Chapter 7 - Behavioral interventions

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) and Specific Learning Disorder (SLD) are two commonly co-occurring conditions—each associated with serious, chronic impairments. Comorbidity is often associated with synergistic, deleterious effects on functional outcomes. Behavioral interventions are the most widely researched, frequently implemented, and consistently effective non-pharmacological treatment for ADHD. Despite the considerable co-occurrence, the effect of SLD comorbidity on outcomes of behavioral interventions for ADHD is surprisingly understudied. This chapter begins with an overview of behavioral theory; ensuing sections review behavioral intervention modalities effective for children with ADHD (i.e., behavioral parent training, school-based interventions, child organizational skills, and their combination). The empirical support for each behavioral approach, with an emphasis on education-related outcomes, is reviewed. Extant literature suggests that while behavioral interventions produce significant, powerful effects on ADHD symptoms, externalizing behaviors, compliance, organization, and social skills, their effects within the school setting, particularly within the domain of academic achievement, are attenuated significantly. Although further study is warranted, the findings suggest that behavioral interventions are necessary but not sufficient for children with ADHD/SLD comorbidity. Therefore, multimodal treatment targeting ADHD (i.e., behavioral intervention, medication) and SLD (i.e., direct instruction, tutoring) is necessary to address the cross-domain deficits associated with comorbidity.