Spikes in symptom severity are noted for adolescents with attention deficit/hyperactivity disorder (ADHD) at the transitions to middle and high school that are attributed to developmental maladjustment. This study evaluated the effectiveness of high-intensity (HI; 412 hr, $4,373 per participant) versus low-intensity (LI; 24 hr, $97 per participant) skills-based summer intervention delivered to adolescents with ADHD by local school district staff. Participants were 325 ethnically diverse rising sixth and ninth graders with ADHD randomized to HI versus LI (n = 218) or recruited into an untreated comparison group (n = 107). Group × Time 1-year outcome trajectories were compared using linear mixed models. Both interventions possessed high fidelity and were viewed by families as enjoyable and beneficial. Youth attendance was higher for HI (~80%) versus LI (~45%). Parent training attendance was uniform across groups (~50%). Parent and student attendance did not impact trajectories. Primary benefits of HI over LI were to note taking (d = .50), parent contingency management (d = .43), and parent-rated ADHD symptoms (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 grade point average (HI vs. untreated d = .47, ninth grade only). Summer HI treatment was superior to LI in engagement and uptake of certain skills. However, the extent to which these medium benefits on a limited number of outcomes justify high costs compared to LI remains an open question. Delivering treatment during the summer instead of school year may limit generalizability.

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.

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