Interventions for Children with Attention and Reading Disorders (ICARD)

Principal Investigator:

Carolyn Denton, Ph.D., University of Texas Health Science Center at Houston (UTHealth)

Co-Investigators:

Oscar Bukstein, M.D., University of Texas Health Science Center at Houston (UTHealth)

Jeff Epstein, Ph.D., Cincinnati Children’s Hospital Medical Center

Linda Ewing-Cobbs, Ph.D., University of Texas Health Science Center at Houston (UTHealth)

Anson Koshy, M.D., University of Texas Health Science Center at Houston (UTHealth)

Mary Prasad, Ph.D., University of Texas Health Science Center at Houston (UTHealth)

Leanne Tamm, Ph.D., Cincinnati Children’s Hospital Medical Center

Heather Taylor, Ph.D., University of Texas Health Science Center at Houston (UTHealth)

Aaron Vaughn, Ph.D., Cincinnati Children’s Hospital Medical Center

Funding Agency:

National Institute of Child Health and Human Development/National Institutes of Health

Description of Project:

The purpose of this research is to learn about the best treatment approaches for children who have both Attention Deficit Hyperactivity Disorder (ADHD) and serious reading difficulties (RD).  ADHD and RD are common childhood disorders and frequently co-occur. A number of studies suggest that students who have both disorders have even more severe academic and social difficulties and higher school dropout rates than students who have only RD or only ADHD. Nevertheless, there has very little research on interventions for students with both conditions. Educators, physicians, clinicians, and parents need to know:

  • Whether it is sufficient to provide these students with supplemental reading interventions without directly treating the ADHD
  • Whether students’ reading outcomes will improve with ADHD treatments alone, without supplemental reading intervention
  • Whether students need treatments for both ADHD and RD. This study is comparing student outcomes when students receive treatment for ADHD only, RD only, or the combination of the two

Both the ADHD and RD treatments have already been found to be effective for students who have a single disorder, and it is not our purpose to test a new experimental approach. We are providing these effective treatments either alone or in combination to find out whether students with both RD and ADHD need to be treated for both conditions or whether they will respond well to reading intervention or ADHD treatment alone.

Procedures:

Children who have both ADHD (either inattentive or combined type) and serious reading difficulties (RD) are being identified at participating schools. If their parents agree to participate in the study, these children are randomly assigned to receive either:

  • ADHD treatment alone
  • RD treatment alone
  • Both ADHD and RD treatment

Children’s inattention, reading performance, and other related outcomes are assessed before and after the intervention to compare the effects of the three treatment approaches.  The interventions are provided for 16 weeks.

  • ADHD Treatment.  Children who are assigned to the ADHD treatment group receive two kinds of treatment. The first is medication that is fully approved by the FDA for the treatment of ADHD.  The medication prescribed and carefully monitored by the study physicians. Using frequent feedback from parents and teachers about the students’ ADHD symptoms and any side effects they may experience, the doctors find the best medication and the optimal dose of the medication to support each child.  The second component of the ADHD treatment is a parent class designed to help parents understand ADHD and provide them with strategies for working with their children at home. The classes are provided by project psychologists. Parents are asked to attend nine sessions, including one joint meeting with the psychologist, parents, and the child’s classroom teacher to discuss home-school communication strategies.
  • Reading Treatment. Children who are assigned to receive the reading treatment are provided with small-group intensive reading instruction four days per week for 45 minutes per day, either individually or in groups of two students with one teacher.  The intervention includes a focus on (a) phonemic awareness, phonics and word reading; (b) reading fluency; and (c) reading comprehension. The amount of time the teacher spends working on each area depends on the need of each child.  The programs used in the intervention are all supported by scientific reading research, which has found that they are generally effective for students with reading difficulties and disabilities.
  • Combined Treatment. Children who are assigned to the combined treatment group receive both the ADHD and reading treatments described above.

Participants:

Participants are children in Grades 2-5 in the Houston and Cincinnati areas, who have both ADHD and serious reading difficulties and attend participating schools. Each year of the study, we will recruit 18-27 students across the two sites, for a total of 216 children (108 at each site).

Sites:

The study is being conducted in the greater Houston and Cincinnati areas. In Houston, participating schools include private schools and independent charter schools, as well as schools in the Alvin and Fort Bend school districts.

Timeline:

2010-2015

The project is no longer accepting new participants. Data collection has concluded, and data analyses are underway.

 

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