Lehigh University Study Finds Online Parent Training Can Help Young Children with ADHD as Effectively as In-Person Treatment

A forthcoming study from Lehigh University College of Education researchers George J. DuPaul and Lee Kern finds that an online parent training program for families of young children with attention-deficit/hyperactivity disorder (ADHD) can be as effective as traditional in-person treatment.

The study, Face-to-Face vs. Online Behavioral Parent Training for Young Children with ADHD: Child and Parent Outcomes, focused on PEAK (Promoting Engagement for ADHD pre-Kindergartners), a 10-session behavioral parent training program developed for caregivers of children ages 3 to 6 with ADHD. The program teaches parents and caregivers practical strategies they can use at home and in the community to support their child’s behavior, reduce conflict, and improve daily routines.

The findings are important because behavioral parent training is recommended as a first-line treatment for young children with ADHD, but many families cannot access it because of therapist shortages, cost, transportation, childcare, work schedules, or the challenge of attending regular clinic appointments. The American Academy of Pediatrics recommends behavioral parent training like PEAK as a first-line treatment that should be tried before medication for young children with ADHD.

“Parents are often told that behavioral parent training should be the first step, but too many families never get a real opportunity to try it. This study shows that we may be able to bring evidence-based support to families in a way that fits their lives.”

“Parents are often told that behavioral parent training should be the first step, but too many families never get a real opportunity to try it,” said DuPaul, professor and associate director of the Center for Community-Driven Assistive Technologies at Lehigh University. “This study shows that we may be able to bring evidence-based support to families in a way that fits their lives.”

The randomized controlled trial included 196 families of young children with ADHD. Families were assigned to one of three groups: in-person behavioral parent training, online behavioral parent training, or a wait-list control group. Researchers found that both the online and in-person versions of PEAK produced meaningful improvements in child ADHD symptoms, defiant behavior, and parent behavior when compared with the wait-list group.

The online and in-person programs also produced statistically equivalent results, meaning families who completed the online program saw improvements comparable to those who received face-to-face services.

“For many families, the issue is not whether behavioral parent training works. The issue is whether they can get to it,” said Kern, professor and director of the Center for Promoting Research to Practice at Lehigh University. “An online model gives families another doorway into treatment, especially when in-person services are unavailable or unrealistic.”

Unlike a live telehealth appointment, the online version of PEAK is asynchronous, allowing parents and caregivers to complete program sessions on their own schedule. That flexibility may be especially important for families balancing work, transportation barriers, childcare needs, or limited local access to specialists.

The study also found that caregivers in both PEAK groups showed increased use of positive parenting behaviors, including clearer directions and more specific praise. Caregivers also reported reduced pessimism about their parenting and their child’s future, an important finding because parental confidence and consistency can play a major role in how children respond to behavioral support.

“This is not about replacing clinicians,” Kern said. “It is about expanding the reach of what we know works. If we can help parents build skills earlier, we can support children before behavior patterns become more difficult to change.”

ADHD often begins early in childhood and can affect learning, relationships, behavior, and family stress. Medication can be helpful for some children, but it may come with side effects and does not always address the day-to-day behavior challenges families face at home, in preschool, or in the community.

The Lehigh University study suggests that online behavioral parent training could provide more families with access to support before medication is considered or while other treatment decisions are being made.

“Families should have options,” DuPaul said. “The promise of this work is that evidence-based parent training can move beyond the clinic walls and still make a measurable difference.”

Professor and Associate Dean for Research Bridget Dever, along with multiple current and past graduate students in school psychology and special education at the College of Education, were part of the research team.

The article will be published in the Journal of Clinical Child and Adolescent Psychology, the official journal of the American Psychological Association's Society of Clinical Child and Adolescent Psychology. The research was funded by the Institute of Education Sciences, U.S. Department of Education. The PEAK program is licensed to Scalable Care, a digital health company.