This study examines the prevalence and characteristics of services reported by school staff for 543 high school students participating in the 8-year follow-up of the multi-site Multimodal Treatment study of ADHD (MTA). Overall, 51.6 % of students with a history of attention-deficit/hyperactivity disorder (ADHD) were receiving services through an individualized educational plan (IEP) or a 504 plan, a rate higher than expected for this age group. Less than 5 % of these had 504 plans; 35.5 % attended special education classes. Very few services (except tutoring) were provided outside of an IEP or 504 plan. Almost all students with services received some type of academic intervention, whereas only half received any behavioral support or learning strategy. Less than one-fourth of interventions appear to be evidence based. Students receiving services showed greater academic and behavioral needs than those not receiving services. Services varied based upon type of school, with the greatest number of interventions provided to students attending schools that only serve those with disabilities. Original MTA treatment randomization was unrelated to services, but cumulative stimulant medication and greater severity predicted more service receipt. Results highlight a need for accommodations with greater evidence of efficacy and for increased services for students who develop academic difficulties in high school.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Akinbami, L. J., Liu, X., Pastor, P. N., & Reuben, C. A. (2011). Attention deficit hyperactivity disorder among children aged 5–17 years in the United States, 1998–2009. NCHS data brief, no 70. Hyattsville, MD: National Center for Health Statistics.
American Disabilities Act Amendment of 2008, Pub. L. No. 110-325, 122 Stat. 3553.
Barkley, R. A., Fischer, M., Smallish, L., & Fletcher, K. (2006). Young adult outcome of hyperactive children: Adaptive functioning in major life activities. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 192–202.
Bussing, R., Fernandez, M., Harwood, M., Wei, H., Garvan, C. W., Eyberg, S. M., et al. (2008). Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: Psychometric properties and normative ratings from a school district sample. Assessment, 15, 317–328.
Bussing, R., Porter, P., Zima, B. T., Mason, D., Garvan, C., & Reid, R. (2012). Academic Outcome Trajectories of Students With ADHD: Does Exceptional Education Status Matter? Journal of Emotional and Behavioral Disorders, 20, 131–143. doi:10.1177/1063426610388180.
Bussing, R., Zima, B. T., Mason, D., Hou, W., Garvan, C. W., & Forness, S. (2005). Use and persistence of pharmacotherapy for elementary school students with attention-deficit/hyperactivity disorder. Journal of Child & Adolescent Psychopharmacology, 15, 78–87.
DuPaul, G. J., & Stoner, G. (2003). ADHD in the schools: Assessment and intervention strategies (2nd ed.). New York, NY: Guildford Press.
Evans, S. W., Schultz, B. K., DeMars, C. E., & Davis, H. (2011). Effectiveness of the Challenging Horizons after-school program for young adolescents with ADHD. Behavior Therapy, 42, 462–474.
Gresham, F. M., & Elliott, S. N. (1989). Social skills rating system—Parent, teacher, and child forms. Circle Pines: American Guidance System.
Jastak, S., & Wilkinson, G. S. (1984). The wide range achievement test-revised: Administration manual. Wilmington, DE: Jastak Assessment Systems.
Jensen, P. S., Arnold, L. E., Swanson, J., Vitiello, B., Abikoff, H. B., Greenhill, L. L., et al. (2007). Follow-up of the NIMH MTA study at 36 months after randomization. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 988–1001.
Jensen, P. S., Hoagwood, K. E., Roper, M., Arnold, L. E., Odbert, C., Crowe, M., et al. (2004). The services for children and adolescents-parent interview: Development and performance characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 1334–1344.
Jensen, P. S., Kettle, L., Roper, M. T., Sloan, M. T., Dulcan, M. K., Hoven, C., et al. (1999). Are stimulants overprescribed? Treatment of ADHD in four US communities. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 797–804.
Kamphaus, R. W. (2005). Clinical assessment of child and adolescent intelligence. New York, NY: Springer.
Kent, K. M., Pelham, W. E., Molina, B. S. G., Sibley, M. H., Waschbusch, D. A., Yu, J., et al. (2011). The academic experience of male high school students with ADHD. Journal of Abnormal Child Psychology, 39, 451–462. doi:10.1007/s10802-010-9472-4.
