1170 Parent-Administered Pediatric Tuina for Sleep Disturbance in Early School-Aged Children with ADHD: An Exploratory Randomized Controlled Trial

Abstract Introduction Pediatric tuina is a traditional Chinese medicine (TCM) external complementary and alternative therapy. Parent-administered pediatric tuina (PPT) has shown promising clinical effects on sleep disturbance in children with attention-deficit/hyperactivity disorder (ADHD), but evidence remains limited in the school-aged population. Methods This three-arm exploratory randomized controlled trial evaluated the feasibility and preliminary effects of PPT for sleep disturbance in early school-aged children with ADHD. The study enrolled 61 parent-child dyads with children aged 6-8 years diagnosed with ADHD in Hong Kong from October 2023 to May 2024. Participants were randomized to PPT, parent-child interaction exercise (PIE), and routine care (RC) groups. The PPT intervention included 2 face-to-face training sessions where parents learned to practice prescribed pediatric tuina techniques for ADHD every 2 days for 8 weeks. Feasibility outcomes included recruitment, retention, and intervention adherence rates. The primary efficacy outcome was the Sleep Disturbance Scale for Children (SDSC). Secondary outcomes included Children's Eating Behaviour Questionnaire, Conners Parent Rating Scale, and Pediatric Quality of Life Inventory. Results A total of 61 parent-child dyads (mean [SD] parent age, 40.3 [3.4] years; 56 [91.8%] female parents; children: median age, 7.0 years; 44 [72.1%] male) were randomized to PPT (n=22), PIE (n=20), and RC (n=19) groups. The study demonstrated satisfactory feasibility with retention rate of 96.7% (59/61) and intervention adherence rate of 70% (14/20 completers with ≥24 sessions). Compared with RC, the PPT group showed significantly greater reduction in SDSC scores at both week 4 (MD = -10.50; 95% CI, -18.57 to -2.43; d = -0.628; P = .011) and week 8 (MD = -11.42; 95% CI, -19.53 to -3.30; d = -0.687; P = .006). Conclusion Findings demonstrate that PPT with parent training was feasible in ADHD family settings and significantly improved sleep disturbance among children with ADHD, while exploratory analyses indicated benefits for satiety responsiveness and behaviors. PPT showed comparable effects with PIE in improving ADHD symptoms and children’s quality of life. Support (if any) Hong Kong Chinese Medicine Development Fund