Comparing Efficacy of Interventions in Elementary School Children At-Risk for ADHD

• In Event: Poster Session 07
  In Poster Session: PS 07 Topic - Education, Schooling

Abstract

Early narrative comprehension predicts later reading achievement, but children demonstrating symptoms of Attention-Deficit Hyperactivity Disorder (ADHD) commonly exhibit several comprehension difficulties, including problems identifying and using goal structure in stories, making causal connections, and drawing appropriate inferences. These comprehension difficulties persist and often widen with age, relative to peers without such symptoms. Interventions are necessary to address these comprehension difficulties.
Comprehension of goal structure is important to creating a coherent narrative. Goal structure in stories includes events that motivate a character’s goal (Initiating events), the goal itself (G), attempts to achieve the goal (A), and outcomes of these attempts (O). Children with ADHD have difficulty understanding and maintaining goal structure in narratives, including fewer goal elements than typically developing peers in stories they create, narrate, or recall.
Self-efficacy, a domain-specific belief about one’s ability to complete a task, is associated with academic achievement. High but realistic levels of self-efficacy for a particular task enhance motivation and persistence. Children with ADHD symptoms often begin with an inflated sense of self-efficacy, but give up easily when asked to complete challenging tasks. However, successful experiences promote a more realistic sense of self-efficacy. Thus, developing a realistic, high sense of self-efficacy for academic tasks and social challenges in the classroom may promote success in children with symptoms of ADHD.
The current randomized controlled trials study compares the Narrative Structure (NS) intervention, a comprehension intervention developed to target the comprehension difficulties of children with symptoms of ADHD, to two counterfactuals; Reciprocal Teaching (RT), an alternative approach to improving comprehension that is not targeted at specific difficulties of children at-risk for ADHD; or Problem Solving (PS), which addresses social and emotional difficulties specific to the target population but does not focus on narrative comprehension. We will report preliminary evidence from five semesters of the project.
Participants were 3rd and 4th graders who exhibited elevated symptoms of inattention and hyperactivity (i.e., at-risk for ADHD) and difficulties with narrative comprehension. Students’ schools were randomly assigned to one of the three interventions. During each semester, up to 4 groups of 6 children per group were instructed at each school, with an average of 6 schools participating.
Children completed multi-measure pretests and posttests. Focal measures for the current report are: goal elements included in participant-generated stories; comprehension of goal elements; and intervention-relevant self-efficacy.
Children in the NS intervention correctly answered significantly more goal-related questions concerning their own stories relative to children in the RT and PS intervention conditions, respectively. Additionally, significant increases in self-efficacy were specific to the respective domains of instruction for students completing the NS and PS interventions, whereas students completing the RT intervention reported more general gains in their self-perceptions.
Thus, children who received instruction in narrative structure (NS intervention) improved their understanding of goal structure relative to children in the RT and PS interventions. Additionally, based on children’s own comments and those of their parents, reported increases in self-efficacy may be translating to increased interest, motivation, persistence, and reflective approaches to literacy and social problems.

Authors

• Elizabeth P Lorch, University of Kentucky
  Presenting Author

• Angela N Hayden, University of Kentucky
  Non-Presenting Author

• Janice F. Almasi, University of Kentucky
  Non-Presenting Author