Academic journal article School Psychology Review

Preventing Failure among Middle School Students with Attention Deficit Hyperactivity Disorder: A Survival Analysis

Academic journal article School Psychology Review

Preventing Failure among Middle School Students with Attention Deficit Hyperactivity Disorder: A Survival Analysis

Article excerpt

Abstract. Middle school students with attention deficit hyperactivity disorder ADHD) often experience academic decline within each school year, characterized by deteriorating grades from the first grading period to the last. This study reexamines whether the Challenging Horizons Program--Consultation Model (CHP-C) effectively reduces or delays academic failure. Report card data for two groups of students with ADHD--one that received the CHP-C and a control group that did not--were compared on whether and when grade point averages fell below passing. Results suggest that the CHP-C significantly reduced or delayed the onset of failure experiences in both sixth and seventh grades, even after the influence of student IQ was held constant. Practical implications of these findings are discussed.


Attention deficit hyperactivity disorder (ADHD) has been widely discussed in the professional literature, and it is estimated that more than 6,000 peer-reviewed articles have been devoted to the topic (Barkley, 2006, p. 76). Based on this extensive research base, ADHD is now recognized as a chronic disorder that often causes academic impairments that persist from elementary school into secondary school and beyond (American Psychiatric Association, 2000). However, little treatment research has focused exclusively on secondary school students with ADHD (Wolraich et al., 2005) and, as a result, little is known about the effectiveness of psychosocial interventions in addressing academic impairment in this population.

When examining academic impairment, researchers have relied on various measurement strategies. Recent reviews of the treatment literature suggest that the most commonly used indicators are student performance on standardized achievement tests, student performance on curriculum-based measurements (e.g., words read correctly per minute), and teacher rating scales (Raggi & Chronis, 2006; Trout, Lienemann, Reid, & Epstein, 2007). To a lesser extent, "universal measures" of school performance--including report cards, absenteeism, and suspensions or expulsions--have also been used for this purpose (Mattison, 2004, p. 359). Research examining universal measures has shown that, when compared to their peers, students with ADHD experience higher rates of suspensions, expulsions, and school dropout, as well as poorer report card performance and a reduced likelihood of post-secondary education (e.g., Barkley, Anastopoulos, Guevremont, & Fletcher, 1991; Klein & Mannuzza, 1991).

Among universal measures of academic outcomes, traditional A-F grading systems (hereafter referred to as "grades") are particularly appealing for research purposes because their widespread use and familiarity imparts face validity (Evans, Langberg, Raggi, Allen, & Buvinger, 2005). Moreover, evidence suggests that grades are a valid measure of academic impairment. For example, in a sample of middle school students in a special education setting, Mattison (2004) found that average grades (i.e., grade point average [GPA]) correlated more strongly with teacher ratings of student psychopathology than did other universal measures (e.g., disciplinary referrals, absences). In particular, a significant proportion (up to 25%) of the variance in grades was explained by teacher ratings of inattention and oppositional behaviors. Molina, Smith, and Pelham (2001) found similar relationships within a sample of middle school children in a general education setting and in another sample of children participating in a prospective study of ADHD. Specifically, findings from both samples suggested that teacher ratings of inattention and defiant behavior were significantly correlated with GPA. Molina and colleagues suggest that this relationship provides evidence for the ecological validity of GPA as a measure of ADHD-related academic impairment (p. 79).

However, grades are difficult to interpret because there are rarely objective measurement criteria across classrooms, teachers generally lack instruction in principles of measurement to consistently make valid judgments, and single-letter grades oversimplify student performances on myriad tasks (Allen, 2005). …

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