The purpose of the proposed project is to [develop and test the preliminary] efficacy of a parent-teen collaborative intervention to increase the academic functioning of middle school students with Attention Deficit/Hyperactivity Disorder (ADHD). As part of the tested intervention, we will also explore ways to improve home-school communication during the middle school years. To this end, two cohorts of 42 middle school students with ADHD (total N=84) will be randomly assigned to receive the intervention or participate in a monitored treatment as usual control condition. Each cohort will be recruited during the fall and the intervention will be delivered during the spring, as middle school students with ADHD experience the most academic impairment during these months (Schultz, Evans, & Serpell, 2009). The program will teach parents: 1) to monitor daily academic targets at school and at home and 2) to implement a comprehensive home privilege program designed to reinforce academic improvement. These intervention components are evidence-based for elementary school students with ADHD (DuPaul & Stoner, 2003; Pelham & Fabiano, 2008), and show preliminary efficacy in the middle school setting (Evans et al., 2009), but have proven difficult to implement effectively in middle schools due to barriers that will be discussed. To test the intervention's efficacy, the study will examine treatment effects on GPA, parent/teacher ratings of academic functioning and classroom behavior, and parent/self ratings of the parent-teen relationship. Participants will participate in an intake evaluation in the fall and [mid-treatment, post-treatment, and six- month follow-up evaluations to assess maintenance and generalization of the STAND intervention]. Teacher ratings will be collected at these points as well. To investigate [the feasibility of STAND, we will obtain measures of] preferences for intervention delivery (i.e., web-based, email, paper/pencil), [satisfaction, therapeutic alliance, treatment credibility, parent and adolescent engagement, parent, adolescent, and teacher compliance with treatment procedures, and barriers to treatment participation.] This project represents the first attempt to develop an exportable and collaborative comprehensive parent-coordinated academic intervention for middle school students with ADHD. If intervention participants show meaningful improvements in academic functioning [and maintenance of treatment effects], this program could significantly benefit the sorely underserved population of adolescents with ADHD. Given that few solutions have decreased the substantial barriers to treatment delivery in this population, the lessons learned in this study will also inform dissemination research. PUBLIC HEALTH RELEVANCE: Adolescents with ADHD are at an increased risk for a slew of negative life outcomes, including school drop-out, interpersonal difficulties, delinquency, substance use, and unemployment (Barkley et al., 2007; Mannuzza, Gittelman-Klein, Bessler, Malloy & LaPadula, 1993; Molina et al., 2007b; Sibley et al., under review; Weiss & Hechtman, 1993). In addition, the annual cost of illness for ADHD is estimated to be approximately 42.5 billion in the United States (Pelham, Foster, & Robb, 2007). These outcomes highlight the intense need for treatment in this population, in order to ameliorate the negative effect of ADHD on those who suffer from this disorder and on the U.S. public.
