Organizational-skills interventions in the treatment of ADHD

Summary & key facts

People with ADHD often have trouble keeping track of stuff and using time well. Researchers have tested training programs that teach systems for organizing materials, managing homework, planning, and using time. These programs, sometimes combined with simple rewards or consequences to encourage practice, have been linked to clear improvements in organization, homework management, time use, and planning for children, teens, and adults. There is some evidence that getting more organized can also lower ADHD symptoms and help school work, but more high-quality and longer-term studies are needed before these programs can be called proven treatments.

Key facts:

• Children with ADHD commonly lose or forget homework and struggle to plan for tests because of problems organizing materials.
• Adults with ADHD most often show organization problems in time management, for example through procrastination and missed appointments or deadlines.
• Researchers developed skills-and-strategy training that teaches systems for managing time and materials more effectively.
• These organizational programs often add contingency management, which means using rewards or consequences to help people actually use the new skills.
• Studies that looked at these programs for children, teens, and adults found noticeable improvements in keeping materials organized, managing homework, using time better, and planning ahead.
• Some research suggests that better organization from these programs can reduce ADHD symptoms and improve school performance, but that evidence is limited.
• The authors say more randomized, controlled studies and long-term follow-up are needed before these interventions can be judged as established, evidence-based treatments.

Abstract

Children with attention-deficit/hyperactivity disorder (ADHD) often experience problems with temporal and materials organization. These difficulties remain prominent throughout development. For children, organizational problems are most apparent in the school setting and result in impairments such as lost and forgotten homework assignments and inadequate planning for tests. Temporal aspects of organization tend to be most salient for adults with ADHD and manifest as procrastination and missed appointments and deadlines. Skills and strategy training interventions have been developed to address the organizational problems of children and adults with ADHD. Patients are taught systems for managing their time and materials more effectively. Contingency management is often used in conjunction with organizational skills training to promote the use of organizational skills and their generalization. Organizational skills interventions have been evaluated as standalone interventions and part of multicomponent interventions for children, adolescents and adults with ADHD. These interventions are associated with significant improvements in the organization of materials, homework management, time management and planning. There is also some evidence to suggest that organizational improvements lead to reductions in ADHD symptoms and gains in academic functioning. Additional research using randomized controlled research designs and long-term follow-up evaluation is necessary before organizational interventions may be considered established evidence-based interventions for patients with ADHD.

Topics

Attention Deficit Hyperactivity Disorder Behavioral and Psychological Studies Children's Physical and Motor Development

Categories

Health Sciences Medicine Psychiatry and Mental health

Tags

Clinical psychology Contingency Contingency management Developmental psychology Intervention (counseling) Linguistics Philosophy Procrastination Psychiatry Psychological intervention Psychology Psychotherapist

Conditions & symptoms

ADHD Difficulty focusing Lack of energy or motivation