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Lawson GM, Owens JS, Mandell DS, Tavlin S, Rufe S, Lyon AR, Eiraldi R, Power TJ. Implementation resources to support teachers' use of behavioral classroom interventions: protocol of a randomized pilot trial. Pilot Feasibility Stud 2023; 9:151. [PMID: 37626422 PMCID: PMC10463490 DOI: 10.1186/s40814-023-01381-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Teacher-delivered behavioral classroom management interventions are effective for students with or at-risk for attention-deficit/hyperactivity disorder (ADHD) or other disruptive behavior challenges, but they can be difficult for teachers to use in the classroom. In this study, we will pilot test a package of implementation strategies to support teachers in using behavioral classroom interventions for students with ADHD symptoms. METHODS We will use a 2-group, randomized controlled trial to compare outcomes for teachers who receive Positive Behavior Management Implementation Resources (PBMIR), a theory and data-driven implementation resource package designed to increase teacher implementation of behavioral classroom management interventions, with those who do not receive this additional implementation support. We will measure teacher implementation outcomes (e.g., observed fidelity to behavioral classroom interventions) and student clinical outcomes (e.g., ADHD-related impairment, ADHD symptoms, student-teacher relationship, academic performance) before and after an 8-week intervention period for both groups; we will also measure teacher-reported acceptability, appropriateness, and feasibility for the PBMIR group following the intervention period. DISCUSSION If there is preliminary evidence of feasibility and effectiveness, this pilot study will provide the foundation for evaluation the PBMIR at a larger scale and the potential to improve outcomes for students with or at risk for ADHD. TRIAL REGISTRATION This clinical trial was registered at ClinicalTrials.gov. ( https://clinicaltrials.gov/ ) on 8/5/2022 which was prior to the time of first participant enrollment. The registration number is: NCT05489081.
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Affiliation(s)
- Gwendolyn M Lawson
- Children's Hospital of Philadelphia, Philadelphia, USA.
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
| | | | - David S Mandell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | | | - Steven Rufe
- Rufe Educational Consulting, LLC, Schwenksville, PA, USA
| | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Ricardo Eiraldi
- Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Thomas J Power
- Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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Shutzman B, Gershy N. Children's excessive digital media use, mental health problems and the protective role of parenting during COVID-19. COMPUTERS IN HUMAN BEHAVIOR 2023; 139:107559. [PMID: 36405875 PMCID: PMC9650221 DOI: 10.1016/j.chb.2022.107559] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/28/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
Abstract
COVID-19's outbreak in March 2020 and the social distancing measures that followed it changed the lives of children worldwide. Studies assessing the pandemic's implications for children have reported an alarming increase in the use of digital media (DM) and warned of its adverse impacts on children's functioning and development. The current study aimed to assess the relationship between excessive and problematic DM use and emotional, behavioral, and academic functioning among Israeli adolescents during COVID-19 and to identify adolescents at elevated risk of developing problematic DM use. Three hundred forty-seven Israeli parent-child dyads (M age = 11.81, SD = 1.41) separately completed measures assessing children's DM use (time and addiction), functioning (academic, social, emotional, and behavioral), behavioral dysregulation, and the parents' parenting practices. The results showed that DM addiction, but not DM use, was related to children's emotional, behavioral, and academic difficulties. Moreover, the results indicated that negative parenting and behavioral dysregulation increased the risk of DM addiction, which in turn increased emotional, behavioral, and academic difficulties. The results underscored parents' role in preventing problematic DM use and highlighted the need to treat DM use and problematic DM use as distinct constructs.
