The long term objective of this study is to determine the value of adding treatment programs like the Challenging Horizons Program (CHP) to the services available to youth with ADHD in a community. There continues to be a lack of data on effective psychosocial treatments for adolescents with ADHD. This is problematic, as medication is inadequate for most youth as a sole form of treatment and adolescence is a time where the impairment associated with ADHD becomes increasingly dangerous, life-altering, and serious. Specifically, this study aims to: 1) Evaluate the efficacy of the after-school program model and the consultation model of CHP as compared to each other and as compared to community care, 2) Estimate cost-effectiveness ratios for each of the two levels of services, and 3) Identify moderators and mediators of treatment response for the two CHP intervention models. In addition, the findings should inform treatment decisions about which children need which level of care. Treatment services are delivered either through an after-school program (CHP-AS) or through teachers employed by the school who are trained and provided with ongoing consultation on the CHP methods (CHP-C). Over five years 315 participants who meet criteria for ADHD will be recruited at seven middle schools across two sites and randomly assigned to receive either the CHP-AS, CHP-C or community care. Costs of providing the services for all three conditions will be measured as well as symptom and impairment outcomes. Data collection will occur on an ongoing basis over the academic year of a child's participation in the project. In addition, formal evaluations will occur at baseline, immediately post-treatment, and 6 months post-treatment. Consistent with findings from preliminary studies it is expected that response to both active treatment conditions will vary across participants. Assessments will be collected that identify potential moderators and mediators of treatment response and these will be included in the analyses in order to identify child and parent characteristics that may predict response to treatment as well as variables related to the treatment process (e.g., attendance) that predicts response.

Public Health Relevance

The lack of adequate treatments for youth with problems related to substance use, automobile accidents, school failure and other difficulties associated with adolescents with ADHD presents a serious public health problem. This study evaluates the effectiveness and cost associated with two emerging comprehensive treatment options for youth and identifies characteristics of the teens (moderators) and the treatment (mediators) that predict positive outcomes. The development of a cost-effective treatment for young adolescents with ADHD that can be integrated into schools and the community will provide invaluable assistance to the public health field and address problems across multiple sectors of public well being.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Study Section
Interventions Committee for Disorders Involving Children and Their Families (ITVC)
Program Officer
Sherrill, Joel
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Ohio University Athens
Schools of Arts and Sciences
United States
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Dvorsky, Melissa R; Langberg, Joshua M; Evans, Steven W et al. (2018) The Protective Effects of Social Factors on the Academic Functioning of Adolescents With ADHD. J Clin Child Adolesc Psychol 47:713-726
Dvorsky, Melissa R; Langberg, Joshua M; Becker, Stephen P et al. (2018) Trajectories of Global Self-Worth in Adolescents with ADHD: Associations with Academic, Emotional, and Social Outcomes. J Clin Child Adolesc Psychol :1-16
Ray, A Raisa; Evans, Steven W; Langberg, Joshua M (2017) Factors Associated with Healthy and Impaired Social Functioning in Young Adolescents with ADHD. J Abnorm Child Psychol 45:883-897
Bourchtein, Elizaveta; Langberg, Joshua M; Owens, Julie S et al. (2017) Is the Positive Illusory Bias Common in Young Adolescents with ADHD? A Fresh Look at Prevalence and Stability Using Latent Profile and Transition Analyses. J Abnorm Child Psychol 45:1063-1075
Becker, Stephen P; Mehari, Krista R; Langberg, Joshua M et al. (2017) Rates of peer victimization in young adolescents with ADHD and associations with internalizing symptoms and self-esteem. Eur Child Adolesc Psychiatry 26:201-214
Schultz, Brandon K; Evans, Steven W; Langberg, Joshua M et al. (2017) Outcomes for adolescents who comply with long-term psychosocial treatment for ADHD. J Consult Clin Psychol 85:250-261
Evans, Steven W; Langberg, Joshua M; Schultz, Brandon K et al. (2016) Evaluation of a school-based treatment program for young adolescents with ADHD. J Consult Clin Psychol 84:15-30
Zoromski, Allison K; Owens, Julie Sarno; Evans, Steven W et al. (2015) Identifying ADHD Symptoms Most Associated with Impairment in Early Childhood, Middle Childhood, and Adolescence Using Teacher Report. J Abnorm Child Psychol 43:1243-55
Vigo, Ronaldo; Evans, Steven W; Owens, Julie Sarno (2015) Categorization behaviour in adults, adolescents, and attention-deficit/hyperactivity disorder adolescents: A comparative investigation. Q J Exp Psychol (Hove) 68:1058-72
Watabe, Yuko; Owens, Julie Sarno; Evans, Steven W et al. (2014) The relationship between sluggish cognitive tempo and impairment in children with and without ADHD. J Abnorm Child Psychol 42:105-15

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