Single and Combined Effects of Positive Behavior Support, Medication and Academic Accommodation for Children with ADHD

积极行为支持、药物治疗和学业适应对多动症儿童的单一和综合影响

基本信息

批准号：
10703219
负责人：
GREGORY A FABIANO
金额：
$ 61.11万
依托单位：
FLORIDA INTERNATIONAL UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10703219
关键词：
Academic achievement Academic support Achievement Americans with Disabilities Act Area Attention Attention deficit hyperactivity disorder Behavior Behavior Therapy Behavioral Characteristics Child Child Support Civil Rights Classification Combined Modality Therapy Compensation Crossover Design Diagnosis Diagnostic Procedure Disabled Persons Disruptive Behavior Disorder Education Effectiveness Environment Equus caballus Evaluation Exhibits Furniture Guidelines Heterogeneity Impairment Individual Individual Differences Inferior Instruction Intervention Investigation Laboratories Learning Learning Disabilities Literature Measures Medical Neurocognitive Neurocognitive Deficit Outcome Outcome Measure Outsourcing Participant Performance Pharmaceutical Preparations Pharmacological Treatment Placebos Policies Productivity Reaction Time Recommendation Research Research Design Ritalin Role Sampling Schools Short-Term Memory Site Stimulant Students Symptoms System Testing Time Treatment Efficacy Work academic standard behavior measurement behavior observation common treatment comorbidity design distraction educational atmosphere effective intervention efficacy evaluation efficacy study evidence base experience functional improvement improved learning outcome marginalization pharmacologic policy recommendation processing speed remediation response social treatment effect treatment program treatment response

项目摘要

Children with attention-deficit/hyperactivity disorder (ADHD) experience profound, sustained, and severe impairments in academic functioning and long-term progress, making the identification and evaluation of effective approaches critical. Therefore, it is surprising that such little empirical work has explored effective intervention approaches related to learning. This proposal will investigate the efficacy of common academic accommodations (extra time, frequent breaks, low-distraction environment, and adaptive furniture) provided for children with attention- deficit/hyperactivity disorder (ADHD) as well as classroom behavior management positive supports and medication. There has not yet been a rigorous trial that investigates these interventions alone and in combination with one another for children with ADHD in standard educational settings. Thus, in this proposed study, the efficacy of commonly employed academic accommodations, behavioral support interventions, and medication will be rigorously evaluated in a within-subject design in a classroom setting conducted under well- controlled conditions in a summer treatment program setting. Specific aims for the project include an evaluation of the single and combined effects of behavioral supports, medication, and academic accommodations. Further, the moderating effect of child characteristics using standard diagnostic procedures as well as baseline neurocognitive functioning will be explored. Participants will be 288 children (grades K-5; 72 per year for four years; 36 per site), diagnosed with ADHD. At baseline, information on comorbidities (specific learning disability, disruptive behavior disorder) and neurocognitive impairments (processing speed, working memory, reaction time variability, inhibitory control and attention) will be measured and evaluated as moderators. Then, in a within-subject design, all children will receive each level of the behavior modification accommodations (i.e., no positive behavioral supports, positive behavioral supports), each level of medication (i.e., placebo, .3 mg/kg methylphenidate) and each level of the academic accommodations (i.e., extended time, adaptive furniture, frequent breaks, preferential/low distraction seating vs. a standard classroom environment). Measures of key outcome will include objective measures of behavioral and academic functioning. These include observations of behavior in the classroom (i.e., on-task behavior) and academic productivity (i.e., work completion) in independent seatwork and group instruction settings.

患有注意力缺陷/多动障碍 (ADHD) 的儿童会经历深刻、持续和学术功能和长期进步严重受损，使得识别和评估有效方法至关重要。因此，令人惊讶的是，很少有实证工作探索有效的方法。与学习相关的干预方法。该提案将调查常见学术住宿（加时、频繁为注意力集中的儿童提供休息、低干扰环境和适应性家具）缺陷/多动障碍（ADHD）以及课堂行为管理积极支持和药物。目前还没有一项严格的试验单独调查这些干预措施在标准教育环境中，针对患有多动症的儿童，将其相互结合起来。因此，在这个提议中研究、常用学术住宿的功效、行为支持干预措施以及药物治疗将在课堂环境中通过受试者内设计进行严格评估，并在良好的环境下进行。夏季治疗计划环境中的受控条件。该项目的具体目标包括评估行为的单一和综合影响支持、药物和学术住宿。此外，儿童特征的调节作用将探索使用标准诊断程序以及基线神经认知功能。参与者将是 288 名被诊断患有以下疾病的儿童（K-5 年级；四年中每年 72 名；每个地点 36 名）多动症。在基线时，有关合并症的信息（特定学习障碍、破坏性行为障碍）和神经认知障碍（处理速度、工作记忆、反应时间变异性、抑制控制和注意力）将作为调节者进行测量和评估。然后，在主题内设计中，所有孩子都会接受各个级别的行为矫正调整（即没有积极的行为支持、积极的行为支持）行为支持）、每个药物水平（即安慰剂、0.3 mg/kg 哌甲酯）以及每个水平学术住宿（即延长时间、适应性家具、频繁休息、优先/低分心座位与标准教室环境）。关键成果的衡量将包括行为和学术功能的客观衡量。其中包括对课堂行为（即任务行为）和学术生产力的观察（即，工作完成）在独立座位作业和小组指导环境中。