Brandon K. Schultz

Effectiveness of the Challenging Horizons After-School Program for Young Adolescents with ADHD.

There are no empirically supported psychosocial treatments for adolescents with attention-deficit hyperactivity disorder (ADHD). This study examined the treatment benefits of the Challenging Horizons Program (CHP), a psychosocial treatment program designed to address the impairment and symptoms associated with this disorder in young adolescents. In addition to evaluating social and academic functioning outcomes, two critical questions from previous studies pertaining to the timing, duration, and family involvement in treatment were addressed. Forty-nine students recruited in two cohorts were randomly assigned to receive either the CHP or a community care condition. Outcomes suggested that students who received the CHP improved compared to students in the control condition on measures of symptoms and impairment. Implications related to timing, duration, and family involvement are reported, as well as recommendations for future studies.

Evaluation of a school-based treatment program for young adolescents with ADHD.

OBJECTIVE This study compared 2 school-based training interventions for adolescents with attention deficit-hyperactivity disorder (ADHD): the Challenging Horizons Program-after school version (CHP-AS) and Challenging Horizons Program-mentoring version (CHP-M) with each other and with a community care (CC) condition. METHOD Participants were 326 students (sixth through eighth grade) diagnosed with ADHD. Interventions were conducted for 1 academic year. CHP-AS occurred twice weekly and included organization, social functioning, and academic study skills interventions. In CHP-M, students were paired with a mentor (e.g., teacher) who was trained by a consultant and delivered a subset of the CHP-AS interventions during school. No direct intervention was provided in CC. Participants were assessed at pretreatment, 4 occasions during the intervention year, posttreatment, and at a 6-month follow-up. RESULTS Intent-to-treatment analyses using hierarchical linear modeling to compare outcomes between the 3 conditions indicate participation in the CHP-AS intervention is associated with moderate effect size improvements in parent-rated organization and time-management skills, homework problems, and ADHD symptoms of inattention, and with small improvements in overall academic functioning and grade point average (GPA). These improvements were in comparison to CC and to CHP-M. Gains were sustained into the next school year and even increased in magnitude for several of the measures. CONCLUSIONS The CHP-AS program leads to significant benefits for adolescents with ADHD compared with the services provided in the CHP-M and CC. The persistence of improvements over time supports the use of training interventions that teach skills for adolescents.

Psychosocial interventions used to treat children with ADHD: safety and efficacy.

Although stimulant therapy is the most common treatment for attention-deficit/hyperactivity disorder (ADHD) in children, it is not always effective in reducing behavioral symptoms. As a result, research on psychosocial interventions has progressed in recent years. This article provides a synopsis of psychosocial interventions for childhood ADHD, with an emphasis on basic behavior management principles, evidence-based interventions, and safety issues. Developmental issues that distinguish psychosocial interventions for children and adolescents are highlighted, and practical recommendations for collaborating with mental health professionals are provided.

Readying students to test: The influence of fear and efficacy appeals on anxiety and test performance

Educational accountability policies have led to a growth in the use of high-stakes examinations for a number of important educational decisions, including the evaluation of teacher effectiveness. As such, educators are under increasing pressure to raise student test performance. In an attempt to prepare students for a high-stakes exam, teachers often resort to using threat-based messages that focus on the negative consequences of test failure rather than messages highlighting students’ ability or expectation for high performance. However, the relative influence of teacher messaging (threat-based or facilitating) under different testing conditions is unknown. The present investigation examined the use of fear and efficacy appeals with 487 university students. Anxiety, motivation, and test performance data were collected during a typical, lower stakes testing situation and a higher-stakes, final course examination. A two-way mixed ANOVA and a mediation analysis were used to examine between (i.e. fear and efficacy appeals) and within (i.e. different testing conditions) subject factors. Results suggest that fear appeals significantly harm student test performance relative to efficacy appeals, even when controlling for the impact of intrinsic motivation on test anxiety. Contrary to prediction, student anxiety did not appear to explain the relationship between fear appeals and lowered test performance. The potential implications of findings are discussed, including the importance of instructional context with regards to teacher instructional practices and student success.

