Sustained Effects of Collaborative School-Home Intervention for Attention-Deficit/Hyperactivity Disorder Symptoms and Impairment.

OBJECTIVES The Collaborative Life Skills (CLS) program is a school-home intervention for students with attention-deficit/hyperactivity disorder (ADHD) symptoms and impairment. CLS integrates school, parent, and student treatments followed by booster sessions during a maintenance period into the subsequent school year. The program is delivered by school-based mental health providers. Beneficial post-treatment effects have been documented. This study evaluated the effects of CLS after the maintenance period in the subsequent school year. METHOD Using a cluster randomized design, schools within a large urban public school district were randomly assigned to CLS (12 schools) or usual services (11 schools). Approximately 6 students participated at each school (N = 135, grade range = 2-5). Measures were completed at baseline, after treatment, and follow-up during the next school year. RESULTS Students from schools assigned to CLS compared with those assigned to usual services showed significantly greater improvement at follow-up on parent, but not teacher, ratings of ADHD and oppositional defiant disorder symptom severity, organizational skills, and global impairment. Within-group analyses indicated that parent- and teacher-reported post-treatment gains for CLS in ADHD and oppositional defiant disorder symptoms, organizational skills, and academic competence were maintained into the next school year. CONCLUSIONS These results extend support for CLS to the following school year by demonstrating sustained benefits on parent-reported ADHD and oppositional defiant disorder symptoms and functional impairment. The lack of significant teacher-reported differences between CLS and usual services highlights the need for further study of booster treatments for improving outcomes with new teachers across school years. CLINICAL TRIAL REGISTRATION INFORMATION Study of the Collaborative Life Skills Program; http://clinicaltrials.gov; NCT01686724.