Remediating organizational functioning in children with ADHD: Immediate and long-term effects from a randomized controlled trial.

Abstract

Objective The study compared the efficacy of two behavioral interventions to ameliorate organization, time management and planning (OTMP) difficulties in 3rd–5th grade children with Attention-Deficit/Hyperactivity Disorder (ADHD). Method In a dual-site randomized controlled trial, 158 children were assigned to Organizational Skills Training (OST, N=64); “PATHKO”, a performance-based intervention that precluded skills training (N=61); or a wait-list control (WL, N=33). Treatments were 20 individual clinic-based sessions over 10–12 weeks. OST involved skills building provided primarily to the child. PATHKO trained parents and teachers to reinforce children contingently for meeting end-point target goals. Primary outcomes were the Children’s Organizational Skills Scales (COSS-Parent, COSS-Teacher). Other relevant functional outcomes were assessed. Percentage of participants no longer meeting inclusion criteria for OTMP impairments informed on clinical significance. Assessments occurred at post-treatment, 1-month post-treatment, and twice in the following school year. Results OST was superior to WL on the COSS-P (Cohen’s d = 2.77; p< .0001), COSS-T (d = 1.18; p< .0001), children’s COSS self-ratings, academic performance and proficiency, homework, and family functioning. OST was significantly better than PATHKO only on the COSS-P (d = .63; p< .005). PATHKO was superior to WL on most outcomes, but not in academic proficiency. 60% of OST and PATHKO participants no longer met OTMP inclusion criteria vs. 3% of controls. Significant maintenance effects were found for both treatments. Conclusions Two distinct treatments targeting OTMP problems in children with ADHD generated robust, sustained functional improvements. The interventions show promise of clinical utility in children with ADHD and organizational deficits.

RETRACTED: Sluggish Cognitive Tempo, Internalizing Symptoms, and Executive Function in Adults With ADHD

“…Among studies that did consider internalizing comorbidity, a study of 165 children aged 7 to 11 with ADHD-I found a correlation between organization problems measured by the Children's Organizational Skills Scale and one of the three SCT factors-"sleepy/tired"-that remained significant after partialing out the effect of depression severity across both parent and teacher reports (Abikoff et al, 2013;McBurnett et al, 2014). A smaller study of children aged 7 to 12 compared 19 children with ADHD-I and SCT to 68 children with ADHD but not SCT-and reported that children with SCT and ADHD-I had fewer problems with sustained attention but greater problems with EF as measured by the BRIEF (Capdevila-Brophy et al, 2014).…”

Evidence-Based Psychosocial Treatments for Children and Adolescents With Attention Deficit/Hyperactivity Disorder

“…Investigators have developed and evaluated interventions that focus on training children with ADHD to overcome their difficulties organizing school materials. There were two studies of organization training that met all EBT Evaluation Criteria; one evaluating a clinicbased intervention for elementary school aged children (Abikoff et al, 2013) and one evaluating school-based interventions for young adolescents (Langberg, Epstein, Becker, Girio-Herrera, & Vaughn, 2012). The approach for training organization of materials and the tracking of assignments is similar across these two studies.…”

PHDA: Afinal, qual a sua origem? Uma revisão dos fatores etiológicos

“…Os alunos com PHDA têm problemas com o envolvimento, planificação, organização e conclusão das tarefas (Abikoff et al, 2013;Junod, DuPaul, Jitendra, Volpe, & Cleary, 2006;Langberg et al, 2011) e, por isso, necessitam de um acompanhamento mais próximo do professor, pelo menos no início da realização das mesmas, algo que deve ser considerado pela classe docente.…”