Trajectories and Predictors of Response to the Challenging Horizons Program for Adolescents With ADHD

The Challenging Horizons After School Program is one of the only psychosocial interventions developed specifically for adolescents with attention-deficit/hyperactivity disorder (ADHD) that has demonstrated efficacy in multiple randomized controlled trials. To date, however, all research with the intervention has evaluated outcomes at the group level, and it is unclear whether all adolescents respond similarly, or if the intervention is particularly well suited for certain adolescents with ADHD. This type of information is needed to guide stakeholders in making informed choices as part of dissemination and implementation efforts. The purpose of this study was to evaluate trajectories of response to intervention for a large sample of middle-school age adolescents with ADHD (grades 6-8) who received the after-school intervention (N=112). An additional goal of the study was to evaluate potential predictors of response trajectories, focusing on determining what factors best distinguished between intervention responders and nonresponders. Latent trajectory analyses consistently revealed four or five distinct classes. Depending on the outcome, between 16% and 46% of participants made large improvements, moving into the normal range of functioning, and between 26% and 65% of participants made small or negligible improvements. Multivariate predictor analyses revealed that a strong counselor/adolescent working alliance rated from the adolescent perspective and lower levels of parenting stress and parent-adolescent conflict consistently predicted an increased likelihood of intervention response. Implications of these findings for disseminating the after school intervention and for further intervention development are discussed.

A critical review of videoconferencing software to support school consultation

With recent advances in technology, several viable options now exist for school consultants to communicate with teachers via synchronous online videoconferencing (VC) without the need for specialized equipment. Unfortunately, few studies have evaluated the effectiveness of school consultation through VC, so practitioners are provided little guidance when determining if VC is suited to these specific needs. In this article, we identify the VC software packages most commonly used in the growing telehealth literature and discuss how features common to these programs might support effective school teleconsultation. We focus our attention on six specific capabilities: (a) onscreen document sharing; (b) group VC; (c) instant messaging; (d) recording capabilities; (e) integrated cloud storage; and (f) ethical compliance in regard to client confidentiality. Potential applications of these features are discussed, as well as practical and ethical considerations for trainers and school practitioners.

Longitudinal evaluation of the importance of homework assignment completion for the academic performance of middle school students with ADHD.

The primary goal of this study was to longitudinally evaluate the homework assignment completion patterns of middle school age adolescents with ADHD, their associations with academic performance, and malleable predictors of homework assignment completion. Analyses were conducted on a sample of 104 middle school students comprehensively diagnosed with ADHD and followed for 18 months. Multiple teachers for each student provided information about the percentage of homework assignments turned in at five separate time points and school grades were collected quarterly. Results showed that agreement between teachers with respect to students assignment completion was high, with an intraclass correlation of .879 at baseline. Students with ADHD were turning in an average of 12% fewer assignments each academic quarter in comparison to teacher-reported classroom averages. Regression analyses revealed a robust association between the percentage of assignments turned in at baseline and school grades 18 months later, even after controlling for baseline grades, achievement (reading and math), intelligence, family income, and race. Cross-lag analyses demonstrated that the association between assignment completion and grades was reciprocal, with assignment completion negatively impacting grades and low grades in turn being associated with decreased future homework completion. Parent ratings of homework materials management abilities at baseline significantly predicted the percentage of assignments turned in as reported by teachers 18 months later. These findings demonstrate that homework assignment completion problems are persistent across time and an important intervention target for adolescents with ADHD.

A Practical Guide to Implementing School-Based Interventions for Adolescents with ADHD

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Balancing Feasibility and Treatment Adherence in School Mental Health Research

price are net prices, subject to local VAT. Prices indicated with * include VAT for books; the €(D) includes 7% for Germany, the €(A) includes 10% for Austria. Prices indicated with ** include VAT for electronic products; 19% for Germany, 20% for Austria. All prices exclusive of carriage charges. Prices and other details are subject to change without notice. All errors and omissions excepted. B.K. Schultz, S.W. Evans A Practical Guide to Implementing School-Based Interventions for Adolescents with ADHD

Outcomes for adolescents who comply with long-term psychosocial treatment for ADHD.

There are many challenges to developing flexible school mental health programs that achieve adequate adherence to treatment protocols. While we must consider how educators and school systems perceive school mental health programs (acceptability and feasibility), to ensure that treatment research and development follow scientific principles, interventions must be implemented as intended. The present study examines issues of feasibility and adherence in a school-based psychosocial treatment program for young adolescents with attention deficit/hyperactivity disorder (ADHD). Consistent with recommendations from a treatment development team of stakeholders, a multiple-informant questionnaire system was designed to assess treatment adherence. Preliminary data that demonstrate the utility of this method and the role of various informants are presented. We also discuss how treatment procedures could be modified to improve adherence to the key elements of the treatment, and provide recommendations for adding to and modifying multiple-informant questionnaires.