Current recommendations for the treatment of attention deficit/hyperactivity disorder (ADHD) call for a multimodal approach including a combination of medication, behavior modification, school accommodations, and ancillary services. One method that has been proposed as an effective and efficient means for increasing students' attention and academic productivity is self-regulation. This article reports the results of a meta-analysis of the literature on the use of four self-regulation interventions (self-monitoring, self-monitoring plus reinforcement, self-management, and self-reinforcement) for children with ADHD. Combined effect sizes for these four treatments were greater than 1.0 for on-task behavior, inappropriate behavior, and academic accuracy and productivity, indicating that self-regulation interventions are effective for children with ADHD.
References
1.
AjibolaO., & ClementP. W. (1995). Differential effects of methylphenidate and self-reinforcement on attention-deficit hyperactivity disorder. Behavior Modification, 19, 211–233.
2.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorder (4th ed.). Washington, DC: Author.
3.
American Psychological Association. (2001). Publication manual of the American Psychological Association (5th ed.). Washington, DC: Author.
4.
ArdoinS. P., & MartensB. K. (2000). Testing the ability of children with attention deficit hyperactivity disorder to accurately report the effects of medication on their behavior. Journal of Applied Behavior Analysis, 33, 593–610.
5.
BarkleyR. A. (1997). ADHD and the nature of self-control. New York: Guilford.
6.
BarkleyR. A. (1998). Attention-Deficit Hyperactivity Disorder: A handbook for diagnosis and treatment (2nd ed.). New York: Guilford.
7.
BarkleyR. A., CopelandA. P., & SivageC. (1980). A self-control classroom for hyperactive children. Journal of Autism and Developmental Disorders, 10, 75–89.
8.
BowersD. S., ClementP. W., FantuzzoJ. W., & SorensenD. A. (1985). Effects of teacher-administered and self-administered reinforcers on learning disabled children. Behavior Therapy, 16, 357–369.
9.
BuskP. L., & SerlinR. C. (1992). Meta-analysis for single-case research. In KratochwillT. R. & LevinJ. R. (Eds.), Single-case research design and analysis: New directions for psychology and education (pp. 187–212). Hillsdale, NJ: Lawrence Erlbaum.
10.
ChaseS. N., & ClementP. W. (1985). Effects of self-reinforcement and stimulants on academic performance in children with attention deficit disorder. Journal of Clinical Child Psychology, 14, 323–333.
11.
ChristieD. J., HissM., & LozanoffB. (1984). Modification of inattentive classroom behavior: Hyperactive children's use of self-recording with teacher guidance. Behavior Modification, 8, 391–406.
12.
CohenJ. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). New York: Academic Press.
13.
ColeC. L., & GardnerW. I. (1984). Self-management training. Psychiatric Aspects of Mental Retardation Reviews, 3, 17–20.
14.
ConnersC. K. (1969). A teacher rating scale for use in drug studies with hyperactive children. American Journal of Psychiatry, 126, 152–156.
15.
ConnersC. K., EpsteinJ. N., MarchJ. S., AngoldA., WellsK. C., KlaricJ., et al. (2001). Multimodal treatment of ADHD in the MTA: An alternative outcome analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 159–167.
16.
CotugnoA. J. (1992). The diagnosis of attention deficit hyperactivity disorder (ADHD) in community mental health centers: Where and when. Psychology in the Schools, 30, 338–344.
17.
DaviesS., & WitteR. (2000). Self-management and peer-monitoring within a group contingency to decrease uncontrolled verbalizations of children with attention-deficit/hyperactivity disorder. Psychology in the Schools, 37, 135–147.
18.
De Haas-WarnerS. (1992). The utility of self-monitoring for preschool on-task behavior. Topics in Early Childhood Special Education, 12, 478–495.
19.
DouglasV. I., ParryP., MartonP., & GarsonC. (1976). Assessment of a cognitive training program for hyperactive children. Journal of Abnormal Child Psychology, 4, 389–410.
20.
DuPaulG. J., & StonerG. (2003). ADHD in the schools: Assessment and intervention strategies. New York: Guilford.
