Parameters of Adherence to a Yearlong Daily Report Card Intervention for Students With Attention-Deficit/Hyperactivity Disorder

Abstract

Given that attention-deficit/hyperactivity disorder (ADHD) is a chronic disorder, which is likely to require sustained treatment, investigations of the adherence to long-term treatments are clearly needed. The current project is the first analysis examining the parameters of adherence to a daily report card (DRC) intervention over the course of an academic school year. To gain a greater understanding of the complexities inherent in long-term treatment implementation, parameters of adherence with respect to specific, setting-related criteria (i.e., month of the school year, day of the week, and consultant contact) were examined. Participants were 33 children enrolled in first through sixth grade. All participants were diagnosed with ADHD (85% were diagnosed with comorbid oppositional defiant disorder or conduct disorder), received special education services, and were assigned to an intervention condition wherein behavioral consultants worked with the teacher and parent to construct and implement a DRC intervention. Overall, results provide preliminary support for the utility of the DRC as a sustainable intervention for the duration of an entire school year. Although rates of adherence were relatively stable, a fine-grained examination indicated variability in adherence across days of the week and around behavioral consultation meetings. These results contribute to the research literature supporting the utility of continued behavioral support to enhance treatment adherence.

Notes

note: Dr. Fabiano is a co-author of the book entitled, “Daily Behavior Report Cards: An Evidence-based System of Assessment and Intervention” and he receives royalties from the Guilford Press. The co-authors reported no financial conflicts of interest disclosures or any other interests that may have influenced the writing of this manuscript or the conduct of the research.

^aRates of teacher adherence on Fridays were significantly lower than Mondays, d = .45.

^bRates of teacher adherence on Fridays were significantly lower than Tuesdays, d = .49.

^cRates of teacher adherence on Fridays were significantly lower than Wednesdays, d = .38.

^dRates of teacher adherence on Fridays were significantly lower than Thursdays, d = .36.

^aSubsequent pairwise comparisons reveal that rates of adherence were significantly higher the day after the consultation visit compared with the day before the consultation visit, d = .30.