Comparing School Based Interventions for Adolescents With Attention Deficit Hyperactivity Disorder
Condition: Attention Deficit Disorder With Hyperactivity
MeSH terms: Hyperkinesis; Attention Deficit Disorder with Hyperactivity
Study type: Interventional
Phase: Phase 2

Summary: 
      This study will compare the efficacy and cost effectiveness of two methods of treating
      adolescents with attention deficit hyperactivity disorder in school.
    

Detailed description: 
      Attention deficit hyperactivity disorder (ADHD) is characterized by inattention,
      hyperactivity, and impulsivity. Approximately 50% to 70% of children who had ADHD continue to
      meet its criteria in adolescence, but the problems stemming from adolescent ADHD can be more
      serious-including an increased risk of substance use, delinquency, academic failure, serious
      social impairment, and legal problems. Problems in school more than double when students with
      ADHD move from elementary school to middle and high school.

      Treating ADHD with medications alone is often ineffective, but adding other methods, such as
      behavioral treatments, may be beneficial. Researchers have developed a psychosocial treatment
      for adolescents with ADHD, called the Challenging Horizons Program (CHP), that is delivered
      in school and targets social impairment, family conflict, and academic failure. Two versions
      of CHP were developed, an after-school model and a consultation model. The after-school model
      involves 2 to 3 days of individualized treatment per week and has a higher cost than the
      consultation model because it involves hiring specialized counseling staff and finding space
      to house the program after school. The consultation model involves teaching CHP intervention
      strategies to school staff, who then mentor students with ADHD and deliver interventions as
      needed to solve problems. This model is less expensive, but it does not deliver treatment as
      often or consistently as the after-school model. This study will compare the after-school and
      consultation models of the CHP to determine their relative efficacy and cost effectiveness.
      The study will also evaluate factors that may predict which adolescents would benefit most
      from either of the two models.

      Participation in this study will last a full school year. Participants from schools taking
      part will be randomly assigned to one of three groups: after-school CHP, consultation CHP, or
      standard community care. Participants receiving after-school CHP will attend two 2.5-hour
      after-school sessions per week in which they will work with counselors on homework
      management, educational skills, and interpersonal skills. Participants receiving consultation
      CHP will be assigned a teacher mentor (who will volunteer to work with the student), and the
      mentor and student will meet as needed. A study clinician will provide support to the teacher
      mentors, who will learn the same interventions as counselors in the after-school condition.
      Participants in the community care condition will not receive any intervention but will
      receive a list of community psychosocial and medical service providers for children and their
      families. All participants will undergo study assessments pre-treatment; in November,
      January, and March of the school year; post-treatment; and at a 6-month follow-up.
      Assessments will include questionnaires and clinical interviews completed by student, their
      parents, and their teachers. ADHD symptoms, academic performance, relevant skills of
      adolescents, and program costs will be assessed.
    

Intervention name(s): Challenging Horizons Program (CHP) after-school model; Challenging Horizons Program (CHP) consultation model
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Interventions delivered by a counselor 2 days a week as an after-school program. Interventions will strengthen skills in materials organization, homework management, studying, note taking, and socialization.; Interventions delivered by a mentor (e.g., a teacher or school counselor) as needed, with expert consultation available
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Attention Deficit Hyperactivity Disorder; ADHD; School Based; Intervention; Psychosocial; Academic Intervention; Behavioral