Functional Impairment in school-aged South African children with ADHD: design, implementation, and evaluation of a targeted intervention

dc.contributor.advisorThomas, Kevin G F
dc.contributor.authorFischer, Mareli
dc.date.accessioned2025-09-01T19:16:28Z
dc.date.available2025-09-01T19:16:28Z
dc.date.issued2025
dc.date.updated2025-09-01T19:14:14Z
dc.description.abstractDespite the fact that Attention-Deficit/Hyperactivity Disorder (ADHD) is a globally prevalent psychiatric disorder with significant lifelong impact on the quality of life of diagnosed individuals, there is little Africa-based research considering (a) the functional impact of the disorder within the population or (b) locally appropriate interventions that might alleviate that impact. Study 1 was a needs assessment project that described the functional impairment experienced by a South African sample of school-aged children with ADHD (N = 99). The specific focus was on identifying the areas of life where those children faced the most severe challenges related to their symptoms. I used the Mini International Neuropsychiatric Interview for Children (MINI-Kid) as a diagnostic tool, and the Child Behavior Checklist (CBCL), the Strengths and Difficulties Questionnaire (SDQ), and the Impairment Rating Scale (IRS) as measures of functional impairment. Each of these was administered to the parent of a child with ADHD. Results indicated that although ADHD diagnosed children experienced significant impairment in all domains of functioning (including family relationships, social interactions, activities/hobbies, and home life), they experienced especially severe difficulties in the school environment. Study 2, which built on the results from Study 1, described the design, implementation, and testing of a psychosocial intervention (an 8-week parent-training group) targeting the identified domains of ADHD related functional impairment. Participants (parents of school-aged ADHD-diagnosed children) were pseudo-randomly assigned to an intervention group (n = 62), a non-structured support group (n = 66), or a waitlist control group (n = 50). The same diagnostic process and measures of functional impairment as in Study 1 were used to establish the child's pre intervention functioning. The measures were re-administered immediately post-intervention and, for the intervention group only, 6 months later. Results indicated that participants assigned to the intervention condition rated their child's functional impairment as significantly improved following their participation in the 8-week parent-training process, and these improvements were sustained at the 6-month follow-up measurement point. Although analyses detected no significant between-group differences in functional impairment at baseline, at the post-intervention measurement point ratings from intervention group participants were significantly lower than those of participants assigned to the two control groups. The major conclusion, therefore, is that this parent-training intervention is effective in relieving broad-based ADHD-related functional impairment in low-income and low-resource settings. Studying functional impairment and interventions in this way will pave the way for evidence-based, cost-effective treatment plans focused on alleviating the myriad of personal and societal challenges associated with ADHD.
dc.identifier.apacitationFischer, M. (2025). <i>Functional Impairment in school-aged South African children with ADHD: design, implementation, and evaluation of a targeted intervention</i>. (). University of Cape Town ,Faculty of Humanities ,Department of Psychology. Retrieved from http://hdl.handle.net/11427/41670en_ZA
dc.identifier.chicagocitationFischer, Mareli. <i>"Functional Impairment in school-aged South African children with ADHD: design, implementation, and evaluation of a targeted intervention."</i> ., University of Cape Town ,Faculty of Humanities ,Department of Psychology, 2025. http://hdl.handle.net/11427/41670en_ZA
dc.identifier.citationFischer, M. 2025. Functional Impairment in school-aged South African children with ADHD: design, implementation, and evaluation of a targeted intervention. . University of Cape Town ,Faculty of Humanities ,Department of Psychology. http://hdl.handle.net/11427/41670en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Fischer, Mareli AB - Despite the fact that Attention-Deficit/Hyperactivity Disorder (ADHD) is a globally prevalent psychiatric disorder with significant lifelong impact on the quality of life of diagnosed individuals, there is little Africa-based research considering (a) the functional impact of the disorder within the population or (b) locally appropriate interventions that might alleviate that impact. Study 1 was a needs assessment project that described the functional impairment experienced by a South African sample of school-aged children with ADHD (N = 99). The specific focus was on identifying the areas of life where those children faced the most severe challenges related to their symptoms. I used the Mini International Neuropsychiatric Interview for Children (MINI-Kid) as a diagnostic tool, and the Child Behavior Checklist (CBCL), the Strengths and Difficulties Questionnaire (SDQ), and the Impairment Rating Scale (IRS) as measures of functional impairment. Each of these was administered to the parent of a child with ADHD. Results indicated that although ADHD diagnosed children experienced significant impairment in all domains of functioning (including family relationships, social interactions, activities/hobbies, and home life), they experienced especially severe difficulties in the school environment. Study 2, which built on the results from Study 1, described the design, implementation, and testing of a psychosocial intervention (an 8-week parent-training group) targeting the identified domains of ADHD related functional impairment. Participants (parents of school-aged ADHD-diagnosed children) were pseudo-randomly assigned to an intervention group (n = 62), a non-structured support group (n = 66), or a waitlist control group (n = 50). The same diagnostic process and measures of functional impairment as in Study 1 were used to establish the child's pre intervention functioning. The measures were re-administered immediately post-intervention and, for the intervention group only, 6 months later. Results indicated that participants assigned to the intervention condition rated their child's functional impairment as significantly improved following their participation in the 8-week parent-training process, and these improvements were sustained at the 6-month follow-up measurement point. Although analyses detected no significant between-group differences in functional impairment at baseline, at the post-intervention measurement point ratings from intervention group participants were significantly lower than those of participants assigned to the two control groups. The major conclusion, therefore, is that this parent-training intervention is effective in relieving broad-based ADHD-related functional impairment in low-income and low-resource settings. Studying functional impairment and interventions in this way will pave the way for evidence-based, cost-effective treatment plans focused on alleviating the myriad of personal and societal challenges associated with ADHD. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - school-aged South African children KW - ADHD KW - targeted intervention LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - Functional Impairment in school-aged South African children with ADHD: design, implementation, and evaluation of a targeted intervention TI - Functional Impairment in school-aged South African children with ADHD: design, implementation, and evaluation of a targeted intervention UR - http://hdl.handle.net/11427/41670 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/41670
dc.identifier.vancouvercitationFischer M. Functional Impairment in school-aged South African children with ADHD: design, implementation, and evaluation of a targeted intervention. []. University of Cape Town ,Faculty of Humanities ,Department of Psychology, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/41670en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Psychology
dc.publisher.facultyFaculty of Humanities
dc.publisher.institutionUniversity of Cape Town
dc.subjectschool-aged South African children
dc.subjectADHD
dc.subjecttargeted intervention
dc.titleFunctional Impairment in school-aged South African children with ADHD: design, implementation, and evaluation of a targeted intervention
dc.typeThesis / Dissertation
dc.type.qualificationlevelDoctoral
dc.type.qualificationlevelPhD
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