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

J Am Acad Child Adolesc Psychiatry. 2018 Apr;57(4):245-251. doi: 10.1016/j.jaac.2018.01.016. Epub 2018 Feb 8.


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;; NCT01686724.

Keywords: attention-deficit/hyperactivity disorder; behavioral intervention; disruptive behavior; follow-up; school-home intervention.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / therapy*
  • Attention Deficit and Disruptive Behavior Disorders / therapy
  • Behavior Therapy / methods*
  • Child
  • Family Therapy / methods*
  • Female
  • Humans
  • Male
  • Mental Health
  • Outcome Assessment, Health Care
  • School Health Services / organization & administration*

Associated data