21.
EastmanB. G., & RasburyW. C. (1981). Cognitive self-instruction for the control of impulsive classroom behavior: Ensuring the treatment package. Journal of Abnormal Child Psychology, 9, 381–387.
22.
EdwardsL., SalantV., HowardV. F., BrougherJ., & McLaughlinT. F. (1995). Effectiveness of self-management on attentional behavior and reading comprehension for children with attention deficit disorder. Child and Family Behavior Therapy, 17, 1–17.
23.
ErvinR. A., DuPaulG. J., KernL., & FrimanP. C. (1998). Classroom-based functional and adjunctive assessments: Proactive approaches to intervention selection for adolescents with attention deficit hyperactivity disorder. Journal of Applied Behavior Analysis, 31, 65–78.
24.
GershonJ. (2002). A meta-analytic review of gender differences in ADHD. Journal of Attention Disorders, 5, 143–154.
25.
GoldmanL. S., GenelM., BezmanR. J., & SlanetzP. J. (1998). Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Journal of the American Medical Association, 279, 1100–1107.
26.
GrahamS., & HarrisK. R. (2003). Students with learning disabilities and the process of writing: A meta-analysis of SRSD studies. In SwansonH. L., HarrisK. R., & GrahamS. (Eds.), Handbook of learning disabilities (pp. 323–344). New York: Guilford.
27.
GrahamS., HarrisK. R., & ReidR. (1992). Developing self-regulated learners. Focus on Exceptional Children, 24(6), 1–16.
28.
GumpleT. P., & DavidS. (2000). Exploring the efficacy of self-regulatory training as a possible alternative to social skills training. Behavioral Disorders, 25, 131–141.
29.
HarrisK. R. (1986). Self-monitoring of attentional behavior versus self-monitoring of productivity: Effects on on-task behavior and academic response rate among learning disabled children. Journal of Applied Behavior Analysis, 19, 417–423.
30.
HarrisK. R., FriedlanderB. D., SaddlerB., FrizzelleR., & GrahamS. (in press). Self-monitoring of attention versus self-monitoring of academic performance: Effects among students with ADHD in the regular classroom, Journal of Special Education.
31.
HinshawS. P., HenkerB., & WhalenC. K. (1984). Cognitive-behavioral and pharmacologic interventions for hyperactive boys: Comparative and combined effects. Journal of Consulting and Clinical Psychology, 52, 739–749.
32.
HoffK. E., & DuPaulG. J. (1998). Reducing disruptive behavior in general education classrooms: The use of self-management strategies. School Psychology Review, 2, 290–303.
33.
HornW. F., ChatoorI., & ConnersC. K. (1983). Additive effects of Dexedrine and self-control training. Behavior Modification, 7, 383–402.
34.
KernL., RingdahlJ. E., HiltA., & Sterling-TurnerH. E. (2001). Linking self-management procedures to functional analysis results. Behavior Disorders, 26, 214–226.
35.
MaceF. C., BelfioreP. J., & HutchinsonJ. M. (2001). Operant theory and research on self-regulation. In ZimmermanB. & SchunkD. (Eds.), Learning and academic achievement: Theoretical perspectives. (pp. 39–65). Mahwah, NJ: Lawrence Erlbaum.
36.
MathesM., & BenderW. N. (1997). The effects of self-monitoring on children with attention-deficit/hyperactivity disorder who are receiving pharmacological interventions. Remedial and Special Education, 18, 121–128.
37.
McDougallD., & BradyM. P. (1998). Initiating and fading self-management interventions to increase math fluency in general education classes. Exceptional Children, 64, 151–166.
38.
MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56, 1073–1086.
39.
National Institute of Mental Health. (1996). Attention deficit hyperactivity disorder (DHHS Publication No. 96-3572). Washington, DC: U.S. Government Printing Office.
40.
NelsonJ. R., SmithD. J., YoungR. K., & DoddJ. M. (1991). A review of self-management outcome research conducted with students who exhibit behavioral disorders. Behavioral Disorders, 16, 169–179.
