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IES Grant

Title: Efficacy of a Narrative Comprehension Intervention for Elementary School Children At-Risk for Attention-Deficit Hyperactivity Disorder
Center: NCER Year: 2017
Principal Investigator: Lorch, Elizabeth Awardee: University of Kentucky
Program: Cognition and Student Learning      [Program Details]
Award Period: 5 years (07/01/2017 – 06/30/2022) Award Amount: $3,237,898
Goal: Efficacy and Replication Award Number: R305A170574
Description:

Purpose: The purpose of this project is to test the efficacy of the Narrative Structure (NS) intervention, which is a supplemental after school intervention for third grade students at-risk for Attention Deficit Hyperactivity Disorder (ADHD) developed with prior IES funding (A Narrative Comprehension Intervention for Elementary School Children At-Risk for Attention-Deficit Hyperactivity Disorder). According to the National Center for Education Statistics, a substantial proportion of U.S. children struggle with reading comprehension. Children with ADHD are particularly likely to experience comprehension problems, such as demonstrating interrelated impairments in building coherent, goal-based story representations and in using causal structure to identify important events, make inferences, and guide story recall. The NS intervention was designed to improve comprehension in these interrelated domains in which children with ADHD exhibit deficit.

Project Activities: The NS intervention consists of 15 lessons and was designed to be administered in after school settings to third-grade students at-risk for ADHD. The research team will conduct an efficacy study using a cohort cluster-randomized design to compare the NS intervention to two counterfactuals. During each academic semester from the spring of Year 1 through Year 5, a new cohort of students will participate in their assigned intervention in two groups of six in an after school environment, with instruction delivered by school personnel. For all children, pre-tests and post-tests of comprehension and measures of self-efficacy in all intervention domains will be collected in addition to ongoing data collection during instructional sessions.

Products: Researchers will produce evidence of the efficacy of the NS intervention for third-grade students at-risk for ADHD and peer-reviewed publications.

Structured Abstract

Setting: Participating schools are located in urban and suburban areas of Kentucky.

Sample: Approximately 1440 third grade students at-risk for ADHD will participate in this study (Year 1 = 144, Year 2 = 336, Year 3 = 336, Year 4 = 336, and Year 5 =1 288). Students will be drawn from 30 schools, with 8 groups of 6 students per school (4 groups will participate in the spring semester and 4 groups will participate the following fall semester). Students will be drawn from a student body where 51.0% of students qualify for free or reduced lunch, 53.2% are Caucasian, 22.4% are African-American, 15.1% are Hispanic, 4.4% are Asian, and the rest represent other ethnicities. Students will be eligible to participate if the student is in the bottom half of the class based on the most recent Measures of Academic Progress (MAP) reading score; teacher ratings of ADHD symptoms for the student are at least 1 SD above the normed mean; and the student does not have a combined IQ score lower than 70, and/or a comprehension score above z = -1.0 on the Test of Integrated Language and Literature Skills (TILLS).

Intervention: The NS intervention was designed for third-grade students at-risk for ADHD and is intended to improve their reading comprehension skills. It consists of 15 scripted lessons delivered through three 90-minute sessions per week over five weeks. It is delivered to groups of six third-grade students by school personnel (e.g., teachers, literacy coaches, and interventionists) in an after school program. The sequence of lessons moves from simple to complex; teaches declarative, procedural, and conditional knowledge in the domain; provides ample opportunity for modeling, interaction, and guided practice during instruction; and helps students to integrate knowledge across the four instructional domains to improve narrative comprehension. There are nine two-hour professional development modules designed to train school personnel to implement the intervention with fidelity.

Research Design and Methods: The research team will implement a pre-test/post-test, multiple cohort cluster-randomized design to test the efficacy of the NS intervention relative to two counterfactuals. Participating schools will be randomly assigned to one of the three conditions. During each academic semester from the spring of Year 1 through Year 5, a new cohort of third grade students who meet the eligibility criteria will participate in the assigned intervention in two groups of six students in an afterschool environment, with instruction delivered by school personnel. For all children, pre-tests and post-tests of comprehension and measures of self-efficacy in all intervention domains will be collected, in addition to ongoing data collection during instructional sessions. Observers will monitor fidelity of implementation for all conditions.

Control Condition: In this study, participating schools are randomly assigned to the NS intervention or to one of two counterfactuals, Reciprocal Teaching (RT), which represents an alternative approach to improving narrative comprehension but is not targeted at specific difficulties of children at-risk for ADHD, or Problem Solving (PS), which addresses difficulties specific to the target population but does not focus on narrative comprehension.

Key Measures:  Key measures include the Test of Integrated Language and Literature Skills (TILLS), the Kaufman Brief Intelligence Test (KBIT-2), the Yopp-Singer Test of Phoneme Segmentation, the Conners Parent Rating Scale-Revised, the Child Behavior Checklist/6-18-Revised, the Child Behavior Checklist-Youth Self-Report, four subscales of the Motivation for Reading Questionnaire (Reading Efficacy, Reading Challenge, Reading Curiosity, and Reading Involvement), the Metacognitive Awareness of Reading Strategies Inventory, The Kentucky Performance Rating for Educational Progress, the Measures of Academic Progress (MAP), and researcher developed pre-test and post-test measures of narrative comprehension, student comprehension during lessons, participant ratings of difficulty and engagement, and student efficacy in the domains addressed by the interventions. In addition, fidelity of implementation will be monitored through observation.

Data Analytic Strategy: The research team will use hierarchical linear modeling of primary outcomes to compare narrative comprehension and self-efficacy across conditions.

Related IES Projects:  A Narrative Comprehension Intervention for Elementary School Children At-Risk for Attention-Deficit Hyperactivity Disorder (R305A120171)


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