An Evaluation of a Summer Treatment Program for Adolescents With ADHD☆

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Abstract

Although adolescents with attention-deficit/hyperactivity disorder (ADHD) experience serious life impairment (Molina et al., 2009; Wolraich et al., 2005), very few effective psychosocial interventions exist to treat this population (Pelham & Fabiano, 2008; Smith, Waschbusch, Willoughby, & Evans, 2000). Intensive child-directed interventions are an important component in the treatment of childhood ADHD (Pelham et al., 2005), yet no study exists that fully evaluates an intensive adolescent-directed intervention. The current investigation is a pilot study of 19 adolescents with ADHD (age range: 11-16) who participated in an 8-week intensive Summer Treatment Program–Adolescent (STP-A) during the summer of 2009. The program was developed to address specific difficulties associated with ADHD in adolescence. As such, the program was designed to be ecologically valid, age appropriate, and parent-involved. Results suggest that almost all adolescents who attended the STP-A benefitted from the program according to parent, self, and staff ratings and objective measures. These ratings also indicated that participants showed moderate improvement in each of the 6 domains targeted by treatment (i.e., conduct problems, adult-directed defiance, social functioning, inattention/disorganization, mood/well-being, and academic skills). All parents indicated that both they and their children benefitted from the program and all but 1 parent indicated that the STP-A was more effective than the treatments they had utilized in the past. A case example is presented to illustrate typical improvement patterns during the STP-A. Discussion addresses the role of the STP-A in the treatment of ADHD in adolescence.

Section snippets

Participants

Participants were 19 adolescents who attended the STP-A during the summer of 2009. The STP-A was offered as a clinical service at a university research center in the northeastern United States. Participants ranged in age from 11.25 to 16.75 years (M = 14.06, SD = 1.73). Demographic, educational, and diagnostic characteristics of the sample, along with their service utilization history, are listed in Table 1. During the spring of 2009, advertisements for the STP-A were distributed to the research

Overall Improvement

Overall improvement ratings indicated that across all but one rater, most adolescents (82.4% to 94.7%) improved at least somewhat after participating in the STP-A (see Table 2). Parent, counselor, and History/Writing teacher ratings showed similar patterns of improvement (converging around somewhat improved); the Science/Health teacher tended to rate the adolescents as unchanged. Adolescents tended to rate themselves as more improved than parents, teachers, and counselors (converging around

Discussion

This study represents the first attempt to evaluate an intensive adolescent-directed intervention for ADHD. The results of our program evaluation suggest that: (a) according to the majority of raters, most adolescents who attended the STP-A showed overall improvement in functioning that was present across home, classroom, and non-academic STP-A contexts; (b) this improvement was present across all target domains of treatment; (c) a majority of adolescents (67.7%-100%) met most objective

References (69)

  • BarkleyR

    Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment

    (2006)
  • BarkleyR. et al.

    The efficacy of problem-solving communication training alone, behavior management training alone, and their combination for parent–adolescent conflict in teenagers with ADHD and ODD

    Journal of Consulting and Clinical Psychology

    (2001)
  • BarkleyR. et al.

    The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder

    Journal of Abnormal Psychology

    (2002)
  • BarkleyR.A. et al.

    A comparison of three family therapy programs for treating family conflicts in adolescents with attention-deficit hyperactivity disorder

    Journal of Consulting and Clinical Psychology

    (1992)
  • BarkleyR.A. et al.

    ADHD in Adults: What the Science Says

    (2007)
  • BotvinG.J.

    Life Skills Training: Middle School

    (2004)
  • BukowskiW.M. et al.

    Variations in patterns of attraction same-and other-sex peers during early adolescence

    Developmental Psychology

    (2000)
  • CunninghamC.E.

    COPE: Large-group, community-based, family-centered parent training

  • De Los ReyesA.E. et al.

    Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations for further study

    Psychological Bulletin

    (2005)
  • DeshlerD. et al.

    Academic and cognitive interventions for LD adolescents: I

    Journal of Learning Disabilities

    (1984)
  • EcclesJ

    Schools, academic motivation, and stage-environment fit

  • EvansS. et al.

    Measuring symptoms and functioning of youth with ADHD in middle schools

    Journal of Abnormal Child Psychology

    (2005)
  • EvansS.W. et al.

    Development of a school-based treatment program for middle school youth with ADHD

    Journal of Attention Disorders

    (2005)
  • EvansS.W. et al.

    Psychostimulant effects on academic and behavioral measures for ADHD junior high school students in a lecture format classroom

    Journal of Abnormal Child Psychology

    (1991)
  • EvansS.W. et al.

    The efficacy of notetaking to improve behavior an comprehension of adolescents with attention deficit hyperactivity disorder

    Exceptionality

    (1994)
  • EvansS. et al.

    Dose–response effects of methylphenidate on ecologically valid measures of academic performance and classroom behavior in adolescents with ADHD

    Experimental and Clinical Psychopharmacology

    (2001)
  • EvansS.W. et al.

    A school-based organization intervention for young adolescents with Attention Deficit/Hyperactivity Disorder

    School Mental Health

    (2009)
  • EvansS.W. et al.

    Cumulative benefits of secondary school-based treatment of students with attention deficit hyperactivity disorder

    School Psychology Review

    (2007)
  • FabianoG. et al.

    The single and combined effects of multiple intensities of behavior modification and methylphenidate for children with attention deficit hyperactivity disorder in a classroom setting

    School Psychology Review

    (2007)
  • FabianoG.A. et al.

    A practical measure of impairment: Psychometric properties of the Impairment Rating Scale in samples of children with attention deficit hyperactivity disorder and two school-based samples

    Journal of Clinical Child and Adolescent Psychology

    (2006)
  • FischerM. et al.

    The stability of dimensions of behavior in ADHD and normal children over an 8-year followup

    Journal of Abnormal Child Psychology

    (1993)
  • FloryK. et al.

    Childhood ADHD Predicts Risky Sexual Behavior in Young Adulthood

    Journal of Clinical Child and Adolescent Psychology

    (2006)
  • Foster, E.M., Jones, D., Conduct Problems Prevention Research Group, (2005). The high costs of aggression: public...
  • GeddesR

    Future Business Leaders of America School Store: An operating manual

    (1986)

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    ☆

    This study was supported in part by grants DA12414, F31 DA017546 from the National Institute on Drug Abuse. Research was also supported in part grants from the National Institute on Mental Health (MH069614) and Institute of Education Sciences (IESLO3000665A, IESR324B060045).

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