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Orihuela CA, Mrug S, Evans RR. Associations between sleepiness, sleep duration, and academic outcomes in early adolescence. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Catheryn A. Orihuela
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
| | - Sylvie Mrug
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
| | - Retta R. Evans
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
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Becker SP, Epstein JN, Burns GL, Mossing KW, Schmitt AP, Fershtman CEM, Vaughn AJ, Zoromski AK, Peugh JL, Simon JO, Tamm L. Academic functioning in children with and without sluggish cognitive tempo. J Sch Psychol 2022; 95:105-120. [PMID: 36371121 PMCID: PMC9663971 DOI: 10.1016/j.jsp.2022.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/23/2022] [Accepted: 10/03/2022] [Indexed: 11/11/2022]
Abstract
Sluggish cognitive tempo (SCT) is increasingly conceptualized as a transdiagnostic set of symptoms associated with poorer functional outcomes, although the extent to which SCT is associated with academic functioning remains unclear. This study recruited children based on the presence or absence of clinically elevated SCT symptoms, using a multi-informant and multi-method design to provide a comprehensive examination of academic functioning in children with and without clinically elevated SCT symptoms. Participants were 207 children in Grades 2-5 (ages 7-11 years; 63.3% male), including 103 with clinically elevated teacher-reported SCT symptoms and 104 without elevated SCT, closely matched on grade and sex. A multi-informant, multi-method design that included standardized achievement testing, curriculum-based measurement (CBM), grades, classroom and laboratory observations, and parent and teacher rating scales was used. Children with elevated SCT symptoms had poorer academic functioning than their peers across most domains examined. Specifically, compared to children without SCT, children with elevated SCT had significantly lower grade point average (d = 0.42) and standardized achievement scores (ds = 0.40-0.77), poorer CBM performance including lower productivity (ds = 0.39-0.51), poorer homework performance and organizational skills (ds = 0.58-0.85), and lower teacher-reported academic skills (ds = 0.63-0.74) and academic enablers (ds = 0.66-0.74). The groups did not significantly differ on percentage of time on task during classroom observations or academic enabler interpersonal skills. Most effects were robust to control of family income, medication use, and attention-deficit/hyperactivity disorder inattentive symptoms, although effects for motivation and study skills academic enablers were reduced. This study demonstrates that children with clinically elevated SCT symptoms have wide-ranging academic difficulties compared to their peers without SCT. Findings point to the potential importance of assessing and treating SCT to improve academic outcomes.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Jeffery N Epstein
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - G Leonard Burns
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Kandace W Mossing
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Aidan P Schmitt
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Chaya E M Fershtman
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Aaron J Vaughn
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Allison K Zoromski
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - James L Peugh
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - John O Simon
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Leanne Tamm
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Wu D, Au VH, Yang B, Horne SJ, Weedon J, Bernstein MJ, Goldstein NA. Impact of Adenotonsillectomy on Homework Performance in Children With Obstructive Sleep-Disordered Breathing. Ann Otol Rhinol Laryngol 2021; 131:1231-1240. [PMID: 34872386 DOI: 10.1177/00034894211062543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE As a first line treatment for pediatric obstructive sleep-disordered breathing (SDB), adenotonsillectomy (AT) has been shown to confer physiologic and neurocognitive benefits to a child. However, there is a scarcity of data on how homework performance is affected postoperatively. Our objective was to evaluate the impact of AT on homework performance in children with SDB. METHODS Children in grades 1 to 8 undergoing AT for SDB based on clinical criteria with or without preoperative polysomnography along with a control group of children undergoing surgery unrelated to the treatment of SDB were recruited. The primary outcome of interest was the differential change in homework performance between the study group and control at follow-up as measured by the validated Homework Performance Questionnaire (HPQ-P). Adjustments were made for demographics and Pediatric Sleep Questionnaire (PSQ) scores. RESULTS 116 AT and 47 control subjects were recruited, and follow-up data was obtained in 99 AT and 35 control subjects. There were no significant differences between the general (total) HPQ-P scores and subscale scores between the AT and control subjects at entry and there were no significant differences in the change scores (follow-up minus initial scores) between the groups. Regression modeling also demonstrated that there were no group (AT vs control) by time interactions that predicted differential improvements in the HPQ-P (P > .10 for each model) although initial PSQ score was a significant predictor of lower HPQ-P scores for all models. CONCLUSIONS Children with SDB experienced improvement in HPQ-P scores postoperatively, but the degree of change was not significant when compared to controls. Further studies incorporating additional educational metrics are encouraged to assess the true scholastic impact of AT in children with SDB.
