A Randomized Controlled Trial of a School-Implemented School–Home Intervention for Attention-Deficit/Hyperactivity Disorder Symptoms and Impairment

Abstract Objective This study evaluated the efficacy of a novel psychosocial intervention (Collaborative Life Skills, CLS) for primary-school students with attention-deficit/hyperactivity disorder (ADHD) symptoms. CLS is a 12-week program consisting of integrated school, parent, and student treatments delivered by school-based mental health providers. Using a cluster randomized design, CLS was compared to usual school/community services on psychopathology and functional outcomes. Method Schools within a large urban public school district were randomly assigned to CLS (12 schools) or usual services (11 schools). Approximately six students participated at each school (N=135, mean age= 8.4 years, grade range=2nd -5th , 71% boys). Using PROC GENMOD (SAS 9.4), the difference between the means of CLS and usual services for each outcome at posttreatment was tested. To account for clustering effects by school, the Generalized Estimating Equation method was used. Results Students from schools assigned to CLS, relative to those assigned to usual services, had significantly greater improvement on parent and teacher ratings of ADHD symptom severity and organizational functioning, teacher-rated academic performance, and parent ratings of oppositional defiant disorder (ODD) symptoms and social/interpersonal skills. Conclusion These results support the efficacy of CLS relative to typical school and community practices for reducing ADHD and ODD symptoms and improving key areas of functional impairment. They further suggest that existing school-based mental health resources can be re-deployed from non-empirically supported practices to those with documented efficacy. This model holds promise for improving access to efficient, evidence-based treatment for inattentive and disruptive behavior beyond the clinic setting.