Efficacy of an Organizational Skills Intervention for Middle School Students With ADHD
Condition: Attention-Deficit/Hyperactivity Disorder (ADHD)
MeSH terms: Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed
      childhood disorders, with prevalence rates estimated at 8%. Several of the primary symptoms
      of ADHD relate to problems with temporal and materials organization (i.e. has difficulty
      organizing tasks and activities, loses things, is forgetful, and fails to finish
      school-work). In the school setting, problems with organization manifest as forgetting to
      complete or losing homework assignments, difficulties planning for the completion of
      long-term projects and studying for tests, and problems keeping class materials organized.
      These organizational difficulties become particularly problematic in middle school and are
      associated with low school grades and high parent and teacher ratings of academic impairment.
      In fact, organization of homework materials is one of the strongest predictors of academic
      performance in students with ADHD, above and beyond the impact of intelligence, school
      services, and ADHD medication use, and mediates the relationship between symptoms of ADHD and
      school grades.

      Given the relationship between temporal and materials organization and poor school
      performance, it is clear there is a need for interventions to address these difficulties. The
      PI sought to address this need by completing an IES Goal 2 study to develop a school-based
      intervention targeting organizational skills that was feasible for school mental health (SMH)
      providers to implement. The Homework, Organization and Planning Skills (HOPS) intervention
      was developed and refined based upon input from 20 school mental health (SMH) providers,
      students with ADHD and their families. SMH providers implemented the HOPS intervention, rated
      the intervention as highly user-friendly and feasible to implement, and demonstrated
      excellent fidelity to intervention procedures. Students who received the HOPS intervention
      made significant improvements in homework problems and organizational skills compared to a
      waitlist control. The feasibility and fidelity data demonstrate that the intervention has
      potential for widespread dissemination. Preliminary outcome data suggest that the
      intervention may significantly improve the academic performance of students with ADHD.
      However, the small sample size (N=23 HOPS & N=24 control) precludes firm conclusions about
      efficacy and moderators and mediators of intervention response. Accordingly, the primary goal
      of this Goal 3 study is to evaluate the efficacy of the HOPS intervention, which focuses
      teaching students' organization and time-management skills, as compared to an intervention
      targeting on-task behaviors during homework completion and efficiency of work completion, the
      Homework Support Intervention (HSI), and to assess moderators and mediators of intervention
      response.

      Middle school students with ADHD (N=260) will be randomly assigned to receive the HOPS
      intervention or the HSI intervention. Students in both groups will receive the same amount of
      intervention in terms of duration and frequency of intervention sessions. Six cohorts of
      students will be recruited for the project. Each cohort will consist of 22 students at each
      of two schools (44 per cohort) who will be randomly assigned to each of the two conditions.
      Objective measures of skills implementation, parent and teacher ratings of organization,
      homework problems, and academic impairment, and school grades will be examined pre and post
      intervention as well as at 8-week and 6-month follow-ups. Treatment fidelity and integrity
      will be closely monitored. Moderator and mediator analyses will be used to answer important
      questions about the types of students most likely to benefit from organizational skills
      intervention and the key mechanisms of change that lead to improved academic performance.
      This study has significant potential to improve the academic performance of students with
      ADHD because the intervention was designed with SMH provider input and has clear potential
      for widespread dissemination upon proof of efficacy.
    


Intervention name(s): Homework, Organization, and Planning Skills (HOPS) Intervention; Homework Support Intervention (HSI)
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: ADHD; Homework; School; Organization; Time-management