Langberg, J. M., Arnold, L. E., Flowers, A. M., Altaye, M., Epstein, J. N., & Molina, B. S. (2010). Assessing homework problems in children with ADHD: Validation of a parent-report measure and evaluation of homework performance patterns. School Mental Health, 2(1), 3–12.
Langberg, J. M., Epstein, J. N., Altaye, M., Molina, B. S. G., Arnold, L. E., & Vitiello, B. (2008). The transition to middle school is associated with changes in the developmental trajectory of ADHD symptomatology in young adolescents with ADHD. Journal of Clinical Child & Adolescent Psychology, 37, 651–663. doi:10.1080/15374410802148095.
Leslie, L. K., Lambros, K. M., Aarons, G. A., Haine, R. A., & Hough, R. L. (2008). School-based service use by youth with ADHD in public-sector settings. Journal of Emotional and Behavioral Disorders, 16, 163–177.
Lewandowski, L. J., Lowett, B. J., Parolin, R., Gordon, M., & Codding, R. S. (2007). Extended time accommodations and the mathematics performance of students with and without ADHD. Journal of Psychoeducational Assessment, 25, 17–28.
Molina, B. S. G., Hinshaw, S. P., Swanson, J., Arnold, E., Vitiello, B., Jensen, P., et al. (2009). The MTA at 8 years: Prospective follow up of children treated for combined type ADHD in a multisite study. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 484–500. doi:10.1097/CHI.0b013e31819c23d0.
Morgan, P. L., Frisco, M. L., Farkas, G., & Hibel, J. (2010). A propensity score matching analysis of the effects of special education services. Journal of Special Education, 43, 236–254.
MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment of attention deficit hyperactivity disorder (ADHD). Archives of General Psychiatry, 56, 1073–1086.
MTA Cooperative Group. (2004). National Institute of Mental Health multimodal treatment study of ADHD follow-up: 24-month outcomes of treatment strategies for attention-deficit/hyperactivity disorder (ADHD). Pediatrics, 113, 754–761.
National Secondary Transitional Technical Assistance Center – NSTTAC. (2010). Evidence based practices and predictors in secondary transition: What we know and what we still need to know. Charlotte, NC: NSSTAC.
Newman, L., Wagner, M., Huang, T., Shaver, D., Knokey, A.-M., Yu, J., et al. (2011). Secondary school programs and performance of students with disabilities. A special topic report of findings from the National Longitudinal Transition Study-2 (NLTS2) (NCSER 2012-3000). U.S. Department of Education. Washington, DC: National Center for Special Education Research. Menlo Park, CA: SRI International. Retrieved from www.nlts2.org/reports/2011_11/nlts2_report_2011_11_complete.pdf.
Office of Special Education Programs. (2004). Facts from OSEP’s National Longitudinal Studies: A profile of students with ADHD who receive special education services. Menlo Park, CA: SRI International. Retrieved from www.nlts2.org/fact_sheets/nlts2_fact_sheet_2004_11.pdf.
Raggi, V. L., & Chronis, A. M. (2006). Interventions to address the academic impairment of children and adolescents with ADHD. Clinical Child and Family Psychology Review, 9(2), 85–111.
Reid, R., Maag, J. W., Vasa, S. F., & Wright, G. (1994). Who are the children with attention deficit-hyperactivity disorder? A school-based survey. The Journal of Special Education, 28(2), 117–137.
Schnoes, C., Reid, R., Wagner, M., & Marder, C. (2006). ADHD among students receiving special education services: A national survey. Exceptional Children, 72, 483–496.
Schultz, B. K., Storer, J., Watabe, Y., Sadler, J., & Evans, S. W. (2011). School-based treatment of attention-deficit/hyperactivity disorder. Psychology in the Schools, 48, 254–262.
Turnbull, R. H. (2005). Individuals with Disabilities Education Act reauthorization: Accountability and personal responsibility. Remedial and Special Education, 26, 320–326.
U.S. Department of Education. (2008). Individuals with Disabilities Education Act (IDEA) population and enrollment data. Retrieved from Data Accountability Center website: http://www.IDEAdata.org.
Wagner, M., Kutash, K., Duchnowski, A. J., & Epstein, M. H. (2005). The special education elementary longitudinal study and the national longitudinal transition study: Study designs and implications for children and youth with emotional disturbance. Journal of Emotional and Behavioral Disorders, 13, 25–41. doi:10.1177/10634266050130010301.
