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School-Based Interventions for Students With Attention Deficit Hyperactivity Disorder: Research Implications and Prospects

This series of articles devoted to schoolbased interventions for students with attention deficit hyperactivity disorder (ADHD) addresses issues that are central to the treatment of this disorder. ADHD has been one of the most extensively investigated mental conditions of childhood. Still, important questions regarding the extent of treatment effectiveness remain unanswered. Research has principally evaluated treatment effects in terms of symptom reduction. However, it is the dysfunction evident in school behavior and performance that typically triggers a clinical referral and leads to a diagnosis of ADHD. Thus, it seems logical that the level of functioning in school be considered a critical outcome variable when assessing treatment effects. Although one might assume that beneficial changes in symptoms, such as reduction in disruptive behavior and increases in attention, will translate downstream into better overall school performance, it has been difficult to demonstrate effects of treatment of ADHD on academic performance (MTA Collaborative Group 1999; DuPaul et al., 2006). As DuPaul (2007) notes, the relation between ADHD symptoms and academic performance is complex. Treatment research that includes both indices of ADHD symptoms and ecologically valid measures of functioning allows for testing hypotheses regarding the relation among these variables and therefore has the potential to identify mediators through which treatment may affect academic achievement. Understanding these treatment pathways may lead to a more effective use of existing interventions and to the development of novel, more effective approaches. Moreover, ADHD not only has proximal detrimental effects on classroom deportment (i.e., teacher–student and peer relationships, disruptive classroom behavior) and academic achievement (i.e., assignment completion, grades on academic subjects), but also raises