Try a new search

Format these results:

Searched for:



Total Results:


Adult ADHD: Psychosocial Treatment Components and Efficacy Status

Gallagher, Richard; Feder, Michael A.
Psychosocial treatments for attention-deficit/hyperactivity dis- order (ADHD) in adults and emerging adults have developed to address core symptoms of ADHD (hyperactivity, impulsivity, and inattention) and associated functional impairments. These psychosocial treatments have been developed to enhance the effect of medication treatments. Evidence-based psychosocial treatments teach patients skills in organization, time management, and planning by using a cognitive-behavioral framework. The latest version of these programs also teaches mindfulness skills, so patients learn to think critically before acting impulsively. Cognitive components to address maladaptive thoughts found in ADHD and associated patterns found in comorbid anxiety and depression facilitate mental health. Research indicates that these skill-based programs lead to significant changes including reductions in core symptoms, improved executive functioning, and reduced functional impairments. This article reviews the findings from meta-analyses and details treatment targets and treatment components contained in efficacious interventions.
ISSN: 0048-5713
CID: 3694492

The organized child : an effective program to maximize your kid's potential-- in school and in life

Gallagher, Richard; Spira, Elana G; Rosenblatt, Jennifer
New York, NY : The Guilford Press, [2018]
Extent: x, 206 p. ; 26 cm
ISBN: 9781462533213
CID: 3122322

An initial investigation of brain functional reorganization following organizational skills training in children with attention-deficit/ hyperactivity disorder [Meeting Abstract]

Chen, B; Somandepalli, K; Abikoff, H B; Gallagher, R; Di, Bartolo C; Stanislawski, E; Petkova, E; Milham, M P; Castellanos, F X; DiMartino, A
Objectives: Organizational Skills Training (OST), is a 10-week psychosocial intervention found effective in improving organizational, time management, and planning (OTMP) skills in children with Attention-Deficit/Hyperactivity Disorder (ADHD). Little is known about the feasibility of identifying brain markers for treatment response. Using resting state fMRI (R-fMRI), we aimed to examine neuronal correlates of post-treatment change as a first step toward larger controlled studies of objective predictors of treatment response. Methods: We examined pre- and post-OST R-fMRI data of 15 children (12 males; mean age: 9+/-1 year) with ADHD and significant impairments in OTMP skills indexed by total scores on Children's Organizational Skills Scales-Parent (COSS-P) or Teacher (COSS-T). Our primary outcome measure was the change in COSS-P scores. As secondary summary outcome measure, we used prepost Z-score differences averaged across COSS-T, Homework Problems Checklist, Academic Progress Report and Academic Performance Rating scales. We selected a priori the intrinsic functional connectivity (iFC) of the dorsal anterior cingulate cortex (dACC), based on its role on cognitive control. Multivariate distance matrix regression (MDMR) analysis additionally allowed for whole-brain explorations. Follow-up iFC analyses were conducted on regions with significant within-subject post-OST differences by MDMR analysis. Results: COSS-P decreased significantly (t=7.1, p< 0.0001). In a cluster involving striatum bilaterally, dACC iFC decreased post-OST; these decreases were positively correlated with COSS-P improvements (r=.34, NS) and to improvements in the summary outcome (r=.63; p<0.03). MDMR analyses revealed iFC changes in the right medial and lateral precentral cortex. Followup seed-based iFC analyses of this region showed significant decreases in cortico-striatal iFC post-OST. Conclusions: Results support the feasibility of identifying changes in brain iFC after OST. Two distinct analysis converged on decreased corticosubcortical iFC post-treatment which related to change in clinical measures. As decreases in striato-cortical iFC characterize typical development, results suggest regionally-specific enhanced maturational effects of OST
ISSN: 1527-5418
CID: 2401582

Is there an overlap in organizational skills impairment among children with autism spectrum disorder and attention deficit/ hyperactivity disorder? [Meeting Abstract]

