Organizational Skills Training

Context: Although multiple factors influence school functioning, executive function (EF)
deficits have been found to be a key predictor of academic achievement. EF is a higher order
cognitive ability associated with persistent goal-directed behavior. Organization, time
management, and planning (OTMP) skills are aspects of EF that are particularly associated
with children's academic performance. Organizational demands increase over the course of
early schooling and are relatively high by 3rd through 5th grade. Poor OTMP skills during
this period adversely impact academic functioning. In the late elementary school grades, as
students are expected to become more organized, some students have difficulty learning these
skills in spite of classroom supports provided by teachers, placing them at increased risk
for academic failure.

Objectives: The purpose of this Goal 3 efficacy study is to conduct an evaluation of the
Organizational Skills Training Program - School version (OST-S), a fully developed
intervention for students in general education. The proposed study builds upon research
demonstrating the efficacy of a clinic-based version of the OST intervention (OST-C) in
remediating OTMP skills deficits and improving academic functioning for 3rd, 4th and 5th
graders with attention-deficit hyperactivity disorder (ADHD), and a recent pilot research
demonstrating the feasibility and potential effectiveness of OST-S provided by end users
("school partners") for 3rd through 5th graders. It also builds upon research training school
staff to implement evidence-based interventions with high fidelity.

Study Design: This is a cluster-randomized trial with a treatment as usual (TAU) control
group.

Setting/Participants: Schools are located in Pennsylvania and New Jersey and include 20 urban
and suburban schools serving a diverse population. Students (3rd to 5th grade) who are
struggling the most with OTMP deficits and whose academic performance is negatively impacted
by their OTMP deficits will be referred to the study team by their general education
teachers.

Study Interventions and Measures: OST-S is a small group skills training intervention, with
parents and teachers supporting children's use of new skills. The program manual includes
strategies for training and coaching school staff, referred to as school partners, to
effectively implement OST-S and guidelines to modify the program for implementation in
diverse schools with diverse students. Each student session includes: (a) homework review to
assess completion of between-session skills implementation; (b) skill-building activities,
which include the use of modeling, shaping, guided practice, and reinforcement for organized
behavior; and (c) activities to promote generalization of skills. Sessions address four
organizational challenges: (a) tracking assignments, (b) managing materials, (c) managing
time, and (d) planning for long term assignments.

Investigators will measure the following: intervention fidelity, stakeholder engagement,
student OTMP skills, student academic self-efficacy, student academic outcomes, student
characteristics, feasibility, usability, and acceptability of OST-S. In addition,
Investigators will track the interventions that are offered as treatment-as-usual in TAU
schools. A cost analysis related to the implementation of OST-S will also be completed.

Inclusion Criteria:

Any student enrolled in grades 3 thru 5 in one of the participating schools who meets the
following criteria.

1. First, students will be recommended by their general education teacher if the
following are true: (a) students who are struggling the most with OTMP skills, (b)
whose OTMP skill deficits are the students' primary concern (c) whose academic
performance is negatively impacted by their OTMP deficits, and (d) who have at least
one parent who speaks English.

2. Second, students must have or be at risk for developing OTMP deficits.

Exclusion Criteria:

1. Students will be excluded if they are in a pull-out special education classroom for
more than 50% of the day as the organizational demands for these students may differ
from those students placed mostly in general education.

2. Students with a one-to-one aide will be excluded because the presence of an aide
substantially alters how an organizational intervention is implemented.

3. Students from families in which both caregivers do not speak English will be excluded
because the program has not yet been developed for non-English speakers.

4. Only one student per family will be included in the study.