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Affiliation(s)
- Derek Wu
- Division of Pediatric Otolaryngology, SUNY Downstate Medical Center, Brooklyn, NY, USA.,Department of Otolaryngology - Head and Neck Surgery, Northwestern University, Chicago, IL, USA
| | - Vivienne H Au
- Division of Pediatric Otolaryngology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Billy Yang
- Division of Pediatric Otolaryngology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Sylvia J Horne
- Division of Pediatric Otolaryngology, SUNY Downstate Medical Center, Brooklyn, NY, USA.,Department of Otolaryngology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Jeremy Weedon
- Medical Research Library, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Michelle J Bernstein
- Division of Pediatric Otolaryngology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Nira A Goldstein
- Division of Pediatric Otolaryngology, SUNY Downstate Medical Center, Brooklyn, NY, USA
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Exploration of Clinician Adherence and Competency as Predictors of Treatment Outcomes in a School-Based Homework and Organization Intervention for Students with ADHD. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09430-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Green CD, Dvorsky MR, Langberg JM, Jones HA, Floyd AL. The Impact of Social Determinants of Health on the Efficacy of School-Based Interventions for Adolescents with ADHD. SCHOOL MENTAL HEALTH 2020; 12:580-594. [PMID: 34093886 PMCID: PMC8174022 DOI: 10.1007/s12310-020-09367-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Adolescents with Attention-deficit/hyperactivity disorder (ADHD) experience significant impairment in functioning. There are multiple clinic-based interventions that address these impairments (e.g., behavioral parent training). However, clinic-based interventions are often associated with barriers to care (e.g., transportation and financial resources), which can limit access based upon social determinants of health (e.g., parental income). School-based interventions have been developed to address the impairments adolescents with ADHD experience, with the goal of also improving access to care and limiting the impact social determinants of health. Despite this, to date, there has been almost no research evaluating the role of social determinants of health on the efficacy of school-based ADHD interventions. In a sample of 222 adolescents with ADHD randomly assigned to receive two different interventions, the present study evaluates the impact of income, maternal education, single-parent status, and race, on intervention efficacy. Single-parent status had the greatest impact on intervention efficacy, resulting in diminished improvements for two of the three outcomes. There was also a significant moderation effect for income, but only for parent-rated homework performance. In addition, main effects were found for single-parent status and race that represent disparities present at baseline that remained post-intervention. Overall, this study suggests that although school-based models of service delivery have the potential to significantly improve access to care, social determinants of health, and single-parent status, in particular, still need to be considered and addressed.
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Affiliation(s)
- Cathrin D. Green
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St., P.O. Box 842018, Richmond, VA 23284-2018, USA
| | - Melissa R. Dvorsky
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Joshua M. Langberg
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St., P.O. Box 842018, Richmond, VA 23284-2018, USA
| | - Heather A. Jones
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St., P.O. Box 842018, Richmond, VA 23284-2018, USA
| | - Alfonso L. Floyd
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St., P.O. Box 842018, Richmond, VA 23284-2018, USA
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Academic Motivation Deficits in Adolescents with ADHD and Associations with Academic Functioning. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 48:237-249. [PMID: 31741133 DOI: 10.1007/s10802-019-00601-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The present study evaluates differences in self-reported intrinsic and extrinsic academic motivation and amotivation between eighth-grade adolescents with (n = 162) and without (n = 140) ADHD. This study also examines associations between motivation and academic functioning with objective (i.e., grade point average, standardized reading and math scores) and cross-rater measurement (i.e., parent-reported homework performance). Multivariate analysis of variance controlling for sex, intelligence, and medication status found that adolescents with ADHD exhibited a significant motivational deficit compared to adolescents without ADHD across all areas of academic motivation, including intrinsic motivation (d = 0.49), extrinsic motivation (d = 0.43), and amotivation (d = 0.42). To examine whether motivation was differentially associated with academic impairment in the ADHD and comparison groups, a multi-group path analysis was conducted controlling for sex, intelligence, and medication status. Findings showed that motivation was differentially associated with academic impairment for adolescents with and without ADHD. For the comparison group, higher amotivation was associated with poorer homework performance and lower intrinsic motivation was associated with lower reading accuracy. In the ADHD group, higher amotivation was associated with poorer homework performance and math fluency, higher extrinsic motivation was associated with better homework performance and higher GPA, and higher intrinsic motivation was associated with higher reading accuracy. This study builds upon previous research in demonstrating that adolescents with ADHD have academic motivational deficits when compared to their peers without ADHD. Research is needed to understand the longitudinal interplay of academic motivation and academic functioning, with an eye towards developing or modifying interventions to increase academic motivation and academic success.