Roth, M E; Stanislawski, E; Doggett, R; Di, Bartolo C; Gallagher, R; Abikoff, H B; Di, Martino A
Objectives: Organization, time management, and planning (OTMP) difficulties have an impact on a substantial proportion (~50 percent) of children with ADHD, and they improve with behavioral intervention. Given symptomatic overlap between ASD and ADHD, children with ASD may also experience OTMP impairments. To date, examinations of this domain in ASD are missing. Objectives include the following: 1) to characterize the nature and extent of OTMP deficits in children with ASD and identify rates of ADHD comorbidity in children with ASD with and without OTMP impairments (ASD+, ASD-, respectively); and 2) to identify similarities and differences between the ASD+ and ASD- subgroups and children with ADHD and OTMP impairments (ADHD+). Methods: We examined data (N = 85) of children aged 8-13 years with DSM-IV-TR diagnoses of ASD (n = 35) or ADHD (n = 31), as well as typically developing children (TDC) (n = 19). ANOVA compared the groups on parent scores on the Children's Organizational Skills Scale (COSS-P) and the subgroups on ASD traits, ADHD traits, and executive functions (ratings on the Social Responsiveness Scale, Conners' Parent Rating Scale, and Behavior Rating Inventory of Executive Functions). A threshold for significance was set at P = 0.01. Results: Children with ASD and ADHD had higher (i.e., more severe) COSS-P Total T scores than TDC. Forty-two percent of the children with ASD were ASD+ (i.e., COSS-P Total T >65), and 47 percent were categorized as ADHD+. Eighty-seven percent of the ASD+ had comorbid ADHD per clinician's interview, in contrast with only 27 percent of the ASD- subgroup. The severity of ADHD traits and executive dysfunction was no different between ASD+ and ADHD+ groups. In contrast, ASD- children had significantly lower ratings of ADHD and executive function severity than children with OTMP deficits. It is noteworthy that the ASD+ and ASD- groups differed in ASD ratings. Results were replicated with a second, independent sample group (N = 150). Conclusions: A substantial proportion of children with ASD exhibited OTMP functional impairment difficulties, which accompanied other symptoms typically observed in ADHD. Given the availability of evidence-based interventions for OTMP impairments in ADHD, adaptations of this intervention for this population may be warranted
ISSN: 1527-5418
CID: 2401502

Organizational skills training for children with ADHD : an empirically supported treatment

Gallagher, Richard; Abikoff, Howard B; Spira, Elana G
New York : The Guilford Press, 2014
ISBN: 1462513689
CID: 2414352

Remediating organizational functioning in children with ADHD: Immediate and long-term effects from a randomized controlled trial

Abikoff, Howard; Gallagher, Richard; Wells, Karen C; Murray, Desiree W; Huang, Lei; Lu, Feihan; Petkova, Eva
Objective: The study compared the efficacy of 2 behavioral interventions to ameliorate organization, time management, and planning (OTMP) difficulties in 3rd- to 5th-grade children with attention-deficit/hyperactivity disorder (ADHD). Method: In a dual-site randomized controlled trial, 158 children were assigned to organizational skills training (OST; N = 64); PATHKO, a performance-based intervention that precluded skills training (N = 61); or a wait-list control (WL, N = 33). Treatments were 20 individual clinic-based sessions over 10-12 weeks. OST involved skills building provided primarily to the child. PATHKO trained parents and teachers to reinforce children contingently for meeting end-point target goals. Primary outcomes were the Children's Organizational Skills Scales (COSS-Parent, COSS-Teacher). Other relevant functional outcomes were assessed. Percentage of participants no longer meeting inclusion criteria for OTMP impairments informed on clinical significance. Assessments occurred at post-treatment, 1-month post-treatment, and twice in the following school year. Results: OST was superior to WL on the COSS-P (Cohen's d = 2.77; p < .0001), COSS-T (d = 1.18; p < .0001), children's COSS self-ratings, academic performance and proficiency, homework, and family functioning. OST was significantly better than PATHKO only on the COSS-P (d = 0.63; p < .005). PATHKO was superior to WL on most outcomes but not on academic proficiency. Sixty percent of OST and PATHKO participants versus 3% of controls no longer met OTMP inclusion criteria. Significant maintenance effects were found for both treatments. Conclusions: Two distinct treatments targeting OTMP problems in children with ADHD generated robust, sustained functional improvements. The interventions show promise of clinical utility in children with ADHD and organizational deficits. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
PMID: 22889336
ISSN: 0022-006x
CID: 217752