Wagner, M, Marder, C, & Cardoso, D. (2004). Disability profiles of youth with disabilities. National Longitudinal Study of Youth. http://www.nlts2.org.
Wagner, M., Newman, L., Cameto, R., & Levine, P. (2006). The academic achievement and functional performance of youth with disabilities. A report from the national longitudinal transition study-2 (NLTS2). NCSER 2006-3000 (online submission).
Wechsler, D. (1992). Wechsler individualized achievement test. San Antonio: Psychological Corporation.
Wells, K. C., Pelham, W. E., Kotkin, R. A., Hoza, B., Abikoff, H. B., Abramowitz, A., et al. (2000). Psychosocial treatment strategies in the MTA study: Rationale, methods, and critical issues in design and implementation. Journal of Abnormal Child Psychology, 28, 483–505.
This specific research was supported by the Department of Education through a subcontract with Kunitz & Associates, Inc. (KAI), N01-MH12002 KAI 118-S5.
Collaborators from the Multimodal Treatment Study of Children with ADHD (MTA) include from NIMH: Benedetto Vitiello, M.D. (Child & Adolescent Treatment and Preventive Interventions Research Branch), Joanne B. Severe, M.S. (Clinical Trials Operations and Biostatistics Unit, Division of Services and Intervention Research), Peter S. Jensen, M.D. (currently at REACH Institute and Mayo Clinic), L. Eugene Arnold, M.D., M.Ed. (currently at Ohio State University), Kimberly Hoagwood, Ph.D. (currently at Columbia); previous contributors from NIMH to the early phases: John Richters, Ph.D. (currently at National Institute of Nursing Research); Donald Vereen, M.D. (currently at NIDA). Principal investigators and co-investigators from the sites are: University of California, Berkeley/San Francisco: Stephen P. Hinshaw, Ph.D. (Berkeley), Glen R. Elliott, Ph.D., M.D. (San Francisco); Duke University: Karen C. Wells, Ph.D., Jeffery N. Epstein, Ph.D. (currently at Cincinnati Children’s Hospital Medical Center), Desiree W. Murray, Ph.D. (currently at University of North Carolina-Chapel Hill); previous Duke contributors to early phases: C. Keith Conners, Ph.D. (former PI); John March, M.D., M.P.H.; University of California, Irvine: James Swanson, Ph.D., Timothy Wigal, Ph.D.; previous contributor from UCLA to the early phases: Dennis P. Cantwell, M.D. (deceased); New York University: Howard B. Abikoff, Ph.D.; Montreal Children’s Hospital/McGill University: Lily Hechtman, M.D.; New York State Psychiatric Institute/Columbia University/Mount Sinai Medical Center: Laurence L. Greenhill, M.D. (Columbia), Jeffrey H. Newcorn, M.D. (Mount Sinai School of Medicine). University of Pittsburgh: Brooke Molina, Ph.D., Betsy Hoza, Ph.D. (currently at University of Vermont), William E. Pelham, Ph.D. (PI for early phases, currently at Florida International University). Follow-up phase statistical collaborators: Robert D. Gibbons, Ph.D. (University of Illinois, Chicago); Sue Marcus, Ph.D. (Mt. Sinai College of Medicine); Kwan Hur, Ph.D. (University of Illinois, Chicago). Original study statistical and design consultant: Helena C. Kraemer, Ph.D. (Stanford University). Collaborator from the Office of Special Education Programs/US Department of Education: Thomas Hanley, Ed.D. Collaborator from Office of Juvenile Justice and Delinquency Prevention/Department of Justice: Karen Stern, Ph.D.
The Multimodal Treatment Study of Children with ADHD (MTA) was a National Institute of Mental Health (NIMH) cooperative agreement randomized clinical trial, continued under an NIMH contract as a follow-up study and finally under a National Institute on Drug Abuse (NIDA) contract.
About this article
Cite this article
Murray, D.W., Molina, B.S.G., Glew, K. et al. Prevalence and Characteristics of School Services for High School Students with Attention-Deficit/Hyperactivity Disorder. School Mental Health 6, 264–278 (2014). https://doi.org/10.1007/s12310-014-9128-6
- High school
- School services
- Special education
- 504 plan