Organizational Skills Treatment for ADHD Children

描述（由申请人提供）：组织、时间管理和计划（OTMP）技能缺陷是注意力缺陷/多动障碍（ADHD）的严重损害特征，会影响学习成绩和家庭关系。在治疗多动症儿童的OTMP缺陷方面进展甚微。通过R21基金，我们开展了一项旨在治疗多动症儿童组织技能缺陷的研究项目。为此，我们：1)制定了量化多动症儿童OTMP缺陷的评估，2)制定了一个为期10周，20次的手动组织技能培训（OST）计划，旨在针对儿童的特定OTMP缺陷，3)进行了一项试点研究，以估计这种新型干预措施的效果。我们的开放式试点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进行更大规模的干预试验提供了基础。

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.