Social and Behavioral Functioning of Adolescents with ADHD: Individual and Environmental Moderators of School-based Treatment Response

Abstract Individuals with attention-deficit/hyperactivity disorder (ADHD) are likely to experience social and behavioral functioning impairment that can result in adverse outcomes in the school setting, as well as later in life. Recent research, including high school trials of the Challenging Horizons Program (CHP), has increasingly focused on school-based interventions to promote social and behavioral functioning in adolescents with ADHD in naturalistic settings of impairment. This study examined the effects of CHP on school-based behavioral indicators (office disciplinary referrals [ODRs]), as well as the extent to which individual and environmental factors moderate differential treatment response in the domains of social and behavioral functioning. It was hypothesized that treatment would have a small positive effect on student ODRs, and that individual differences, such as baseline disruptive behavior, baseline emotion regulation, and demographics (such as race and gender), as well as environmental factors, such as school characteristics, would moderate treatment response. Baseline emotion regulation, student race, and percentage of students receiving free and reduced lunch moderated the time effect on social functioning, suggesting that students displaying lower baseline emotion regulation, of Black racial background, and attending high schools with a higher percentage of students receiving free and reduced lunch, are likely to demonstrate more positive growth trajectories of parent-rated social functioning outcomes. However, models examining ODRs as an outcome variable and three-way interaction models analyzing moderation of treatment trajectories did not converge. Future research in this area should explore whether baseline emotion regulation, student race, and percentage of students receiving free and reduced lunch remain significant moderators across treatment groups.