1 - (SYM 55) Organizational Skills Training for Upper Elementary Students: Heterogeneity of Treatment Effect

Organization, time management, and planning (OTMP) skills have been shown to predict academic achievement in later grades. Research supports the efficacy of interventions to improve OTMP skills  (Evans et al., 2018); most research focuses on children with ADHD in middle school.

The Organizational Skills Training (OST) program was designed for students in grades 3 to 5 with ADHD. OST is a clinic-based child skills training intervention that involves parents and teachers. A large-scale RCT demonstrated that OST reduced OTMP deficits and improved homework and academic performance relative to the control group with gains sustained into the next school year (Abikoff et al., 2013) .

Questions have been raised about the accessibility of OST, as it was offered in a clinic by highly trained clinicians. To extend its reach, OST was adapted as a small-group intervention implemented in schools by school professionals for students with OTMP deficits regardless of ADHD diagnosis. The adapted program is consistent with a Tier 2 program within the multi-tiered system of support framework often used in schools (OST-T2). In a recent RCT, OST-T2 was effective in improving students’ OTMP skills (large effects) and homework performance (medium effects; masked for review). Small effects on academic performance were noted. There was a general attenuation of effects the following school year.

This study examines how subgroups of students respond to OST-T2. First, based on research that family socioeconomic status (SES) may moderate intervention response, our team is examining SES in subgroup analyses. Second, OST-T2 is unique in targeting students with OTMP problems regardless of ADHD status. This study explores whether the effects of OST-T2 are comparable for students with and without ADHD. Third, research on children with ADHD has shown that those with elevated anxiety may respond better to behavioral interventions than those with lower anxiety. Thus, it is important to examine whether elevated anxiety among children with OTMP challenges affects treatment response.  

Preliminary findings indicate there are differences in changes in students’ OTMP skills at 12-month follow-up, but not post-treatment, for students in the high vs. low SES subgroups; students with lower SES have more difficulty maintaining effects. The findings also suggest children with and without ADHD respond similarly to OST-T2 at post-treatment and 5-month follow-up.  The presentation will describe additional findings from subgroup analyses and identify research and practice implications.