Organizational Skills Treatment for ADHD Children

描述(由申请人提供)：组织、时间管理和计划(OTMP)技能缺陷严重损害注意力缺陷/多动障碍(ADHD)的特征，损害学校表现和家庭关系。在治疗ADHD儿童OTMP缺陷方面取得了很小的进展。通过R21拨款，我们开展了一项旨在弥补ADHD儿童组织技能缺陷的研究计划。为此，我们：1)开发了量化ADHD儿童OTMP缺陷的评估；2)开发了针对儿童特定OTMP缺陷的为期10周、20节课程的组织技能培训(OST)计划；3)进行了一项试点研究，以评估这一新干预措施的效果。我们的开放式先导性研究证明了治疗的可行性、治疗的满意度以及在学校和家庭中OTMP行为的显著改善。研究结果为通过随机对照试验对干预措施进行更大规模的测试提供了基础。 这项申请提出了一项OST的双站点(纽约大学和杜克大学)有效性研究，对象为180名患有ADHD和组织技能缺陷的儿童，年龄8-11岁，在3-5年级，随机分为三种情况之一：OST(N=72)、应急管理(CM；N=72)或等待名单(WL；N=36)。这项研究旨在控制1)有目标任务的简单应急管理，而不需要组织技能培训，2)时间，3)重复评估。治疗对比将检查儿童的1)OTMP技能，2)学业规划技能，3)学业表现，4)家庭作业行为，5)成绩单成绩，6)对学校和老师的态度，7)家庭关系，8)治疗满意度。预测OST将优于WL控制和CM。我们将评估儿童的长期功能，并假设在一个月的随访中，以及在下一年级，接受OST的儿童将比接受CM的儿童表现出显著更好的组织技能。将探讨父母的ADHD症状对他们的治疗实施和孩子结果的影响。如果成功，这项研究将是儿童ADHD治疗方面的重大进步，并为该领域提供一种干预措施，解决该疾病更令人烦恼的临床特征之一。

DESCRIPTION (provided by applicant): Organizational, time management and planning (OTMP) skills deficits are seriously impairing features of Attention-Deficit/Hyperactivity Disorder (ADHD) that compromise school performance and family relations. There have been minimal advancements in the treatment of OTMP deficits in child with ADHD. Via an R21 grant we conducted a research program aimed at remedying organizational skills deficit in children with ADHD. To this end, we: 1) developed assessments to quantify OTMP deficits in children with ADHD, 2) developed a 10-week, 20-session manualized organizational skills training (OST) program designed to target children's specific OTMP deficits, and 3) conducted a pilot study to generate estimates of effect for this novel intervention. Our open pilot study demonstrated treatment feasibility, satisfaction with treatment, and significant improvements in OTMP behaviors at school and home. Findings provide a basis for a larger test of the intervention through a randomized controlled trial. This application proposes a dual-site (NYU and Duke) efficacy study of OST in 180 children with ADHD and organizational skills deficits, ages 8-11, in grades 3-5, randomized to one of three conditions: OST (N = 72), Contingency Management (CM; N = 72), or Wait List (WL; N = 36). The study is designed to control for 1) simple contingency management with target tasks, without organizational skills training, 2) time, and 3) repeat assessments. Treatment contrasts will examine children's 1) OTMP skills, 2) academic planning skills, 3) academic performance, 4) homework behaviors, 5) report card grades, 6) attitudes toward school and teachers, 7) family relationships, and 8) treatment satisfaction. It is predicted that OST will be superior to WL control and CM. We will evaluate children's long-term function, and hypothesize that at one-month follow-up, as well in the next grade, children provided with OST will demonstrate significantly better organizational skills compared to those who received CM. The impact of parents' ADHD symptomatology on their treatment implementation and child outcomes will be explored. If successful, the study will be a major advance in the treatment of children with ADHD, and provide the field with an intervention that addresses one of the more vexing clinical features of the disorder.