Effectiveness and Sustainability of School-Based Interventions for Youth with or at Risk for ADHD

In a pre–post design study, we examined the effectiveness and sustainability of a school mental health program for youth with or at-risk for ADHD ( n = 41) when implemented over the course of 4 years by district-employed school mental health professionals (SMHPs) in a rural community. In the program, children received a daily report card (DRC) intervention and teachers received behavioral consultation sessions twice a month. Parent and teacher ratings of symptoms and impairment were collected at pre-intervention (typically fall) and post-intervention (spring) of each academic year. According to parent ratings, children experienced significant improvement in academic functioning (effect size ( ES ) = .65) and overall functioning ( ES = .57). Changes in parent-rated symptoms were in the expected direction, but small in magnitude (ranged from .22 to .32) and nonsignificant. Changes in teacher ratings of symptoms and impairment were nonsignificant. The ESs ranged from −.12 (self-esteem) to .42 (inattention). Results are discussed in the context of current efforts to disseminate treatments for youth with ADHD and disruptive behavior disorders.