A school consultation intervention for adolescents with ADHD: barriers and implementation strategies

Abstract

Background Academic impairment is among the most troubling domains of impairment for adolescents with Attention Deficit/Hyperactivity Disorder (ADHD). Method This investigation presents results of a yearlong academic intervention delivered to adolescents with ADHD (N = 218) by engaging school staff as interventionists through behavioral consultation with an outside mental health professional. Results The intervention was coordinated successfully in some cases, but not in others. The principal challenge to intervention coordination was sustaining monthly contact between consultants and interventionists (38.5% success rate) and scheduling in‐person consultation meetings with interventionists (40.0% success rate). Implementation of the intervention was enhanced when the student (a) attended a public (vs. private) school, (b) had an IEP or Section 504 plan in place, (c) was in middle school (vs. high school), (d) had a parent who communicated regularly with the school, and (e) had a special education support staff member or counselor (vs. teacher or administrator) as a school interventionist. Conclusions Considering these data, recommendations are provided for effective coordination of academic interventions for adolescents with ADHD.

The importance of therapeutic processes in school-based psychosocial treatment of homework problems in adolescents with ADHD.

“…These homework problems exert a significant negative impact on their long-term academic outcomes, above and beyond the influence of ADHD symptoms, intelligence, and service utilization (Langberg, Molina, et al, 2011). Accordingly, multiple psychosocial treatments have been developed to specifically address homework-related problems in youth with ADHD (e.g., Abikoff et al, 2013; Evans et al, 2016; Langberg, Epstein, Becker, Girio-Herrera, & Vaughn, 2012; Merrill et al, 2017; Pfiffner et al, 2007; Sibley, Olson, Morley, Campez, & Pelham, 2016).…”

The ADHD teen integrative data analysis longitudinal (TIDAL) dataset: background, methodology, and aims

“…Therapists receive 1 day of training prior to implementing treatment. In study B, school consultation was offered in addition to STAND-G; however, almost no participants received a meaningful dose of this intervention component [14].…”

“…Despite their efficacy, implementation and utilization of adolescent ADHD treatments are poor [11][12][13][14]. Thus, efforts are needed to identify patient and service delivery barriers and facilitators.…”

Study protocol of a randomised trial of Summer STRIPES: a peer-delivered high school preparatory intervention for students with ADHD

“…Primary barriers include dislike for stimulant medication, 6 parent-teen conflict that curbs family-based services, 7 and resource barriers that hamper school intervention delivery. 8 As a majority of ADHD-related impairment occurs at school, high schools are a logical deployment setting for interventions. However, school-based interventions for ADHD (which are widespread in elementary schools 9 10 ) are rarely available to high school students and a number of systemic barriers limit access (eg, overburdened school counsellors, high student to teacher ratio 8 11 Open access students with ADHD as they are often not the priority for intervention funds.…”