Evidence map›Paper›PMID 42571030›Full record

ArticleChild and adolescent psychiatry and mental health2026

Efficacy of a stepped-care approach for school-age children with mild to moderate ADHD (ESCAschool-moderate): an adaptive intervention study including a randomized controlled trial.

Manfred Döpfner, Christina Dose, Christopher Hautmann, Martin Hellmich, Lea Teresa Kohl, Anne-Katrin Treier, Elena von Wirth, Katja Becker, Daniel Brandeis, Ute Dürrwächter and 14 more

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In one paragraph

Article in Child and adolescent psychiatry and mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Manfred Döpfner *Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. manfred.doepfner@uk-koeln.de.
Christina Dose *Center for Child and Adolescent Cognitive Behavior Therapy (CEKIP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969, Cologne, Germany.
Christopher HautmannDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Martin HellmichDepartment of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
Lea Teresa KohlCenter for Child and Adolescent Cognitive Behavior Therapy (CEKIP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969, Cologne, Germany.
Anne-Katrin TreierCenter for Child and Adolescent Cognitive Behavior Therapy (CEKIP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969, Cologne, Germany.
Elena von WirthDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Katja BeckerDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Marburg and University Hospital Marburg (UKGM), Marburg, Germany.
Daniel BrandeisDepartment of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany.
Ute DürrwächterDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Psychiatry and Psychotherapy Tübingen, Tübingen, Germany.
Julia GeisslerCentre of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany.
Sarah HohmannDepartment of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany.
Martin HoltmannLWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, Hamm, Germany.
Michael HussDepartment of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
Thomas JansCentre of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany.
Anna KaiserDepartment of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany.
Johanna KetterDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Marburg and University Hospital Marburg (UKGM), Marburg, Germany.
Tanja LegenbauerLWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, Hamm, Germany.
Sabina MillenetDepartment of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany.
Luise PoustkaDepartment of Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany.
Tobias J RennerDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Psychiatry and Psychotherapy Tübingen, Tübingen, Germany.
Jasmin WenningDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR-University Hospital Essen (AöR), University of Duisburg-Essen, Essen, Germany.
ESCAlife Consortium
Tobias BanaschewskiDepartment of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis German multicenter study aimed to analyze the efficacy of telephone-assisted self-help (TASH) and changes during subsequent adaptive treatment in children with mild-to-moderate ADHD.

methodsParticipants were children (6;0-11;11 years) with mild-to-moderate ADHD. Study Step 1 comprised a randomized waitlist-controlled trial on the efficacy of three-month, parent-directed TASH. Depending on their response to TASH, in Step 2, children were assigned to booster TASH (full response), behavior therapy (partial response), or pharmacotherapy plus behavior therapy or counseling (non-response) for six months. The primary outcome was the change in blinded-clinician-rated ADHD symptoms; for subsequent changes (Step 2), we considered semi-blinded ratings. The primary analyses were by intention-to-treat.

resultsOf the 163 included children (77.9% boys), 80 were randomized to TASH and 83 to the waitlist control group. Following TASH, 12 children (8.8%) were classified as full responders, 40 (29.2%) as partial responders, and 85 (62.0%) as non-responders. An analysis of covariance did not yield an effect of TASH on the primary outcome (mean between-group difference = 0.00 ± 0.07, 95% CI[- 0.14, 0.13]; p = 0.95; d = -0.01, 95% CI[- 0.37, 0.34]). During Step 2, full responders demonstrated a stable symptom level (piecewise mixed-effects model for repeated measures; d = - 0.07, 95% CI[- 0.61, 0.47], p = 0.80), partial responders a small increase in ADHD symptoms (d = 0.29, 95% CI[0.00, 0.59], p = 0.05), and non-responders a large decrease (d = - 1.00, 95% CI[- 1.27, - 0.73], p < 0.001).

conclusionsTASH is not effective in reducing blinded-clinician-rated ADHD symptoms in children with mild-to-moderate ADHD. Based on the changes within the response groups during Step 2, hypotheses are generated for adaptive treatment after TASH. Trial registration German Clinical Trials Register (DRKS): DRKS0000897; URL: https://drks.de/search/de/trial/DRKS00008973/details ; registered on December 18th 2015.

Indexed as

Attention-deficit/hyperactivity disorder (ADHD)Behavior therapyChildrenStepped-care designTelephone-assisted self-help

Identifiers

PMID42571030
PMCPMC13452123

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.