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School-based organizational skills training for upper elementary students: Subgroup and mediating effects
Thomas J Power1, Jennifer A Mautone1, Howard Abikoff2
1Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 8(th) Floor, 2716 South St., Philadelphia, PA 19146, United States of America; Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, United States of America.
Abstract:
This study examines for whom and how Organizational Skills Training-Tier 2 (OST-T2, Nissley-Tsiopinis et al., 2024) works for students in grades 3 to 5 with organization, time management, and planning (OTMP) difficulties. The study: (1) investigates subgroup differences for the effect of OST-T2 on student homework and academic performance at post-intervention (about 14 weeks), short-term (about 22 weeks) and long-term follow-up (about 55 weeks); and (2) examines whether improvements in student OTMP skills at 14 weeks mediate the effect of OST-T2 on academic and homework performance at 22 weeks. The study used a cluster-randomized design with 22 schools; 182 students in moderation analyses and 133 in mediation analyses. Subgroup-defining variables were: (a) likely diagnosis of ADHD, (b) caregiver-reported child anxiety, (c) severity of baseline OTMP and homework problems, and (d) family socioeconomic level. Findings suggested that OST-T2 is more effective among children with higher anxiety levels as reported by caregivers. The difference in change scores between the high and low anxiety groups on the caregiver-rated metric of OTMP and homework problems was -0.76 (Cohen's d) at post-treatment (95% CI = -0.12, -1.21, p = .021), -0.66 at 22 weeks (95% CI = -0.08, -1.09, p = .017), and - 0.55 at 55 weeks (95% CI = -0.07, -1.03, p = .026). The analyses generally did not detect subgroup effects based on ADHD diagnostic status and families differing in socioeconomic levels. Results also suggested improvements in OTMP skills in response to OST-T2 are likely to signal downstream impact on student homework performance; estimated average causal mediation effect was -0.66 (95% CI = -1.27, -0.19, p < .001), whereas the average direct effect was only -0.07. Additional longitudinal research with larger samples on predefined subgroups is needed.
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