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Smith ZR, Breaux RP, Green CD, Langberg JM. Evaluation of the Interplay Between Homework Motivation and Sluggish Cognitive Tempo in Youth With ADHD: Associations With Homework Performance. J Atten Disord 2019; 23:1262-1273. [PMID: 29553294 DOI: 10.1177/1087054718763722] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study evaluated which Sluggish Cognitive Tempo (SCT) factors (i.e., Slow, Sleepy, Daydreamer) are most strongly associated with homework motivation, and whether homework motivation mediates the path between SCT and academic impairment. Method: Participants were 285 middle school students (boys 209) in Grades 6 to 8 (ages 10-15 years) who were comprehensively diagnosed with ADHD. Results: Parent- and self-report of SCT Slow behaviors predicted homework motivation above and beyond symptoms of ADHD, oppositional defiant disorder (ODD), anxiety, depression, and intelligence. The mediation models tested were multi-informant and cross-rater (parent-report of SCT to self-report of motivation to teacher-report of homework problems), and suggest that low motivation may help explain the associations between SCT and functional impairment. Conclusion: SCT and motivation are significantly associated constructs. Clinically, youth with ADHD and comorbid SCT may be more likely to present with low motivation, placing them at risk for academic failure. The manuscript discusses potential clinical implications of these findings.
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Affiliation(s)
- Zoe R Smith
- 1 Virginia Commonwealth University, Richmond, USA
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Breaux RP, Langberg JM, Molitor SJ, Dvorsky MR, Bourchtein E, Smith ZR, Green CD. Predictors and Trajectories of Response to the Homework, Organization, and Planning Skills (HOPS) Intervention for Adolescents With ADHD. Behav Ther 2019; 50:140-154. [PMID: 30661554 DOI: 10.1016/j.beth.2018.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/05/2018] [Accepted: 04/06/2018] [Indexed: 11/18/2022]
Abstract
The goal of the present study was to evaluate the relative importance of adolescent and parent skills acquired during participation in the Homework, Organization, and Planning Skills (HOPS) intervention in predicting intervention response. A sample of 111 middle school students with attention-deficit/hyperactivity disorder (66% male; Mage = 11.99, SD = 1.05) received the HOPS intervention, which includes 16 brief sessions with the adolescent and two parent meetings. Each session, school mental health providers completed checklists measuring students' acquisition of homework recording, materials organization, and time management skills. Parents provided information on whether they monitored and used contingencies to reinforce skills use at home. Outcome measures included parent and teacher ratings of homework problems and organizational/time management skills postintervention. Grade point average and assignment completion were also evaluated as objective outcomes. Regressions found accurate homework recording and time management to be unique predictors of parent-reported homework and organizational skills outcomes. Growth mixture models examining organizational skills trajectories throughout the intervention significantly predicted parent- and teacher-reported outcomes, GPA, and assignment completion; homework recording trajectories predicted parent-reported outcomes and GPA. Sixty-eight percent of participants displayed high acquisition of organization and homework recording skills. Parent-reported use of monitoring and contingencies to support adolescent skills implementation was not associated with outcomes. Results highlight the importance of examining individual differences in school-based intervention studies targeting organization, time management, and planning. Importantly, for a school-based adolescent-focused intervention, improvement in outcomes does not appear to be dependent upon parent skills implementation.
