3 - (SYM 22) Lessons and Questions from 20 Years of Research on Organization Training

Organization training (OT) is a well-established intervention for individuals with attention deficit hyperactivity disorder (ADHD). OT was developed as a school-based intervention for adolescents with ADHD and most of the literature focuses on this age group. Training approaches include a brief period of teaching followed by frequent practice with performance feedback over time. Skills that are trained should have direct utility in the individual’s daily lives and there may be advantages to OT that occur in settings similar to the one intended for use of the skill.

A review of multiple studies over twenty years of research evaluating OT higlights interesting patterns and raises important questions about the short and long-term outcomes of these training approaches. First, research suggest that the largest benefits of OT typically occur in the first dozen sessions followed by a flattening of responses. There appear to be benefits for completing these early sessions frequently (1 to 2 times per week) in order to achieve the maximum benefit. Evidence indicates that early gains in OT mediate the relationship between training and grades for an entire academic year for middle school students. Dosage is related to response; nevertheless, the value of extending OT beyond approximately a dozen sessions is unknown. The second point involves the finding that gains related to OT appear to persist for at least one year and some evidence related to benefits for some up to five years after training. Although these findings are mixed, the long-term persistence of benefits may be related to the value of extending OT past 12 sessions. Additional research is needed to adequately answer that issue. Third, there is also evidence that when sessions are inconsistent and less frequent than described above, meaningful gains may not be forthcoming. However, research also suggests that even when sessions are inconsistent and not as frequent as desired, if the training persists over multiple years then meaningful gains are realized. This raises important questions about the frequency and duration of OT as they relate to achieving meaningful benefit to individuals with ADHD.