FOR CHILDREN AND TEENS:
A Review of the Literature
Lisa Joy Tuttle & Elizabeth Ahman
ACO Research Committee Members
Attention Deficit/Hyperactivity Disorder (ADHD) in children can have behavioral, developmental, emotional, and physical effects. ADHD can also impact academic achievement, social relationships, safety, and individual and family quality of life. Additionally, ADHD continues into adulthood for a substantial proportion of individuals, affecting a range of functional areas.
Medication alone is the most common treatment for ADHD in children. Although the American Academy of Pediatrics (AAP) urges using behavioral intervention in conjunction with pharmacotherapy, many young people have not had behavioral treatments, in part because few evidence-based behavioral interventions have widespread availability.
Ahmann, E., Saviet, M., & Tuttle, L. J. (2017). Interventions for children and teens with ADHD: A focus on ADHD coaching. Pediatric Nursing, 43(3), 121–131.
WHY THIS ARTICLE IS IMPORTANT
While few evidence-based behavioral interventions have widespread availability, ADHD coaching is a growing field that can fill an important need for individuals diagnosed with ADHD. ADHD coaching is also a behavioral intervention with an emerging evidence base. In late 2015, along with our colleague Sarah D. Wright, we conducted a literature search to discern the number of studies examining ADHD coaching that had been published up to that point and to explore their findings. The article we describe herein, published in a recent issue of the journal Pediatric Nursing (Ahmann, Saviet, & Tuttle, 2017), addresses a subset of these studies: those examining ADHD coaching with children and teens.
THE LITERATURE SEARCH METHOD
To identify the research on ADHD coaching, we conducted a search of the literature using the keywords “ADHD,” “executive functions,” and “coaching” in the following four databases: PubMed, EBSCO Megafile, Google Scholar, and ERIC. We identified several additional studies through a generic Google search and by cross-referencing citations in articles or books. Only studies of ADHD coaching that examined coaching outcomes were selected for our review; and to enable a comprehensive review, no additional exclusion criteria were applied.
We identified 19 studies examining outcomes of ADHD coaching across age groups. Of these, 7 studies were specific to children and teens, as follows: children (n = 3), teens (n = 3), and one additional study included both teens and young adults with ADHD and/or an autism spectrum disorder (ASD). One of these 7 studies was a randomized controlled trial, the gold standard for clinical research.
Some of the studies related to children and teens examined more than one outcome variable. Six of the seven studies examined the impact of coaching on ADHD symptoms and/or related behaviors (including academic outcomes); one study examined quality of life; one examined self-esteem; and one examined family functioning. Additionally, two studies examined maintenance of gains over time, and two examined satisfaction with coaching. Findings were generally positive.
Specific findings, as summarized in our article (Ahmann et al., 2017, p. 128), included:
• The three studies of coaching for children with ADHD demonstrated behavioral improvements as a result of coaching; in one study parents also reported improvements in quality of life.
• Among adolescents, two small studies examined academic outcomes with coaching, demonstrating improvement.
• The randomized controlled study—including coaching, an interpersonal skills group, and parent training—did not find improvement relative to a control group in grades or classroom behavior but did find statistically significant, clinically meaningful improvement in attention, relationships with peers, academic impairment and family functioning … [although] the impact of coaching alone was not reported.
• Finally, a study of Internet support and coaching for teens and young adults with ADHD and/or ASD found improvements in self-esteem and quality of life.
• Two studies found that benefits of coaching were sustained over a period of time.
• In the four studies exploring the issue, participants reported satisfaction, sometimes high, with the coaching intervention.
WHY THIS STUDY IS IMPORTANT FOR COACHING
As an evidence base for a field of practice goes, seven studies is a fairly small body of research. Further research, with larger study samples, as well as control groups, would be beneficial to expand on the current body of evidence. In fact, the research to date is just the beginning of what we as coaches might hope to see over time as a fully robust evidence base for coaching children and teens with ADHD.
The ACO Research Committee, of which we are a part, has as its mission to regularly provide members with the latest ADHD and coaching research and to inform coaches about how to critically evaluate research reports. We also hope that by reporting our publication we will stimulate interest and enthusiasm about participating in research.
QUESTIONS TO CONSIDER
Following the example of ACO past-President Joyce Kubik, who conducted and published a study of ADHD coaching for adults, how might you, as a practicing coach, design research to contribute to this body of evidence about coaching?
Following the example of ADHD coach Jodi Sleeper-Triplett of JST Coaching and Training, who participated in research on coaching for college students, how might you forge a relationship with researchers in a university, perhaps in your area, to jointly develop a research study?
Despite the fact that further research on coaching for children and teens would be beneficial, as an emerging evidence base, these seven studies, taken together, suggest that ADHD coaching may indeed be a promising behavioral intervention for young people, as well as a useful component of multimodal treatment approaches. And that’s good news, not only for coaches, but for young people and their families as well!