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Remediating organizational functioning in children with ADHD: immediate and long-term effects from a randomized
Howard Abikoff1, Richard Gallagher, Karen C Wells
1Department of Child and Adolescent Psychiatry, New York University Langone Medical Center. howard.abikoff@nyumc.org
Journal of Consulting and Clinical Psychology
|August 15, 2012
Summary
Organizational Skills Training (OST) and PATHKO interventions significantly improved organization, time management, and planning (OTMP) in children with ADHD. Both treatments led to sustained functional gains and reduced OTMP impairments.
Area of Science:
- Child Psychology
- Behavioral Interventions
- Neurodevelopmental Disorders
Background:
- Children with ADHD often experience significant difficulties with organization, time management, and planning (OTMP).
- These OTMP deficits can negatively impact academic performance, family functioning, and overall quality of life.
- Effective interventions are crucial for supporting children with ADHD and ameliorating these challenges.
Purpose of the Study:
- To compare the efficacy of two distinct behavioral interventions: organizational skills training (OST) and PATHKO.
- To evaluate the impact of these interventions on OTMP difficulties in 3rd- to 5th-grade children diagnosed with ADHD.
- To assess the sustained functional improvements and clinical significance of the interventions.
Main Methods:
- A dual-site randomized controlled trial involving 158 children with ADHD.
- Participants were assigned to OST, PATHKO, or a wait-list control group.
- Interventions consisted of 20 clinic-based sessions over 10-12 weeks, with assessments at multiple time points.
Main Results:
- Organizational Skills Training (OST) demonstrated superiority over the wait-list control across multiple domains, including parent and teacher ratings of organizational skills, academic performance, and family functioning.
- OST was also significantly better than PATHKO on parent-reported organizational skills.
- Both OST and PATHKO showed robust and sustained improvements, with a high percentage of participants no longer meeting OTMP impairment criteria compared to controls.
Conclusions:
- Two distinct behavioral interventions, OST and PATHKO, effectively address OTMP problems in children with ADHD.
- These interventions yield significant and lasting functional improvements, demonstrating considerable clinical utility.
- The findings support the use of targeted behavioral strategies for managing organizational deficits in pediatric ADHD.
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