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Molitor SJ, Langberg JM, Evans SW, Dvorsky MR, Bourchtein E, Eddy LD, Smith ZR, Oddo LE. Evaluating the Factor Validity of the Children's Organizational Skills Scale in Youth with ADHD. SCHOOL MENTAL HEALTH 2017; 9:143-156. [PMID: 28983327 PMCID: PMC5624737 DOI: 10.1007/s12310-016-9205-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Children and adolescents with ADHD often have difficulties with organization, time management, and planning (OTMP) skills, and these skills are a common target of intervention. A limited array of tools for measuring these abilities in youth is available, and one of the most prominent measures is the Children's Organizational Skills Scale (COSS). Although the COSS fills an important need, a replication of the COSS factor structure outside of initial measure development has not been conducted in any population. Given that the COSS is frequently used in ADHD research, the current study evaluated the factor structure of the parent-rated COSS in a sample (N = 619) of adolescents with ADHD. Results indicated that the original factor structure could be replicated, although the use of item parcels appeared to affect model fit statistics. An alternative bi-factor model was also tested that did not require the use of parcels, with results suggesting similar model fit in comparison to the original factor structure. Exploratory validity tests indicated that the domain-general factor of the bi-factor model appears related to broad executive functioning abilities.
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Affiliation(s)
- Stephen J. Molitor
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, United States, 23284-2018
| | - Joshua M. Langberg
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, United States, 23284-2018
| | - Steven W. Evans
- Ohio University, 200 Porter Hall, Athens, OH, United States, 45701
| | - Melissa R. Dvorsky
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, United States, 23284-2018
| | - Elizaveta Bourchtein
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, United States, 23284-2018
| | - Laura D. Eddy
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, United States, 23284-2018
| | - Zoe R. Smith
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, United States, 23284-2018
| | - Lauren E. Oddo
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, United States, 23284-2018
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Bikic A, Reichow B, McCauley SA, Ibrahim K, Sukhodolsky DG. Meta-analysis of organizational skills interventions for children and adolescents with Attention-Deficit/Hyperactivity Disorder. Clin Psychol Rev 2016; 52:108-123. [PMID: 28088557 DOI: 10.1016/j.cpr.2016.12.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 12/26/2016] [Accepted: 12/27/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND In addition to problems with attention and hyperactivity, children with ADHD present with poor organizational skills required for managing time and materials in academic projects. Organizational skills training (OST) has been increasingly used to address these deficits. We conducted a systematic review and meta-analysis of OST in children with ADHD. OBJECTIVES The objective of this study was to systematically review the evidence of the effects of OST for children with ADHD for organizational skills, attention, and academic performance. METHODS We searched 3 electronic databases to locate randomized controlled trials published in English in peer-reviewed journals comparing OST with parent education, treatment-as-usual, or waitlist control conditions. Standardized mean difference effect sizes from the studies were statistically combined using a random-effects meta-analyses across six outcomes: teacher- and parent-rated organizational skills, teacher- and parent-rated inattention, teacher-rated academic performance, and Grade Point Average (GPA). Risk of bias was assessed for randomization, allocation concealment, blinding of participants and treatment personnel, blinding of outcome assessors, incomplete outcome data, and selective outcome reporting. RESULTS Twelve studies involving 1054 children (576 treatment, 478 control) were included in the meta-analyses. Weighted mean effect sizes for teacher- and parent-rated outcome measures of organizational skills were g=0.54 (95% CI 0.17 to 0.91) and g=0.83 (95% CI 0.32 to 1.34), respectively. Weighted mean effect sizes of teacher- and parent-rated symptoms of inattention were g=0.26 (95% CI 0.01 to 0.52) and g=0.56 (95% CI 0.38 to 0.74), respectively. Weighted standardized mean effect size for teacher-rated academic performance and GPA were g=0.33 (95% CI 0.14 to 0.51) and g=0.29 (95% CI 0.07 to 0.51), respectively. CONCLUSIONS OST leads to moderate improvements in organizational skills of children with ADHD as rated by teachers and large improvements as rated by parents. More modest improvements were observed on the ratings of symptoms of inattention and academic performance. PROTOCOL REGISTRATION PROSPERO (CRD42015019261).
