Category: ADHD - Child

Symposium

High- Versus Low-Intensity Summer Treatment for ADHD Delivered at Secondary School Transitions

Friday, November 17
10:15 AM - 11:45 AM
Location: Indigo Ballroom E, Level 2, Indigo Level

Keywords: Child | Adolescents
Presentation Type: Symposium

Adolescence appears to be a critical period for determining whether childhood ADHD persists long-term and escalates to serious adult outcomes (Molina et al., 2012; Sibley et al., 2014). Within this period, there is evidence that suddenly increased environmental demands at the transitions to middle and high school lead youth to experience equally sudden decrements in functioning (Langberg et al., 2008; Kent et al., 2011). The concern for already struggling adolescents with ADHD is that added adjustment problems in new secondary school environments can lead to serious consequences— such as course failure, deviant behavior, and dropout (Molina et al., 2012). Therefore, secondary school transitions are an identified point of vulnerability for these youth and treatments that preemptively prepare for critical secondary school transitions may offer a strategic avenue to offset problematic developmental trajectories in youth with ADHD.


This study evaluated the effectiveness of high (HI; 412 hours, $4373 per participant) versus low (LI; 12 hours, $97 per participant) intensity skills-based summer intervention delivered to adolescents with ADHD by local school district staff. Participants were 325 rising sixth and ninth graders with ADHD who were randomized to HI vs. LI (n=218) or recruited into an untreated comparison group (n=107). Group x time one-year outcome trajectories were compared using Linear Mixed Models. Both interventions possessed high fidelity and were viewed by families as enjoyable and beneficial. Average youth attendance was higher for HI (~80%) vs. LI (~45%). Average parent training attendance was uniform across groups (~50%) and did not impact trajectories. Primary acute benefits of HI over LI were to note-taking (d=.50), parent contingency management (d=.43), and ADHD symptoms at home (d=.40-.46; ninth grade only). Secondary analyses suggested that HI may produce additional benefits compared to no treatment for home organization skills (HI vs. untreated d=.54), parent-teen conflict, (HI vs. untreated d=.39), and GPA (HI vs. untreated d=.47, ninth grade only). The summer HI treatment model was superior to LI in its ability to engage families, was successfully delivered by school district staff in a summer school setting, and promoted superior uptake of certain skills for both parents and teens. However, the extent to which these medium benefits on a limited number of outcomes justify high costs compared to LI remains an open question.

Margaret Sibley

Assistant Professor of Psychiatry & Behavioral Health
Florida International University

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