Attention-deficit/hyperactivity disorder predominantly inattentive type

Chapter by: Gallagher, Richard; Rosenblatt, Jennifer L
in: Neuropsychological assessment and intervention for youth: An evidence-based approach to emotional and behavioral disorders by Reddy, Linda A; Weissman, Adam S; Hale, James B [Eds]
Washington, DC : American Psychological Association; US, 2013
pp. 155-176
ISBN: 1-4338-1266-5
CID: 264212

Engaging adolescents with disruptive behavior disorders in therapeutic change

Chapter by: Gallagher, Richard; Kurtz, Steven; Blackwell, Sasha Collins
in: Elusive alliance: Treatment engagement strategies with high-risk adolescents by Castro-Blanco, David; Karver, Marc S. [Eds]
Washington, DC : American Psychological Association, 2010
pp. 77-81
ISBN: 1-4338-0811-0
CID: 5324

Effective methods to improve recruitment and retention in school-based substance use prevention studies

Bruzzese, Jean-Marie; Gallagher, Richard; McCann-Doyle, Sharon; Reiss, Philip T; Wijetunga, Neil A
BACKGROUND: Poor recruitment and high attrition may invalidate results of research studies. This paper describes successful recruitment and retention strategies in a school-based substance use prevention trial and explores factors associated with intervention attendance and retention. METHODS: A total of 384 parent-child dyads from 15 schools in the New York Metropolitan area participated in a control trial, testing the efficacy of parent-training to prevent youth substance use. Assessments were completed immediately post-intervention and 6-, 12-, and 24-month postintervention. Logistic regression analyses were used to determine which familial and study characteristics predicted attendance in the intervention and retention by parents and youth. RESULTS: 84% of intervention parents attended 4 of the 5 workshops; 83% of control parents attended their single workshop. Intervention attendance was predicted by parent job status, but this was not significant after controlling for other family factors. Retention rates ranged from 87% to 91% over the 2 years. No family characteristics predicted retention, but time since baseline and attendance at treatment workshops and the control workshop did. For children, age at baseline and ethnicity predicted retention, but this did not remain significant in the adjusted model. CONCLUSION: Intervention attendance was high and retention rates far exceeded the minimum standard of 70% retention in behavioral studies. Recruitment and retention strategies were effective for different family constellations. Efforts to maximize participation in both treatment and control interventions are critical to retention in longitudinal trials
PMID: 19691714
ISSN: 1746-1561
CID: 101650

Effects of MPH-OROS on the Organizational, Time Management, and Planning Behaviors of Children With ADHD

Abikoff, Howard; Nissley-Tsiopinis, Jenelle; Gallagher, Richard; Zambenedetti, Maurizio; Seyffert, Michael; Boorady, Roy; McCarthy, John
OBJECTIVE:: To evaluate the effects of stimulant medication on organizational, time management, and planning (OTMP) in children with attention-deficit/hyperactivity disorder (ADHD) and ascertain whether OTMP is normalized with medication. METHOD:: Participants included 19 stimulant-naive children with ADHD (aged 8-13 years) and impaired OTMP functioning, defined as greater than 1 SD below norms on the Children's Organizational Skills Scale. A double-blind, placebo-controlled, crossover design, with 4 weeks of each condition, evaluated medication (methylphenidate-osmotic-release oral system [MPH-OROS]) effects on OTMP, based on the parent and teacher versions of the Children's Organizational Skills Scale. The parent and teacher Swanson, Nolan, and Pelham, Version IV, rating scales assessed ADHD symptoms. 'Not impaired' in OTMP was defined as no longer meeting study entry criteria, and 'not impaired' in ADHD symptoms was defined as having mean Swanson, Nolan, and Pelham, Version IV, scores of </=1.0. RESULTS:: MPH-OROS significantly improved children's OTMP behaviors. These improvements were correlated with significant reductions in ADHD symptoms. However, most of the children (61%) continued to show significant OTMP impairments on MPH-OROS. CONCLUSIONS:: The MPH-OROS reduced children's OTMP deficits, and these improvements were associated with improvements in ADHD symptoms. Some children remained impaired in OTMP even after effective stimulant treatment of ADHD symptoms. These youngsters may require other treatments that target OTMP deficits
PMID: 19127171
ISSN: 1527-5418
CID: 96444