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Accumulating evidence highlights the importance of using psychosocial approaches to intervention for children with ADHD that target the family and school, as well as the intersection of family and school. Objective This study was designed to evaluate the effectiveness of a family-school intervention, referred to as Family-School Success (FSS), designed to improve the family and educational functioning of students in grades 2 through 6 who meet criteria for ADHD combined and inattentive types. Key components of FSS were conjoint behavioral consultation, daily report cards, and behavioral homework interventions. Methods FSS was provided over the course of 12 weekly sessions, which included 6 group sessions, 4 individualized family sessions, and 2 school-based consultations. Families participating in the study were given the choice of placing their children on medication; 43% of children were on medication at the time of random assignment. Children (n=199) were randomly assigned to FSS or a comparison group controlling for non-specific treatment effects. Outcomes were assessed at post intervention and 3-month follow-up. The analyses controlled for child medication status. Results Study findings indicated that FSS had a significant effect on the quality of the family-school relationship, homework performance, and parenting behavior. Conclusions The superiority of FSS was demonstrated even though about 40% of the participants in FSS and CARE were on an optimal dose of medication and there were significant Time effects on each measure. This relatively brief intervention was able to produce effect sizes that were comparable to those of the more intensive MTA behavioral intervention.

Despite a significant increase in the number of children and adolescents who receive clinical services for attention deficit hyperactivity disorder (ADHD), there is still a considerable level of unmet need. Children of ethnic minority status continue to lag well behind their non-minority counterparts in the rate of diagnosis and treatment for the disorder. Racial/ethnic disparities in service use are the result of a combination of access barriers and individual, cultural, and societal factors. The ADHD Help-Seeking Behavior Model is proposed as a framework for understanding factors that may be predictive of service use. Variables specific to ADHD and ethnic-minority populations are integrated within the framework of a four-stage pathway model encompassing problem recognition, decision to seek help, service selection, and service use. The authors argue that by systematically addressing factors related to service use for each ethnic minority group, more effective intervention initiatives can be developed to improve identification and treatment for ADHD among underserved children.

Prevention and intervention research studies often fail to include an assessment of program integrity, and when they do, it is often examined in a limited way. Further, despite efforts to reform the intervention research process to include community stakeholders more actively in every phase of investigation, current practice generally employs a hierarchical model of integrity that fails to be responsive to community needs and priorities. In this article, we describe the traditional, hierarchical model of integrity and contrast this framework with a partnership model of treatment integrity. The limitations of the hierarchical model are illustrated through the description of two school-based prevention programs. Core features of the partnership model and steps for implementing this framework in research and practice are described. Although the partnership model has limitations when conducting efficacy research in clinical trials, it has clear advantages over the hierarchical model in conducting effectiveness research and research that is directly linked with practice.

Approximately 10% of children and adolescents have mental health problems necessitating intervention, but well below 50% of these children receive needed services, and far fewer receive the quality of care required to effectively reduce their impairments. Although system reform is needed to improve service utilization and quality of care for all children, preschoolers, girls, individuals of minority status, and the uninsured are most at risk for being underserved. Factors contributing to poor service utilization can be classified into two broad sets: sociopolitical factors referring to issues related to funding and access, and cultural/familial factors including beliefs about mental health services, providers, and treatments. This article describes the help-seeking process and focuses on cultural and familial factors that contribute to movement through these stages, with a particular focus on variables that are amenable to change by practitioners in the school and community, including school psychologists. Guidelines for understanding and changing the help-seeking behavior of families, including suggestions for creating service options, providing family education, and offering individualized family services, are described.Mental health problems are common among children and adolescents. An estimated 20% of children and teens have mental health problems resulting in at least mild impairments, and approximately 10% have moderate to severe impairments necessitating intervention (Duchnowski, Kutash, & Friedman, 2002). Rapid developments in the field of mental health research have provided evidence of validated pharmacological and psychosocial interventions for many externalizing and internalizing disorders. Unfortunately, less than 50% of youth with mental health problems appear to be receiving services