This study evaluated the efficacy of the Child Life and Attention Skills (CLAS) program, a behavioral psychosocial treatment integrated across home and school, for youth with attention-deficit/hyperactivity disorder-inattentive type (ADHD-I). In a 2-site randomized controlled trial, 199 children (ages 7-11 years) were randomized to CLAS (N = 74), parent-focused treatment (PFT, N = 74), or treatment as usual (TAU, N = 51). We compared groups on parent and teacher ratings of inattention symptoms, organizational skills, social skills, and global improvement at posttreatment and also at follow-up during the subsequent school year. CLAS resulted in greater improvements in teacher-reported inattention, organizational skills, social skills, and global functioning relative to both PFT and TAU at posttreatment. Parents of children in CLAS reported greater improvement in organizational skills than PFT and greater improvements on all outcomes relative to TAU at posttreatment. Differences between CLAS and TAU were maintained at follow-up for most parent-reported measures but were not significant for teacher-reported outcomes. These findings extend support for CLAS across 2 study sites, revealing that integrating parent, teacher, and child treatment components, specifically adapted for ADHD-I, is superior to parent training alone and to usual care. Direct involvement of teachers and children in CLAS appears to amplify effects at school and home and underscores the importance of coordinating parent, teacher, and child treatment components for cross-setting effects on symptoms and impairment associated with ADHD-I.

Objective This study aimed to identify children’s long-term placement trajectories following early child welfare involvement and the association of these trajectories with subsequent physical and behavioral well-being. Method Participants were 330 children who entered out-of-home care following a substantiated report of child abuse or neglect during infancy/early childhood and their caregivers. Participants were interviewed at child ages 4 and 12 years to assess children’s physical and behavioral well-being and every 2 years in between to determine child placements. Results Latent Class Analyses identified four stable placement trajectories (i.e., adopted [32%], kinship care [15%], stable reunified [27%], and stable foster care [9%]), and two unstable trajectories (i.e., disrupted reunified [12%] and unstable foster care [5%]). Logistic regressions revealed that children in the unstable trajectories had significantly poorer physical and behavioral well-being than children in stable trajectories. Conclusions and Relevance Maltreated children placed in out-of-home care are at risk for long-term placement instability and poorer physical and behavioral well-being.

This study evaluated educationally relevant outcomes from a newly developed collaborative school-home intervention (Collaborative Life Skills Program [CLS]) for youth with attention and/or behavior problems. Participants included 17 girls and 40 boys in second through fifth grades (mean age = 8.1 years) from diverse ethnic backgrounds. CLS was implemented by 10 school-based mental health professionals at their schools and included 3 integrated components over 12 weeks: group behavioral parent training, classroom behavioral intervention, and a child social and independence skills group. Parent and teacher ratings of attention-deficit/hyperactivity disorder (ADHD) symptoms, organizational skills, and homework problems, and teacher-rated academic skills, report card grades, academic achievement, and classroom observations of student engagement were measured before and after treatment. Significant pre-post improvement was found for all measures, with large effect sizes for ADHD symptoms, organizational skills, and homework problems, and medium to large effects for teacher-rated academic skills, report card grades, academic achievement, and student engagement. Improvements in organizational skills mediated the relationship between improvement in ADHD symptoms and academic skills. Significant improvement in both ratings and objective measures (achievement testing, report cards, classroom observations) suggests that improvement exceeded what might be accounted for by expectancy or passage of time. Findings support the focus of CLS on both ADHD symptom reduction and organizational skill improvement and support the feasibility of a model which utilizes school-based mental health professionals as providers.