Internet-Delivered Parent–Child Interaction Therapy in Preschool Children with Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial

Children with attention-deficit/hyperactivity disorder (ADHD) experience significant dysfunction in various settings. Parent-Child Interaction Therapy (PCIT) is a psychological treatment that includes key components of effective parenting programs. This study evaluated the effectiveness of internet-delivered PCIT (I-PCIT) in 4-5-year-old children with ADHD and their caregivers. Participants (n = 46) were randomly assigned (1:1) to I-PCIT (n = 23) or treatment as usual (n = 23) group. They were assessed at baseline and 16 and 22 weeks after baseline. The primary outcome was the severity of child's disruptive behavior evaluated using the Eyberg Child Behavior Inventory at 16 weeks. Secondary outcomes included child's externalizing behaviors, ADHD symptoms, and parental outcomes (parenting stress, depression, parenting behavior, and confidence). The outcomes were analyzed using regression models to estimate treatment effectiveness for the participants. The I-PCIT group showed significantly fewer disruptive behaviors at 16 weeks (p < .001, estimated group difference: -53, 95% confidence interval: -38, -68). Improvements in ADHD symptoms were not significantly associated with treatment. The I-PCIT intervention was also associated with improvements in parenting stress (p = .002) and higher confidence in parenting (p < .001). This trial showed that the I-PCIT improved disruptive behavior in preschool children with ADHD. The findings of this study provide evidence for the effectiveness of I-PCIT in Japanese children with ADHD. The trial was registered on March 16, 2022 in the UMIN registry (UMIN000047166).