Efficacy of a Narrative Comprehension Intervention for Elementary School Children At-Risk for Attention-Deficit Hyperactivity Disorder

Project Summary/Abstract (1) Title of the project: Efficacy of a Narrative Comprehension Intervention for Elementary School Children At-Risk for Attention-Deficit Hyperactivity Disorder. (2) RFA Topic and Goal: Cognition and Student Learning (NCER-CASL), Efficacy goal (3) Purpose: According to the National Center for Education Statistics, a substantial proportion of U.S. children struggle with comprehension. Children with ADHD are particularly likely to experience comprehension problems, as demonstrated by documented deficits in story domains fundamental to narrative comprehension. Our work on a funded CASL Development and Innovation grant enabled us to complete development of a promising 15-lesson supplemental afterschool intervention for 3rd grade children at-risk for ADHD (Narrative Structure (NS) intervention). The purpose of the proposed 5-year Efficacy study is to complete a comprehensive evaluation that will compare the NS intervention to two counterfactuals. (4) Setting: The evaluation of all three interventions will be conducted in afterschool sessions at public schools in Fayette County, Kentucky. Interventions will be delivered by school personnel, who will receive training in delivery of the interventions. (5) Population: One hundred ninety-two 3rd grade students from 24 district elementary schools will be instructed with the NS intervention or one of the counterfactuals. Participating children will be at risk for ADHD and exhibit narrative comprehension difficulties based on pre-established criteria. (6) Intervention: The NS intervention completed in the Development and Innovation grant project was designed to improve comprehension in four interrelated domains in which children with ADHD exhibit deficits. The sequence of lessons moves from simple to complex; teaches declarative, procedural, and conditional knowledge in the domain; provides ample opportunity for modeling, interaction, and guided practice during instruction; and helps students to integrate knowledge across the four instructional domains to improve narrative comprehension. (7) Control: Participating schools will be randomly assigned to the NS intervention or to one of two counterfactuals, Reciprocal Teaching (RT), which represents an alternative approach to improving narrative comprehension but is not targeted at specific difficulties of children at-risk for ADHD; or Problem Solving (PS), which addresses difficulties specific to the target population but does not focus on narrative comprehension. A behavior management system to maintain children’s attention to instruction will be the same for all of the interventions. (8) Primary Research Method: During each academic semester (semesters 2-9 of the project period), third grade students will participate in the assigned intervention in groups of four in an afterschool environment, with instruction delivered by school personnel. For all children pre-tests and post-tests of comprehension and measures of self-efficacy in all intervention domains will be collected in addition to ongoing data collection during instructional sessions. (9) Measures and Key Outcomes: Measures will include: 1) Pre-test and Post-Test Measures of narrative comprehension; 2) Ongoing assessments of student comprehension during lessons; 3) Participant ratings of difficulty and engagement; 4) Observer scoring of fidelity; 5) Measures of student efficacy in the domains addressed by the interventions; 6) Feedback from instructing teachers via ratings and interviews; and 7) School records and Standardized test scores. (10) Data Analytic Plan: Data analysis will include descriptive measures of fidelity and responses to the lessons as well as HLM to compare narrative comprehension and self-efficacy across conditions, under the direction of the project evaluators.