Purpose: Attention Deficit Hyperactivity Disorder (ADHD) is a serious condition defined by inattention, and/or impulsivity and hyperactivity and associated with significant academic and social impairment. It is estimated that 3 to 7 percent of students in the elementary grades meet criteria for a diagnosis of ADHD. Most of these children are not provided with effective psycho educational interventions to mitigate ADHD and to support optimal learning and social outcomes. The purpose of this project is to develop and assess feasibility, acceptability, and sustainability of an integrated school-home behavioral intervention for children (2nd to 5th graders) with ADHD as implemented by school-based mental health professionals within elementary school settings. The intervention is proposed as a 12-week program and includes integrated school (consultation with teachers and recess supervisors), family (parenting skills groups and family meetings), and child (skills groups) components.

Project Activities: The intervention will be developed and pilot tested with school-based mental health professionals in elementary school settings. This data will be used to inform the development process and to determine whether the intervention shows promise for preventing and ameliorating problem behaviors in children at high risk for or with ADHD.

Products: The products of this project will be a fully developed school-home behavioral intervention for upper elementary aged children at high risk for ADHD or with an existing ADHD diagnosis, published reports, and presentations.

Structured Abstract

Setting: The participating elementary schools are located in California.

Population: Sixty children between the ages of 7 and 11 who are having academic and social problems related to inattention and/or hyperactivity/impulsivity and their teachers, recess supervisors, and family members.

Intervention: The components of the proposed intervention are informed by social learning theory and functional behavior analysis, the types of services required by ADHD students across multiple domains (academic, social, behavioral), and known deficits in motivation and study skills that mediate the relationship between ADHD and poor academic outcomes. The intervention focuses on (a) teacher and parent strategies that reinforce home and school skill development and performance, (b) engaging teaching styles, (c) direct instruction in social and study/organizational skills, (d) predictable routines, (e) clear directions, and (f) classroom accommodations. The intervention is proposed as a 12-week program and includes integrated school (consultation with teachers and recess supervisors), family (parenting skills groups and family meetings), and child (skills groups) components.

Research Designs and Methods: The theoretical model’s critical features (learning theory and functional behavioral analysis) and the demands of support services required by ADHD children in multiple domains (academic, social, behavioral) will guide the iterative development process. Data on teachers and students will be used to identify issues regarding the intervention’s feasibility, usability, and acceptability, as well as issues relevant to clinician training and strategies for classroom implementation.

Key Measures: A variety of measures will be used to assess intervention fidelity and promise of the intervention for improving school functioning. These include: attendance, fidelity checklists, supervisor ratings of the school-based mental health professionals, parent, teacher, and student questionnaires, standardized measures of student behavior academic functioning, and social functioning, official school records, family demographic data, and developmental and medical history of the students.

Data Analytic Strategy: Quantitative and qualitative analyses will be used to guide the development process and to determine intervention fidelity and satisfaction. Pilot data will be analyzed by comparing pre- and post-treatment scores on the behavioral, academic, and social measures using paired t-tests, and by comparing the slopes of grade point average and disciplinary actions pre-intervention to these slopes during and post-intervention.

Control Condition: Due to the nature of the research, there is no control condition.

Products and Publications

Book chapter

Villodas, M.T., Hinshaw, S.P., and Pfiffner, L.J. (2014). Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. In S.G. Hofmann, D. Dozois, W. Rief, and J. Smit (Eds.), The Wiley Handbook of Cognitive Behavioral Therapy, Volume 2 (pp. 775–796). Somerset, NJ: Wiley-Blackwell.

Journal article, monograph, or newsletter

Pfiffner, L., Villodas, M., Kaiser, N., Rooney, N., and McBurnett, K. (2013). Educational Outcomes of a Collaborative School-Home Behavioral Intervention for ADHD. School Psychology Quarterly, 28(1): 25–36.

Pfiffner, L.J., Kaiser, N.M., Burner, C., Zalecki, C., Rooney, M., Setty, P., and McBurnett, K. (2011). From Clinic to School: Translating a Collaborative School-Home Behavioral Intervention for ADHD. School Mental Health, 3(3): 127–142. doi:10.1007/s12310–011–9059–4

Villodas, M., McBurnett, K., Kaiser, N., Rooney, M., and Pfiffner, L.J. (2014). Additive Effects of Parent Adherence on Social and Behavioral Outcomes of a Collaborative School-Home Behavioral Intervention for ADHD. Child Psychiatry and Human Development, 45(3): 348–360. doi:10.1007/s10578–013–0405–7