Attention-deficit/hyperactivity disorder, or ADHD, is not limited to certain hours of the day. For diagnosed children, the condition is with them every hour of every day, year-round.
And their needs will evolve as they grow older.
Given the chronic and changing nature of ADHD — a neurodevelopmental disorder that makes it difficult to focus and control impulsive behavior — effective treatment must be flexible and consistent throughout the child’s life span, both at home and school.
Matt Gormley, assistant professor of psychology, has designed research to determine whether teacher-to-teacher consultation can maintain gains in positive behavior from students with ADHD during their transition from one grade to the next.
His study uses the evidence-based program known as Teachers and Parents as Partners, a problem-solving and decision-making process developed by Nebraska researchers that builds on student strengths and fosters collaboration between parents and teachers to enhance students’ academic, behavioral and social outcomes.
Using the program’s individualized approach, the study identifies target behavior and goals, and crafts a customized plan for home and school to help participating students reach their goals.
“Within the ADHD research literature, there’s very little planning from year to year, or for long-term care,” Gormley said. “This is one of the first studies that transfers an intervention — and in this case, a relationship between parents and teachers — over time.”
The project includes six Lincoln Public Schools students in grades one through four who meet criteria for ADHD, along with their parents and teachers. During the baseline phase, students’ classroom behavior is measured using Behavioral Observation of Students in Schools, a 15-minute direct observation tool. On-task behaviors, such as reading, and off-task behaviors, such as calling out, are recorded every 15 seconds.
Student observations are made by Rebecca Overfield and Cassidy Spradlin, both educational psychology graduate research assistants, to get a sense of students’ on- and off-task behavior.
After the observations, the study enters an eight- to 10-week process to identify, measure and modify student behavior through positive reinforcement, skills training and adjustments to the physical or social learning environments. Parents and teachers collaborate to develop an intervention program suitable for both home and school.
Student classroom progress is shared with parents, who can then provide further encouragement through positive reinforcement.
“For example, after the teacher fills out a brief rating scale for the child’s performance, the child might receive rewards at home, such as extra TV or computer time,” Gormley said.
The program’s second phase begins after summer break, when the consultant, parent and child’s previous teacher meet with the new teacher to discuss the previous intervention plan and determine whether modifications or assessments are needed based on the student’s development. The new teacher also learns the plan’s procedures and develops a new home-school communication process that continues to foster a strong family-school partnership.
“More than just maintaining the intervention, we’re also looking to maintain that parent-teacher partnership from the first year to the second,” Gormley said.
The project is funded through fall 2019 by a Layman Award and housed at the Nebraska Center for Research on Children, Youth, Families and Schools.
ADHD is among the most common reasons for mental health referral for school-aged children, with more than 6 million U.S. families — 11 percent — having a child who meets ADHD criteria. Statistics show the disorder requires annual investments of almost $4,700 per student to address their unique educational needs.
Gormley said too many ADHD treatment programs are inadequate because of their short-term approaches.
“We’ve done a great job doing interventions to kids, but we don’t necessarily do a great job doing interventions with kids,” he said. “With TAPP, we can forge an enduring partnership among parents and teachers to support a child year after year, and set the child up with the skills they need for long-term success.”
Gormley aims to secure federal funding to help develop support for ADHD-diagnosed children’s academic, behavioral and social functioning throughout their academic careers — both at school and home.
“When I think about a 7- or 8-year-old diagnosed with ADHD, I want to think about that child at age 18 or 25, and how we get them from point A to point B,” Gormley said. “To sustain progress, we need to figure out ways to move an effective plan from elementary school to middle school, and from middle school to high school, and beyond.”