This application is for a """"""""From Intervention Development to Services: Exploratory Research Grants (R34)"""""""" in response to PAR-03-078. The proposal is a Stage I development project to develop and conduct a preliminary evaluation of a set of psychosocial interventions for high school aged adolescents with ADHD. The rationale for this project follows from evidence documenting the presence of significant impairment in this population, a decline in the use of medication treatment during these years, and a lack of any reported psychosocial interventions. A treatment manual, training materials, fidelity procedures, assessment instruments, and related materials will be prepared using input from a community development team and experience gained providing these treatment services. Results from pilot studies will provide estimates of effect sizes to inform the planning of future studies, provide data on feasibility and acceptability, and generate hypotheses about moderators and mediators of treatment. The procedures include both clinician and paraprofessional delivered services targeting social impairment and academic problems in the school, community, and family contexts. Some of the interventions are modifications of techniques that have been developed and evaluated for middle school aged adolescents with ADHD. Paraprofessional coaches provide a large portion of the services focusing primarily on the generalization of behaviors to their natural settings. Treatment delivery has been designed to be responsive to the unique developmental issues associated with older adolescents. Like other psychosocial treatments for individuals with chronic disorders, providing medication education to encourage appropriate evaluations and adherence to prescribed medication is an important component of this treatment. During year 01, 10 subjects will be recruited to receive the treatment. The experience and data gained from this will guide the refinement of procedures prior to a pilot clinical trial in years 02 and 03 (n=36). In addition to group differences (treatment vs. community care) analyses will examine rates of attrition, mean number of sessions completed, mean treatment satisfaction ratings, and the proportion of subjects who achieve at least a 0.5 or 1.0 effect size improvement on outcome measures. Exploratory analyses of hypotheses related to potential moderators (gender, comorbid conditions, etc.) and mediators (medication usage, attendance, adherence, etc.) will be completed to inform future work. ? ? ?
| Evans, Steven W; Owens, Julie Sarno; Bunford, Nora (2014) Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. J Clin Child Adolesc Psychol 43:527-51 |
| Sadler, Joanna M; Evans, Steven W; Schultz, Brandon K et al. (2011) Potential Mechanisms of Action in the Treatment of Social Impairment and Disorganization in Adolescents with ADHD. School Ment Health 3:156-168 |
