The Effect of Weighted Vests and Stability Balls With and Without Psychostimulant Medication on Classroom Outcomes for Children With ADHD

Abstract

Current evidence-based, school-based interventions for children with attention deficit hyperactivity disorder (ADHD) include academic intervention, behavioral classroom management, and psychopharmacological intervention. However, some approaches that are commonly used have not been studied in controlled evaluations. The current study is the first rigorous evaluation of the effect of occupational therapy (OT) weighted vests and stability balls on classroom behavior and academic productivity in elementary-age children with ADHD (N = 64). The effect of psychostimulant medication and its combination with each of the OT interventions on classroom outcomes was also examined. The study consisted of a 2 (medication: methylphenidate, placebo) × 3 (OT intervention: stability ball, weighted vest, control) within-subjects design and was conducted over a 6-week period in a weekday, 60-min summer classroom. OT intervention was randomized daily within a medication crossover design. Overall, results indicated that medication but not weighted vest nor stability ball interventions resulted in improvement in two key areas of functioning in school settings: following classroom rules and academic productivity.

Keywords:

• ADHD
• psychopharmacology
• intervention
• classroom

AUTHOR BIOGRAPHICAL STATEMENTS

Fiona L. Macphee earned her BA from New York University and her MS from Florida International University. She is currently a doctoral candidate in the Clinical Science in Child and Adolescent Psychology program at Florida International University. She is working under the mentorship of Dr. William E. Pelham, and her research focuses on multimodal treatment for children with ADHD.

Brittany M. Merrill earned her BA from DePaul University and her MS from Florida International University. She is currently a doctoral candidate at Florida International University in the Clinical Science in Child and Adolescent Psychology program under the mentorship of Dr. William E. Pelham. Her research focuses on childhood ADHD and is primarily concerned with investigating underlying mechanisms of attention problems, combined treatment efficacy, and long-term outcomes among children with ADHD.

Amy R. Altszuler earned her BA in Psychology from University of Miami and her MS from Florida International University. She is currently a research associate at the Center for Children and Families at Florida International University. Her research focuses on multimodal intervention for youth with ADHD.

Marcela C. Ramos earned her BA from and is currently a doctoral student in the Clinical Science Program in Child and Adolescent Psychology at Florida International University. She is interested in working with children and adolescents with ADHD. Under the mentorship of Dr. William E. Pelham, Marcela's research has focused on examining classroom interventions for children with ADHD.

Elizabeth M. Gnagy has a BS from Westminster College. She is a research scientist at the Center for Children and Families at Florida International University. She has been a project coordinator for many investigations of treatment for ADHD in children and adolescents and their long-term outcomes.

Andrew R. Greiner has a BS in psychology from the University of Pittsburgh. He is a research scientist at the Center for Children and Families at Florida International University. He has coordinated summer treatment program training sessions for more than 20 agencies and studies. His research interests include evidence-based treatments for children with ADHD, assessment of treatment integrity and fidelity, and behavior observation coding systems.

Stefany Coxe earned her PhD from Arizona State University. She is an associate professor of quantitative psychology at Florida International University. Her research focuses on evaluating and applying advanced statistical methods to behavioral data. Her quantitative research focuses on the generalized linear model for nonnormal outcome variables, including selecting appropriate models for novel outcome variables and estimating measures of effect size, as well as statistical graphics as a tool for communication. Her applied research largely involves clinical and psychosocial interventions related to ADHD in children and adolescents, toddler mental health, and child mental health adjustment following traumatic events.

Joseph S. Raiker received his BS and MS in psychology and his PhD in clinical psychology from the University of Central Florida. He is an assistant professor of psychology at Florida International University and director of the Program for Attention, Learning, and Memory (PALM). His research focuses on leveraging our emerging understanding of neurocognitive deficits in children with ADHD to improve treatment of youth with the disorder.

Erika Coles earned her BA and MA in psychology and her PhD in clinical psychology from the University at Buffalo, State University of New York. Dr. Coles's research interests include increasing the effectiveness of behavioral interventions for the treatment of ADHD, particularly in the school setting. Specifically, Dr. Coles is developing and examining the feasibility of a multicomponent consultation intervention to enhance teacher integrity and student outcomes in the context of a DRC intervention for students with ADHD. The multicomponent consultation intervention addresses teacher knowledge, attitudes, and skills, as each of these factors can serve as a barrier to high integrity and each has been identified as relevant to the development of adult competencies.

Lisa Burger earned her MS in diagnostic teaching from Florida International University, as well as national board certification as an exceptional needs specialist for early childhood through young adulthood. She is the classroom coordinator for the STP focused on classroom interventions for children and adolescents with ADHD through Florida International University's Center for Children and Families. During the school year, she is a teacher of special education at Nicklaus Children's Hospital and lead teacher for the Project Victory program, which provides students opportunities to practice real-time employability skills in cooperation with businesses throughout Miami-Dade County.

William E. Pelham earned his PhD from Stoneybrook University. He is a distinguished professor of psychology and psychiatry and the director of the Center for Children and Families at Florida International University. He is a University at Buffalo and State University of New York Distinguished Professor Emeritus of Psychology and an adjunct professor of psychiatry at Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine. His research focuses on the treatment, development, and evaluation of ADHD in children and adolescents. His research has revealed critical findings about effective dosing and sequencing in behavioral, pharmacological, and combined interventions. Dr. Pelham created the nationally acclaimed summer treatment program in 1980, which is widely recognized as the state of the art in the treatment of children with ADHD and related behavioral, emotional, or learning challenges.