3 - (SYM 80) Postsecondary Outcomes of a School-based Intervention for Adolescents with ADHD

Many individuals with ADHD experience persistent symptoms and impairment into adulthood, including reduced educational and occupational attainment, and increased substance use (Barkley et al., 2008). These outcomes represent a continuum of a problematic developmental trajectory for youth with ADHD (Becker, 2020), suggesting effective intervention during adolescence may deter against such progression. The current study examined the degree to which effects of a multi-component training intervention for high school students with ADHD (the Challenging Horizons Program; CHP) endure as youth enter emerging adulthood. Adolescents with ADHD (N = 186) were randomized to community control or the CHP. A subgroup (n = 73) of participants were followed into emerging adulthood (M_age=20.9; SD=1.1 years; 4-7 year follow-up) and provided self-report of postsecondary educational outcomes, occupational functioning, and alcohol and substance use. The 39% of participants retained differed from the original sample on just 3 of 15 measured characteristics (i.e., ODD diagnosis, gender, ethnicity). Chi-square and t-test analyses examining educational and occupational outcomes among CHP and CC participants revealed no statistically significant differences. However, trends were identified such that CHP participants reported longer periods at jobs, reduced frequency of being fired, and higher levels of postsecondary educational attainment than community control participants. Latent growth curve modeling revealed no effects of treatment on substance use, but significant effects on alcohol use. Contrary to expectations, treatment was associated with worse alcohol use problems among those who drank alcohol (β = .84), beyond effects of baseline alcohol use, age, gender, or ODD diagnosis. CHP participants were more likely than control participants to meet criteria for WHO-defined risky drinking (22% vs. 5%). Long-term effects of the CHP on occupational and educational outcomes are promising yet may be accompanied by problematic effects on alcohol use. These findings help inform treatment decision-making as providers and families consider benefits, challenges, and long-term impacts for youth.