In this paper, we propose an implementation science research agenda as it applies to school mental health (SMH). First, we provide an overview of important contextual issues to be considered when addressing research questions pertinent to the implementation of mental health interventions in schools. Next, we critically review three core implementation components: (a) professional development and coaching for school professionals regarding evidence-based practices (EBPs); (b) the integrity of EBPs implemented in schools; and (c) EBP sustainment under typical school conditions. We articulate research questions central to the next generation of research in each of these areas as well as methods to address such questions. Our intent in doing so is to contribute to a developing blueprint to guide community-research partnerships as well as funding agencies in their efforts to advance implementation science in SMH.
The purpose of this study was to evaluate the degree with which Individualized Education Programs (IEPs) and 504 Plans prepared for middle school students with Attention Deficit/Hyperactivity Disorder (ADHD) conformed to best practices and included evidence-based services. Specifically, we examined the problem areas identified in the statement of students’ present level of academic achievement and functional performance (PLAAFP) and targeted in the students’ measurable annual goals and objectives (MAGOs). In addition, we compared services to lists of recommended services provided by the U.S. Department of Education (ED) and reviews of evidence-based practices. Participants were 97 middle school students with ADHD, 61.9% with an IEP and 38.1% with a 504 Plan. Most (85%) IEP PLAAFP statements described nonacademic/behavior problems, but less than half had MAGOs targeting these areas of need. Services listed on IEPs and Section 504 Plans were frequently consistent with ED recommendations, but had little to no research supporting their effectiveness. In addition, services with evidence supporting benefit to students with ADHD were rarely included on IEPs or 504 Plans. Implications for special education policy and future directions are discussed.
Youth and adults with Attention-Deficit/Hyperactivity Disorder (ADHD) experience academic and social impairment and engage in risky behaviors. Emotion dysregulation (ED) is associated with ADHD and may contribute to these impairments and behaviors. Although many measures of ED exist, little is known about the physiological bases of ED, in the context of ADHD. In a large sample of children (M = 9.01 years; 62% male) with (n = 48) and without (n = 56) ADHD, we examined (1) the correspondence between parent-reported ED and heart rate variability (HRV) - a psychophysiological marker of parasympathetic engagement and (2) whether parent-reported ED is predicted by HRV above and beyond ADHD. For both aims, we tested both dichotomous and continuous indices of parent-reported ED. Results indicated (1) a dichotomous index of parent-reported emotion regulation was associated with HRV and (2) this index was predicted by HRV above and beyond ADHD. Together, findings indicate that the correspondence between ED and HRV depends on the specific manifestation of ED that is considered (emotion regulation vs. lability/negativity) and the way in which ED is conceptualized (dichotomous vs. continuous).
Youth with Attention-Deficit/Hyperactivity Disorder (ADHD) are at risk for severe and pervasive academic problems and often receive assistance as a result of difficulties in school (Loe & Feldman, 2007). Compared with students without ADHD, students with ADHD are at higher risk for poor grades, grade retention, and dropping out of school and often require additional services (Kent et al., 2011;Loe & Feldman, 2007). As a result of academic impairment, many youth with ADHD qualify for and receive interventions, accommodations, and modifications through special education or Section 504 of the Rehabilitation Act of 1973 (i.e., Section 504 Plans). One of the most common services provided for youth with ADHD is oral test administration (i.e., read aloud; Spiel, Evans, & Langberg, 2014) wherein students have tests or quizzes read to them rather than taking the test in a silent format.Federal law mandates that services provided through special education are to be based on peer-reviewed research to the extent practicable (34. C.F.R. § 300.320). Recent reviews of special education services for students with ADHD raise doubts about whether current practices adhere to this standard (Harrison, Bunford, Evans, & Owens, 2013;Spiel et al., 2014). In fact, no published studies were found examining the efficacy of read aloud as a possible accommodation for students with ADHD. Currently, there is insufficient evidence to determine if reading tests aloud for youth with ADHD provides any benefit. If it does not, then using this service for children with or at risk for ADHD may be incompatible with federal guidelines and could potentially obstruct or delay the provision of services with known effectiveness. As such, research determining the benefits of reading tests aloud is needed.
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