and social competence and thus ease the difficulties often related to starting school; this will spare the child, the school system and the social economic costs. Furthermore other symptoms can be disclosed (language difficulties, low/high intelligence, autism etc.) and action can be planned at an early stage.

Description of the cohort

Inclusion criteria:

• Children age 3-6, diagnosed with ADHD as primary diagnosis

Exclusion criteria:

• Children of parents, whom are not capable of cooperating in order to implement the program
• Children placed at residential institution or in an unstable environment outside the home
• Children or parents, who do not speak/understand Danish
• Children, who are in medical treatment for ADHD
• Children with significant disabilities due to co morbidity, such as autism, attachment disorder or mental retardation

Families in Region Zealand, who fulfils the inclusion criteria, will be informed of the existing means of treatment including the TEAMS treatment project. The child is referred to further treatment in Holbaek. At the first session further information will be given and it will be evaluated whether or not the child fits within the projects target group. Those, who then wish to participate in the project, will be randomized to an intervention group or a control group using the tool OPEN Randomize. There will be an ongoing recruitmen from the ADHD clinics in Region Zealand over a 2-year period. The estimated cohort will be 100-160 children.

Data and biological material

Scales and schemes are used as measuring tools. For the primary efficiency measurements the project uses: ADHD-RS-IV a scale for evaluating the severity of the ADHD symptoms, SDQ-DAN (Strengths and Difficulties Questionnaire), focuses upon the child's strengths and weaknesses in accordance with activity and attention, emotional problems, behavioral difficulties etc. For the secondary efficiency measurements the project uses: TCA (Treatment Compliance Assessment)(Halperin et al:2013) which establishes how much time the child spends on each TEAMS activity and TV/computer games each day. The TCA logbook is filled out by the parent on a dayly bases this also describes the participants compliance with the TEAMS treatment project. Data i stored in OPEN Projects. 

Subprojects

Collaborating researchers and departments

Child and Adolescent Psychiatry, "Region Zealand

• Project Responsible Jesper Pedersen

Child and Adolescent Psychiatry, Holbaek, Region Zealand

• Nursing Supervisor and Head of Department Anne Holm
• Project coordinator and District Nurse Helle Anette Vibholm, MScN
• Supervisor Søren Krue, MD

Queens College, City University of New York, USA

• Professor Jeffrey M. Halperin

Publications associated with the project

Østervang C, Lassen AT, Jensen CM, Coyne E, Dieperink KB. How to improve emergency care to adults discharged within 24 hours? Acute Care planning in Emergency departments (The ACE study): a protocol of a participatory design study. BMJ Open. 2020 Dec 22;10(12):e041743. doi: 10.1136/bmjopen-2020-041743. PMID: 33371037; PMCID: PMC7757437.

Østervang C, Lassen AT, Jensen CM, Coyne E, Dieperink KB. What are the needs and preferences of patients and family members discharged from the emergency department within 24 hours? A qualitative study towards a family-centred approach. BMJ Open. 2021 Nov 9;11(11):e050694. doi: 10.1136/bmjopen-2021-050694. PMID: 34753758; PMCID: PMC8578985.