Although school-based services have great potential to improve outcomes for ADHD students, implementation and efficacy are largely unknown. Schools lack feasible interventions that can be delivered effectively in a regular education setting. They also lack systematic methods for facilitating communication and coordination across home, schools, and community treatment providers. A daily report card system provided in the context of conjoint parent-teacher consultation is a promising school-based intervention for improving academic performance and behavior, promoting home-school communication, and monitoring students' progress. However, treatment adherence by parents and teachers and long-term effectiveness in applied settings is unknown. The primary goal of this study is to examine how well the daily report card system can be delivered over a six month period in a regular education setting with expert consultant support. Thirty-two students with previously diagnosed ADHD who warrant treatment will be recruited from two public elementary schools and randomized to either the daily report card intervention or usual care. Parent and teacher adherence to the study intervention and barriers to successful implementation will be closely examined. The effectiveness of the daily report card intervention as compared to usual care will be evaluated at two times with regard to child outcomes and treatment coordination. Relative to the usual care group, it is hypothesized that students receiving the daily report card intervention will demonstrate decreased ADHD symptoms, improved academic and homework performance, and enhanced school functioning. It is also expected that communication and collaboration across home, school, and community providers will increase. The impact of treatment adherence on outcome measures will be examined in a preliminary manner. Finally, data will be used to generate hypotheses about mediators and moderators of adherence and efficacy. Results from this study will provide pilot data to support a more extensive public health service application, which would include a component to train existing school personnel such that the intervention can be successfully implemented and sustained in the schools.
