Co-Principal Investigator: Erika K. Coles (Florida International University)

Purpose: Research has shown that teacher-implemented interventions for students with attention deficit hyperactivity disorder (ADHD) have positive effects. However, given the many demands that teachers face, the extent to which teachers implement these interventions as recommended (i.e., with integrity) is variable and often declines in the absence of ongoing consultation with another professional. Limited use of these interventions is a significant problem and can compromise student outcomes. The solution is to understand the factors that influence teachers' use of these interventions and to develop a consultation program that offers practice supports that adequately address teachers' implementation needs. The goal of this study is to develop a multi-component consultation intervention that addresses the factors that facilitate high integrity (e.g., knowledge, skills, beliefs) to a daily report card (DRC) intervention, as well as tools for measuring these facilitators and intervention integrity (both adherence and competence).

Project Activities: The project will use an iterative curriculum development process aimed at improving the feasibility and potential impact of the multi-component consultation intervention. During the pilot study in the final year of the project, 60 teachers and 60 students with or at risk for ADHD in grades K–5 will be recruited and randomly assigned to either the multi-component consultation condition or a consultation-as-usual condition. The researchers will collect student outcome data, conduct observations, and conduct interviews with teachers to evaluate the results of implementation. The intervention will be revised through an iterative process of implementation, data collection, data analysis, and protocol enhancement.

Products: The products of this project will include a fully developed consultation program designed to facilitate high integrity to classroom interventions for students with or at risk for ADHD, tools for measuring intervention integrity, peer-reviewed publications, and presentations.

Structured Abstract

Setting: The research will take place in elementary schools in Ohio and Florida. The school districts represent urban, suburban, and rural settings.

Sample: The pilot study will include 60 teachers and 60 students with or at risk for ADHD in grades K–5. Students must be attending one of the participating schools and must meet one of the two criteria: (1) diagnostic criteria for ADHD or (2) criteria for at risk for ADHD. ADHD status will be determined using evidence-based assessment procedures. The medication status of each child will not be controlled during the study, but families will be asked to avoid changes in medication. Changes in medication for study participants will be monitored.

Intervention: The multi-component consultation is a professional development (PD) program that builds upon traditional consultation-as-usual to achieve high quality implementation of the daily report card (DRC) intervention. In addition to the consultation-as-usual activities (see control condition), teachers in the multi-component consultation will (a) participate in PD activities that enhance their understanding of the latest research on ADHD and classroom interventions for ADHD; (b) have the opportunity to implement the interventions and receive feedback to maximize success with the intervention; (c) receive practice supports for making data-based intervention decisions; and (d) participate in individualized problem-solving discussions to identify and overcome possible barriers to implementation (e.g., concerns about intervention effectiveness, competing demands, beliefs about the causes of child misbehavior, ambivalence about implementation).

Research Design and Methods: The project will use an iterative curriculum development process aimed at improving the feasibility and potential impact of the multi-component consultation intervention. In Year 1 of the development project, the researchers will develop and refine the measurement tools and procedures for the two consultation conditions. Using a community-based participatory approach, feedback will be obtained from a 10-member community development team (CDT). The CDT will likely consist of special education staff, school psychologists, school counselors, teachers, and principals. In Year 2, the researchers will conduct a small-scale pilot study with 16 teacher-student dyads to test and refine the documents and procedures in both conditions. Finally, in Year 3 the researchers will conduct the pilot study. The researcher will randomly assign 60 teacher-student dyads to one of two conditions, stratified for student medication status across conditions.

Control Condition: Teachers in the consultation-as-usual condition will (a) receive a 3-hour PD training for the daily report card (DRC) intervention; (b) participate in a problem identification and analysis interview to identify the target behaviors for the DRC; (c) obtain a baseline tracking of these behaviors; and (d) implement the DRC with bi-weekly supportive consultation and integrity observations. Specific practice supports related to knowledge, skills, and integrity barriers will not be used.

Key Measures: The researchers will collect data using a number of measures focused on both teacher and student outcomes. These include the child eligibility assessment measures, assessments of teachers' knowledge, skills, and cognitions about the intervention, assessment of DRC integrity, assessment of consultation integrity, and student outcome measures (symptoms, academic performance and enablers, impairment in student-teacher relationship).

Data Analytic Strategy: Two-level hierarchical linear modeling will be used to evaluate the difference between the multi-component consultation and consultation-as-usual control condition during the pilot study.

Products and Publications

Journal article, monograph, or newsletter

Coles, E.K., Owens, J.S., Serrano, V., Slavec, J., and Evans, S.W. (2015). From Consultation to Student Outcomes: The Role of Teacher Knowledge, Skills, and Beliefs in Increasing Integrity in Classroom Management Strategies. School Mental Health, 7(1): 34–48. doi:10.1007/s12310–015–9143–2

Owens, J.S., Schwartz, M., Erchul, W.P., Himawan, L. K., Evans, S.E., Coles, E.K., and Schulte, A. (2017). Teacher Perceptions of School Consultant Social Influence Strategies: Replication and Expansion. Journal of Educational and Psychological Consultation. : 1–26. doi:10.1080/10474412.2016.1275649 Full text