41.
PfiffnerL. J., & BarkleyR. A. (1998). Treatment of ADHD in school settings. In BarkleyR. A. (Ed.), Attention Deficit Hyperactivity Disorder: A handbook for diagnosis and treatment (2nd ed., pp. 458–490). New York: Guilford.
42.
PintrichP. (2000). The role of goal orientation in self-regulated learning. In BoekaertsM., PintrichP., & ZeidnerM. (Eds.), Handbook of self-regulation (pp. 451–502). San Diego, CA: Academic Press.
43.
ReidR. (1996). Self-monitoring for students with learning disabilities: The present, the prospects, the pitfalls. Journal of Learning Disabilities, 29, 317–331.
44.
ReidR. (1999). Attention deficit hyperactivity disorder: Effective methods for the classroom. Focus on Exceptional Children, 32(4), 1–20.
45.
ReidR., & HarrisK. R. (1993). Self-monitoring of attention versus self-monitoring of performance: Effects on attention and academic performance. Exceptional Children, 60, 29–40.
46.
ReidR., MaagJ. W., VasaS. F., & WrightG. (1994). Who are the children with ADHD: A school-based survey. Journal of Special Education, 28, 117–137.
47.
RosenthalR. (1994). Parametric measures of effect size. In CooperH. & HedgesL. V. (Eds.), The handbook of research synthesis (pp. 231–244). New York: Sage.
48.
SabatinoD. H., & VanceH. B. (1994). Are diagnoses of attention deficit/hyperactivity disorder still meaningful?Psychology in the Schools, 31, 188–196.
49.
ShapiroE. S., & ColeC. L. (1994). Behavior change in the classroom. New York: Guilford.
50.
ShapiroE. S., DuPaulG. J., & Bradley-KlugK. L. (1998). Self-management as a strategy to improve the classroom behavior of adolescents with ADHD. Journal of Learning Disabilities, 31, 545–555.
51.
SharpW., WalterJ., MarshW., RitchieG., HamburgerS., & CastellanosF. (1999). ADHD in girls: Clinical comparability of a research sample. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 40–47.
52.
ShimabukuroS. M., PraterM. A., JenkinsA., & Edelen-SmithP. (1999). The effects of self-monitoring of academic performance on students with learning disabilities and ADD/ADHD. Education and Treatment of Children, 22, 397–414.
53.
SmithB. W., & SugaiG. (2000). A self-management functional assessment-based behavior support plan for a middle school student with EBD. Journal of Positive Behavior Interventions, 2, 208–217.
54.
StewartK. G., & McLaughlinT. F. (1992). Self-recording: Effects on reducing off-task behavior with a high school student with an attention deficit hyperactivity disorder. Child and Family Behavior Therapy, 14, 53–59.
55.
StrayhornJ. (2002). Self-control: Toward systematic training programs. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 17–27.
56.
SwansonH. L., & Sachse-LeeC. (2000). A meta-analysis of single-subject-design intervention research for students with LD. Journal of Learning Disabilities, 33, 114–136.
57.
ToddR. D., SitdhiraksaN., ReichW., JiT., JoynerC., HeathA. C., et al. (2002). Discrimination of DSM-IV and latent class attention-deficit/hyperactivity disorder subtypes by educational and cognitive performance in a population-based sample of child and adolescent twins. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 820–828.
58.
VarniJ. W., & HenkerB. (1979). A self-regulation approach to the treatment of three hyperactive boys. Child Behavior Therapy, 1, 171–192.
59.
WeiszJ. R., WeissB., HanS. S., GrangerD. A., & MortonT. (1995). Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychological Bulletin, 117, 450–468.
60.
WhalenC. K., & HenkerB. (1991). Social impact of stimulant treatment for hyperactive children. Journal of Learning Disabilities, 24, 231–241.
61.
ZimmermanB. (2000). Attaining self-regulation: A social cognitive perspective. In BoekaertsM., PintrichP., & ZeidnerM. (Eds.), Handbook of self-regulation (pp. 13–39). San Diego, CA: Academic Press.
