Remediating organizational functioning in children with ADHD: Immediate and long-term effects from a randomized controlled trial.
Open accessAbstract
OBJECTIVE: The study compared the efficacy of 2 behavioral interventions to ameliorate organization, time management, and planning (OTMP) difficulties in 3rd- to 5th-grade children with attention-deficit/hyperactivity disorder (ADHD). METHOD: In a dual-site randomized controlled trial, 158 children were assigned to organizational skills training (OST; N = 64); PATHKO, a performance-based intervention that precluded skills training (N = 61); or a wait-list control (WL, N = 33). Treatments were 20 individual clinic-based sessions over 10-12 weeks. OST involved skills building provided primarily to the child. PATHKO trained parents and teachers to reinforce children contingently for meeting end-point target goals. Primary outcomes were the Children's Organizational Skills Scales (COSS-Parent, COSS-Teacher). Other relevant functional outcomes were assessed. Percentage of participants no longer meeting inclusion criteria for OTMP impairments informed on clinical significance. Assessments occurred at post-treatment, 1-month post-treatment, and twice in the following school year. RESULTS: OST was superior to WL on the COSS-P (Cohen's d = 2.77; p < .0001), COSS-T (d = 1.18; p < .0001), children's COSS self-ratings, academic performance and proficiency, homework, and family functioning. OST was significantly better than PATHKO only on the COSS-P (d = 0.63; p < .005). PATHKO was superior to WL on most outcomes but not on academic proficiency. Sixty percent of OST and PATHKO participants versus 3% of controls no longer met OTMP inclusion criteria. Significant maintenance effects were found for both treatments. CONCLUSIONS: Two distinct treatments targeting OTMP problems in children with ADHD generated robust, sustained functional improvements. The interventions show promise of clinical utility in children with ADHD and organizational deficits.
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More-focused approaches improve specific areas of daily functioning, such as social or organizational skills.
“More-focused approaches improve specific areas of daily functioning, such as social 200 or organizational skills 201 .”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [201]
Compared to children without the disorder, children with ADHD have more difficulties at school making schedules to finish assignments on time, executing complex planning tasks, organizing material needed for assignments, remembering task instructions, and setting priorities.
“Compared to children without the disorder, children with ADHD have more difficulties at school making schedules to finish assignments on time, executing complex planning tasks, organizing material needed for assignments, remembering task instructions, and setting priorities [6,7].”
Without proper interventions, functional impairments in time management, planning/organizing, and prosocial behavior skills often endure and escalate into adolescence and adulthood.
“Without proper interventions, functional impairments in the areas of time management, planning/organizing, and prosocial behavior skills often endure and escalate into adolescence and adulthood [6,7,11-14].”
Behavioral interventions developed to improve functional outcomes are effective but often time-consuming, costly, and not easily accessible to all children who might benefit.
“Behavioral interventions developed to improve these children’s functional outcomes, although effective [7,14,16], are often time-consuming, costly, and not easily accessible to all children who might benefit from them [17-19].”
After analysing the literature, there is an agreement about the efficiency of targeted face-to-face therapies focused on the enhancement of time management skills.
“After analysing the literature, it can be determined that there is an agreement about the efficiency of targeted face-to-face therapies focused on the enhancement of time management skills [46,47,48,49,50,51,52,53,54].”
From Adaptive Tele-Therapies Based on Serious Games for Health for People with Time-Management and Organisational Problems: Preliminary Results (2014) · cites this paper as [46]
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References 52 · Cited by 240
Research works printed but not linked: 6
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- Douglas VI Rutter M 1983 Attentional and cognitive problems Developmental neuropsychiatry 280 329 New York, NY Guilford Press
- Hinshaw SP Klein RG Abikoff H Nathan JMGPE 2007 Childhood Attention-Deficit/Hyperactivity Disorder: Nonpharmacologic treatments and their combination with medication A guide to treatments that work 3 3 27 New York, NY Oxford University Press
- Little RJA Rubin DB 2002 Statistical analysis with missing data 2 Hoboken, NJ J. Wiley & Sons Inc
- McMahon RJ Forehand RL 2003 Helping the noncompliant child 2 New York, NY Guilford Press
- Moos RH Moos BS 1994 Family Environment Scale Manual 3 Palo Alto, CA Consulting Psychologists Press
- Authors
- Abikoff, H., Gallagher, R., Wells, K. C., Murray, D. W., Huang, L., Lu, F., & Petkova, E.
- Affiliations
- NYU Langone Health (US)
- Duke Medical Center (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2013-02
- Volume
- 81
- Issue
- 1
- Pages
- 113-128
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC3549033
- OpenAlex
- W2109008111
- Cited by
- 240
- References
- 52
- Citations by year
- 2026: 15 · 2025: 17 · 2024: 18 · 2023: 14 · 2022: 16 · 2021: 19 · 2020: 11 · 2019: 14 · 2018: 18 · 2017: 21 · 2016: 25 · 2015: 18 · 2014: 21 · 2013: 11 · 2012: 1
- FWCI
- 11.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH074013)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- attention deficit hyperactivity disorder, organizational skills, time management, planning skills, behavioral interventions, teacher and parent training, contingent reinforcement, maintenance therapy, children, academic performance, homework completion, family functioning
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Behavior Therapy, Child, Educational Status, Family, Female, Humans, Male, Parents, Time, Treatment Outcome, Time Management
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