2 - (SYM 80) School-based Intervention for Adolescents with ADHD: Predictors of Effects on Academic, Behavioral, and Social Functioning

Adolescents with attention-deficit/hyperactivity disorder (ADHD) experience significant academic, behavioral, and social skill difficulties including underachievement, risk for school drop-out, poor peer relations, and emotion dysregulation. Although stimulant medication reduces ADHD symptoms, psychosocial and educational interventions are necessary to address functional impairments. We examined the nature and predictors of academic, behavioral, and social skills trajectories in response to the Challenging Horizons Program (CHP), a multi-component organizational skills training program, in 92 high school students with ADHD. To identify latent trajectory classes for each outcome measure, we conducted three series of unconditional models that differed in growth factor variance (i.e., random vs. fixed at 0, first for slopes and then for intercepts); each series with one, two, and three latent classes with intercepts set at pre-treatment. Subsequently, using the 3-step (R3Step) approach (Asparouhov & Muthén, 2014, 2021), covariates (i.e., predictors) were added to the best fitting unconditional model, one per time given the N, to examine their relationship with latent class membership. Latent trajectory class analyses revealed positive treatment response ranging from 61.5% (report card grades) to 100% (inattention symptoms, organizational skills, social skills). Organizational skill and academic grade treatment response trajectories were predicted by pre-treatment anxiety, treatment dosage, and sex with steeper improvement among females with ADHD. Improvement in behavioral and social functioning was associated with better emotion regulation and family relations prior to treatment along with stronger working alliance with treatment coach at mid-treatment. Socioeconomic factors did not predict adolescent trajectories. Multicomponent organizational skills training appears effective for most high school students with ADHD and the degree of treatment-induced change is associated with multiple malleable factors that can be leveraged to enhance intervention response.