Predictors of Response and Mechanisms of Change in an Organizational Skills Intervention for Students with ADHD
The purpose of the study was to evaluate predictors of response and mechanisms of change for the Homework, Organization, and Planning Skills (HOPS) intervention for middle school students with Attention-Deficit/Hyperactivity Disorder (ADHD). Twenty-three middle school students with ADHD (grades 6–8) received the HOPS intervention implemented by school mental health providers and made significant improvements in parent-rated materials organization and planning skills, impairment due to organizational skills problems, and homework problems. Predictors of response examined included demographic and child characteristics, such as gender, ethnicity, intelligence, ADHD and ODD symptom severity, and ADHD medication use. Mechanisms of change examined included the therapeutic alliance and adoption of the organization and planning skills taught during the HOPS intervention. Participant implementation of the HOPS binder materials organization system and the therapeutic alliance as rated by the student significantly predicted post-intervention outcomes after controlling for pre-intervention severity. Adoption of the binder materials organization system predicted parent-rated improvements in organization, planning, and homework problems above and beyond the impact of the therapeutic alliance. These findings demonstrate the importance of teaching students with ADHD to use a structured binder organization system for organizing and filing homework and classwork materials and for transferring work to and from school.
KeywordsAttention-Deficit/Hyperactivity Disorder Predictors Mechanisms of change Organization Time-management Intervention School mental health
Funding for this study was provided by the Institute of Education Sciences (IES; R305A090305). The opinions expressed are those of the authors and do not represent views of the Institute or the U.S. Department of Education. The authors are grateful to the participating School Mental Health providers, administrators, teachers, and families for their participation and collaboration.
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