Parent-report of child homework problems was examined as a treatment outcome variable in the MTA - Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (ADHD). Five hundred seventy-nine children ages 7.0–9.9 were randomly assigned to either medication management, behavioral treatment, combination treatment, or routine community care. Results showed that only participants who received behavioral treatment (behavioral and combined treatment) demonstrated sustained improvements in homework problems in comparison to routine community care. The magnitude of the sustained effect at the 24-month assessment was small to moderate for combined and behavioral treatment over routine community care (d = .37; .40, respectively). Parent ratings of initial ADHD symptom severity was the only variable found to moderate these effects.

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7-9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.

No abstract

The Irvine Paraprofessional Program (IPP) looks promising for serving elementary-school children with attention-deficit/hyperactivity disorder (ADHD) in the general education classroom. This article describes the components of the IPP, preliminary research studies that support its efficacy, and the benefits of the model. The IPP is a 12-week intensive intervention that includes (a) direct intervention to children with ADHD by specially trained paraprofessionals, (b) teacher consultation by the school psychologist on the use of effective classroom management strategies, (c) school-based reinforcement, and (d) social skills training. Preliminary studies suggest that paraprofessionals can effect positive changes in children with ADHD that can be maintained by the teacher once the paraprofessional is removed from the classroom. The purpose of this article is to provide a description of the IPP as an effective model for serving children with ADHD in the general education classroom.

Within the population of moderately to severely handicapped children is a sub-population of non-verbal children who fail to develop a functional language system and do not appear to profit from the traditional therapeutic methods that concentrate on oral production. Research is reviewed which uses sign language coupled with the spoken word to facilitate the development of receptive and expressive language for the non-verbal child. Procedures for using sign language with the non-verbal child are outlined with specific goals focused on: (a) development of receptive vocabulary, (b) development of quality and quantity of expressive language, (c) development of sentence structure and length, and (d) development of a major means of communication. A brief summary focuses on the use of sign language as a multi-sensory approach to language development.