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Affiliation(s)
- Aida Bikic
- Child Study Center, Yale School of Medicine, 230 South Frontage Road, 06511 New Haven, Yale University, USA; Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19, Odense, Denmark.
| | - Brian Reichow
- Child Study Center, Yale School of Medicine, 230 South Frontage Road, 06511 New Haven, Yale University, USA; Anita Zucker Center for Excellence in Early Childhood Studies, University of Florida, 1345 Norman Hall 618 SW 12th Street, Gainesville, USA
| | - Spencer A McCauley
- Child Study Center, Yale School of Medicine, 230 South Frontage Road, 06511 New Haven, Yale University, USA
| | - Karim Ibrahim
- Child Study Center, Yale School of Medicine, 230 South Frontage Road, 06511 New Haven, Yale University, USA
| | - Denis G Sukhodolsky
- Child Study Center, Yale School of Medicine, 230 South Frontage Road, 06511 New Haven, Yale University, USA.
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Toland MD, Sulis I, Giambona F, Porcu M, Campbell JM. Introduction to bifactor polytomous item response theory analysis. J Sch Psychol 2016; 60:41-63. [PMID: 28164798 DOI: 10.1016/j.jsp.2016.11.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 11/22/2016] [Accepted: 11/22/2016] [Indexed: 11/16/2022]
Abstract
A bifactor item response theory model can be used to aid in the interpretation of the dimensionality of a multifaceted questionnaire that assumes continuous latent variables underlying the propensity to respond to items. This model can be used to describe the locations of people on a general continuous latent variable as well as on continuous orthogonal specific traits that characterize responses to groups of items. The bifactor graded response (bifac-GR) model is presented in contrast to a correlated traits (or multidimensional GR model) and unidimensional GR model. Bifac-GR model specification, assumptions, estimation, and interpretation are demonstrated with a reanalysis of data (Campbell, 2008) on the Shared Activities Questionnaire. We also show the importance of marginalizing the slopes for interpretation purposes and we extend the concept to the interpretation of the information function. To go along with the illustrative example analyses, we have made available supplementary files that include command file (syntax) examples and outputs from flexMIRT, IRTPRO, R, Mplus, and STATA. Supplementary data to this article can be found online at http://dx.doi.org/10.1016/j.jsp.2016.11.001. Data needed to reproduce analyses in this article are available as supplemental materials (online only) in the Appendix of this article.
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Affiliation(s)
- Michael D Toland
- Department of Educational, School, and Counseling Psychology, University of Kentucky, United States.
| | - Isabella Sulis
- Department of Social Sciences and Institutions, University of Cagliari Italy
| | - Francesca Giambona
- Department of Social Sciences and Institutions, University of Cagliari Italy
| | - Mariano Porcu
- Department of Social Sciences and Institutions, University of Cagliari Italy
| | - Jonathan M Campbell
- Department of Educational, School, and Counseling Psychology, University of Kentucky, United States
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Langberg JM, Dvorsky MR, Molitor SJ, Bourchtein E, Eddy LD, Smith Z, Schultz BK, Evans SW. Longitudinal evaluation of the importance of homework assignment completion for the academic performance of middle school students with ADHD. J Sch Psychol 2016; 55:27-38. [PMID: 26931065 DOI: 10.1016/j.jsp.2015.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 08/26/2015] [Accepted: 12/16/2015] [Indexed: 10/22/2022]
Abstract
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.
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Affiliation(s)
| | | | | | | | | | - Zoe Smith
- Virginia Commonwealth University, USA
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