Attention Deficit Hyperactivity Disorders and Classroom-Based Interventions: Evidence-Based Status, Effectiveness, and Moderators of Effects in Single-Case Design Research

Abstract

Students with attention deficit hyperactivity disorder (ADHD) experience symptoms of inattention, impulsivity, and hyperactivity that often manifest as academic impairment. As such, teachers must select interventions to increase the probability of success for students with ADHD in their classes. Prior meta-analyses have evaluated school-based intervention effects; however, no systematic review meta-analysis has evaluated the effectiveness of interventions implemented in classrooms with students with ADHD. Additionally, classroom-based studies are frequently conducted through single-case design methodology, and recent advances in meta-analytic techniques provide the opportunity to explore intervention effectiveness as evaluated through quality research. Therefore, to inform selection of evidence-based interventions to be implemented in classroom settings, the current systematic review with meta-analysis of single-case design studies was conducted to evaluate intervention effectiveness, evidence-based status, and moderators of effects for four intervention types (behavioral, instructional, self-management, and environmental) when implemented with students with ADHD in classroom settings. The analysis included 27 articles published from 1971 to 2018. Overall and specific to each intervention type, the results indicate that classroom-based interventions for students with ADHD were moderately effective. Instructional and self-management interventions were deemed evidence based by What Works Clearinghouse standards and potentially evidence based by Council for Exceptional Children standards. Behavioral interventions were found to be potentially evidence based by Council for Exceptional Children criteria and were most effective when selected through functional behavior analysis and implemented by researchers in secondary settings. Instructional interventions were more effective when implemented in special education settings targeting academic outcomes. Implications for research and practice are discussed.

Effectiveness of Specific Techniques in Behavioral Teacher Training for Childhood ADHD: A Randomized Controlled Microtrial

“…ADHD = attention-deficit/hyperactivity disorder; CEQ = Credibility/Expectancy Questionnaire; IRS = Impairment Rating Scale; ODD = oppositional defiant disorder; RSES = Rosenberg Self-Esteem Scale; STRS = Student-Teacher Relationship Scale; TSES = Teachers' Sense of Efficacy Scale; TTI = Teacher Telephone Interview. (Chronis et al, 2004;Dunlap & Kern, 2018;Ervin et al, 2000;Harrison et al, 2019;Miller & Lee, 2013;Pfiffner et al, 2006). Further, the short and focused nature of our intervention may have added to large effect sizes.…”

Assessing Intervention Effects in the Presence of Missing Scores

“…The N-of-1 or single-case design (SCD) studies have long been used for identifying and implementing effective interventions in school settings [1,2]. SCD studies in education are characterized by repeated measures of an outcome behavior over time, participants serving as their own controls, and smaller samples as compared to group design studies.…”

The Effects of a Multicomponent Self-Monitoring Intervention on the Rates of Pre-Service Teacher Behavior-Specific Praise in a Masked Single-Case Experimental Design

“…SM relates to self-management that is inclusive of goal setting (GS), monitoring, evaluation, and recording that an individual does on themselves. Although some have argued that all are required for meeting the operational definition, others have indicated any one or more could qualify an intervention as self-management (Briesch & Chafouleas, 2009; Harrison et al, 2019).…”