The proposed study involves a school-based secondary prevention program for young children diagnosed with Attention-deficit Hyperactivity Disorder (ADHD). It compares the promotive and preventive effects of a multicomponent, cognitive-behavioral intervention against that of a conventional school consultation service. The overall aim of this study is to advance our understanding of the extent to which the yoked strategies of early detection/diagnosis and comprehensive intervention based on cognitive-behavioral techniques promote developmental competence and reduce maladjustment and serious mental health problems in ADHD youth. A cross-sequential design with randomized blocks assignment of schools will be used to follow cohorts of ADHD children who receive intervention trials beginning at either a young or older age of problem detection. The younger group will include second and third graders who will be followed through the fifth and sixth grades, and the older group will include fourth and fifth graders who will be followed through the seventh and eighth grades. Two cohorts of normal children, stratified by grade and sex, will be recruited and followed to provide normative data on measures of developmental competence and academic, behavioral/emotional and mental health outcomes. Sixteen elementary schools, matched on the basis of socioeconomic status will be randomly assigned to one of two blocks. One block will receive the multicomponent cognitive-behavioral intervention and the other will receive the school consultation intervention. A multi-dimensional assessment of developmental competence that includes measures of social, academic and behavioral adaptation will be administered prior to the intervention and at selected times during the intervention and follow-up phases of the study. Each competency will be evaluated from several perspectives (teacher, parent, peer and self-report) and will provide measures of adaptive and maladaptive functioning in response to ongoing intervention procedures. The preventive aspects of the study will include evaluation of academic, behavioral/emotional and mental health outcomes at one and two years after the intervention when the subjects have entered junior high school. Multivariate statistical techniques (repeated measures MANOVA) will be employed to evaluate the effects of type of intervention and age at onset of intervention on measures of developmental competence and later academic and mental health outcomes.
