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IES Grant

Title: Interventions for English Language Learners At-Risk for ADHD
Center: NCSER Year: 2021
Principal Investigator: Schatz, Nicole Awardee: Florida International University
Program: Social, Emotional, and Behavioral Competence      [Program Details]
Award Period: 4 years (7/1/2021 – 6/30/2025) Award Amount: $3,792,323
Type: Efficacy Award Number: R324A210221

Co-Principal Investigators:  Pelham, William; Lonigan, Christopher

Purpose: The purpose of this study it to examine the efficacy of language, behavior, or a combination of language and behavioral interventions for students classified as English language learners (ELLs) who are also at-risk for ADHD. Although there is substantial support for language development and reading interventions to aid young children in the acquisition of language skills, there is a significant lack of research addressing interventions for ELLs with disabilities of any type, particularly for ELLs with behavior disorders such as ADHD. This study addresses this gap by comparing the efficacy of language intervention alone, behavioral intervention alone, and a combined language and behavior intervention on student language and behavior outcomes.

Project Activities: This project will include a randomized controlled trial comparing the efficacy of language interventions and classroom behavioral interventions for ELLs with or at risk for ADHD.  Students will be randomly assigned and evenly allocated to one of four conditions 1) language intervention, 2) behavior intervention, 3) both the language and behavior interventions, and 4) business as usual control condition. The interventions will run from November through March with end of year assessments in April and May. Outcome measures will include observations of classroom behavior and standardized assessments of language, parent and teacher ratings of academic and behavioral functioning, and student grades and discipline referrals.

Products:  This project will result in evidence of the comparative efficacy of language and behavior interventions for ELLs who are at risk for ADHD on student language and behavior outcomes and information about the cost and cost-effectiveness of the program. The project will also result in a final dataset to be shared, peer-reviewed publications and presentations, and additional dissemination products that reach education stakeholders such as practitioners and policymakers.

Structured Abstract

Setting: The research will take place in a large urban school district in Florida with a high proportion of students identified as English language learners (ELLs).

Population/Sample:  A total of 300 children in grades K–1 (100 per year) will participate. Students will be identified as English language learners in English for Speakers of Other Languages (ESOL) levels 1–4 and identified as at-risk for ADHD based on parent and teacher ratings of behaviors.

Intervention: This project will involve three intervention conditions: 1) an educational language intervention involving small-group, interactive reading emphasizing dialogic reading as well as expressive and receptive syntax; 2) a behavioral classroom intervention in which a behavioral consultant will support parents and teachers in the implementation of a daily report card (DRC); and 3) a combined intervention in which students receive both the language intervention and the behavioral classroom intervention.

Research Design and Methods: This study will involve a 2 (language interventions vs. business as usual) by 2 (DRC vs. business as usual) randomized controlled trial. At the beginning of the school year, students will be randomly assigned to one of four groups: 1) language intervention only; 2) DRC only; 3) language intervention and DRC; 4) business as usual control group. The active treatment phase of the study will last 18 weeks, with key measures assessed at pretreatment baseline, mid-treatment (9 weeks), and end-of treatment.

Control Condition: Students randomized to the business-as-usual control condition will receive whatever interventions or supports schools typically provide to facilitate development of English proficiency and improved classroom behavior according to their schools' existing protocols and as selected by their teachers and parents. Utilization of interventions and services outside of those provided through the proposed project will be carefully monitored across the control group and all treatment groups.

Key Measures: Key proximal measures will include objective measures of language and behavior outcomes. Proximal language outcomes (i.e., student vocabulary, syntax, and listening comprehension) will be assessed via direct assessment using select subtests from the Expressive One-Word Picture Vocabulary Test – 4th Edition, the Comprehensive Assessment of Spoken Language, the Woodcock Johnson Test of Achievement-III and other language assessments. Proximal behavior outcomes will include systematic direct observations of student behavior in the classroom. Intermediate outcomes will include teacher ratings of academic enablers (i.e., academic productivity, accuracy of completed work, and academic engagement). Distal education outcomes will include objective measures of school behavior and performance as well as parent and teacher ratings of social and academic impairment.

Data Analytic Strategy: The main outcomes of this research will be analyzed using mixed-models analysis with group as the between group factor and time as the within subject factor. Potential moderators (e.g., comorbid conditions) and mediators (i.e., fidelity of intervention implementation) will be assessed to evaluate mechanism of treatment effect and to identify potential indicators differential treatment response.

Cost Analysis: Cost of intervention will be quantified in all groups and compared across intervention conditions. Cost-effectiveness analysis will focus on the cost needed in each condition to improve proximal language and behavioral outcomes as outlined above relative to the costs in the business-as-usual control.