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.