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Am Fam Physician. 2005;71(6):1208

Clinicians and researchers rely on parents and teachers to determine whether children with attention-deficit/hyperactivity disorder (ADHD) improve with pharmacotherapeutic interventions. Parents add crucial information related to the child’s impairments in multiple domains, including cognitive and emotional functioning, as well as in school-related activities. However, it is unclear whether parental observations are reliable, particularly in a clinical trial setting evaluating the effects of medications, which has implications for research design. Biederman and colleagues hypothesized that parents were as effective as teachers in observing medication-related improvements in children with ADHD.

The authors searched the literature for randomized controlled trials that used parent and teacher reports to assess the effect of medication on ADHD symptoms. They identified three large-scale studies with a total of 1,445 subjects. The results of all three studies showed that teachers and parents identified improvements in ADHD outcome measures when children received medication. In two of the three studies, larger effects were captured by parent reports than teacher reports.

The authors conclude that parents can reliably detect medication-mediated improvements in ADHD symptoms in their children. This occurs even when children are treated with short-acting medications during school hours. Although geting information from teachers and parents is desirable, teachers are not always easy to access. In addition, parents can assess a broader spectrum of functioning than teachers. These findings have implications for the designs of clinical trials, because parents can accurately document treatment effects in the absence of teachers’ reports.

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