Effectiveness of a Cognitive–Functional Group Intervention Among Preschoolers With Attention Deficit Hyperactivity Disorder: A Pilot Study Lori Rosenberg, Adina Maeir, Aviva Yochman, Idit Dahan, Idit Hirsch MeSH TERMS  activities of daily living  attention deficit disorder with hyperactivity  executive function  children, preschool  social participation Lori Rosenberg, MSc, OT, is Head of Occupational Therapy, Ilanot School, Jerusalem, Israel, and Lecturer, School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel; lori66@gmail.com Adina Maeir, PhD, OT, is Head, School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel. Aviva Yochman, PhD, OT, is Lecturer and Researcher, School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel. Idit Dahan, MSc, OT, is Head, Pediatric Occupational Therapy, Maccabi Health Service, Jerusalem, Israel. Idit Hirsch, MSc, OT, is Occupational Therapist, Maccabi Health Service, Jerusalem, Israel. OBJECTIVE. To test functional improvement after a group cognitive–functional occupational therapy intervention for preschoolers with attention deficit hyperactivity disorder (ADHD). METHOD. Seventeen preschooler–parent dyads attended 11 weekly group sessions focused on acquiring executive strategies through occupational performance. Functional improvement was measured using the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS); executive function, using the Behavior Rating Inventory of Executive Function–Pediatric; ADHD symptomatology, using Conners’ Parent Rating Scale–Revised and Conners’ Teacher Rating Scale–Revised; and social functioning, using the Social Participation scale of the Sensory Processing Measure. RESULTS. Significant improvement was found on the COPM and GAS measures, whereas mixed results were found on the other measures, with improvements found in children whose scores indicated impairment at baseline. CONCLUSIONS. Cognitive–functional group intervention appears to significantly improve daily func- tioning, executive function, and social functioning for children who demonstrate clinical impairment. Further research with a larger sample, a control group, and follow-up is required. Rosenberg, L., Maeir, A., Yochman, A., Dahan, I., & Hirsch, I. (2015). Effectiveness of a cognitive–functional group intervention among preschoolers with attention deficit hyperactivity disorder: A pilot study. American Journal of Occupational Therapy, 69, 6903220040. http://dx.doi.org/10.5014/ajot.2015.014795 A ttention deficit hyperactivity disorder (ADHD) is a neurological condition that emerges during the preschool years (American Psychiatric Association, 2013) and has three main subtypes: predominantly inattentive, predominantly hyperactive–impulsive, and combined. It typically involves not being able to inhibit oneself, despite knowing what one should do (Barkley, 2006). In- attentive ADHD has a prevalence of 2.8% in 2- to 6 yr-olds, and hyperactive– impulsive or combined ADHD is seen in 5.6%–5.7% of this population (Egger & Angold, 2006). Preschoolers with ADHD often exhibit difficulties paying attention and continually shift attention. They are easily distracted, forgetful, and impulsive; have difficulty waiting their turn; interrupt others; or say tactless things (Cermak & Maeir, 2011). These preschoolers show a particular tendency to safety risks, aggression, expulsion from their preschool setting, and high injury rates (La- Forett, Murray, & Kollins, 2008). They have poorer performance of everyday activities (Gol & Jarus, 2005); salient difficulties in social skills (DuPaul, McGoey, Eckert, & Van Brakle, 2001; Thomas, Shapiro, DuPaul, Lutz, & Kern, 2011); and greater propensity to complain, tease, interrupt, lie, show aggression, not help others or share, and not contribute in group discussions than typically developing children (Mrug, Hoza, Pelham, Gnagy, & Greiner, 2007; Murray-Close et al., 2010). The social implications of ADHD seem to The American Journal of Occupational Therapy 6903220040p1 Downloaded From: http://ajot.aota.org/ on 03/03/2016 Terms of Use: http://AOTA.org/terms