School‐based interventions for attention‐deficit/hyperactivity disorder: A systematic review with multiple synthesis methods

Abstract

Non‐pharmacological interventions for attention‐deficit/hyperactivity disorder are useful treatments, but it is unclear how effective school‐based interventions are for a range of outcomes and which features of interventions are most effective. This paper systematically reviews randomised controlled trial evidence of the effectiveness of interventions for children with ADHD in school settings. Three methods of synthesis were used to explore the effectiveness of interventions, whether certain types of interventions are more effective than others and which components of interventions lead to effective academic outcomes. Twenty‐eight studies (n = 1807) were included in the review. Eight types of interventions were evaluated and a range of different ADHD symptoms, difficulties and school outcomes were assessed across studies. Meta‐analyses demonstrated beneficial effects for interventions that combine multiple features (median effect size g = 0.37, interquartile range 0.32, range 0.09–1.13) and suggest some promise for daily report card interventions (median g = 0.62, IQR = 0.25, range 0.13–1.62). Meta‐regression analyses did not give a consistent message regarding which types of interventions were more effective than others. Finally, qualitative comparative analysis demonstrated that self‐regulation and one‐to‐one intervention delivery were important components of interventions that were effective for academic outcomes. These two components were not sufficient though; when they appeared with personalisation for individual recipients and delivery in the classroom, or when interventions did not aim to improve child relationships, interventions were effective. This review provides updated information about the effectiveness of non‐pharmacological interventions specific to school settings and gives tentative messages about important features of these interventions for academic outcomes.

Attainment, attendance, and school difficulties in UK primary schoolchildren with probable ADHD

“…Therefore, our findings suggest that support for teachers to help focus attention and manage associated behavioural disturbance is a priority. For example, a recent multi-method systematic review reported tentative evidence for daily report cards to improve consistent communication between home and school for children with ADHD (Moore et al, 2018). The associated qualitative comparative analysis suggested that strategies that improve self-regulation and are delivered one-to-one were commonly among the most effective interventions for academic outcomes, particularly if combined with personalized programmes and delivered in the classroom.…”

“…Reviews of interventions for children with ADHD in school settings demonstrate that interventions focusing on academic skills to improve academic outcomes tend to be trialled and presumably intended for older children than those in our sample (Moore et al, 2018). Therefore, early intervention that targets the attainment gap for young children with ADHD symptoms should be encouraged.…”

Comprehensive Meta-Analysis of Attention-Deficit/Hyperactivity Disorder Psychosocial Treatments Investigated Within Between Group Studies

“…This decision may have some consequences as the combination of stand-alone interventions represented in the first row of Tables 2, 3, and 4 do not necessarily represent planned combinations of treatment in multimodal interventions. Indeed, another meta-analysis has indicated greater effect size magnitudes for planned combinations of treatments (Moore et al, 2018), and combined treatment is widely recommended for ADHD (Barbaresi et al, 2020). Planned companion papers will further investigate the role of these psychosocial combinations in a network meta-analysis (Schatz et al, 2021).…”

Implications of Unconnected Micro, Molecular, and Molar Level Research in Psychology: The Case of Executive Functions, Self-Regulation, and External Regulation

“…It is essential that we work toward creating cross-level research that makes connections and validates the relationships between conceptual and empirical models at the different levels (Moore et al, 2018; Musso et al, 2019; Sánchez et al, 2019). Only in this way can we verify the external validity of each construct, not only between constructs at the same level, but also between constructs in different research levels and domains.…”