The effectiveness of Behavioral Intervention for Changing Daily Behavior of Children with Attention Deficit/Hyperactivity Disorder in School and Reducing their Task Avoidance Behavior

Students with attention deficit-hyperactivity disorder may have many problems in functional areas including education status. Although these children have normal intelligence they display weak performance in school, and their relationship with parents, teachers, peers, and friends is frequently problematic. For solving the child behavioral problems, the teacher must have active cooperation with parents. Making behavioral contract between home and school is one of these methods. So, this research investigated the effect of a therapeutic plan based on the coordinated behavioral intervention of therapist, home, and school on changing daily school behavior and reducing task avoidance in children with attention deficit-hyperactivity disorder. This research was kind of experimental design (pretest-post-test with a control group and follow-up). The statistical population included all 8-9 years old boys with ADHD who had referred to Tehran psychological services and counseling centers. Among children that despite of ADHD had not comorbid disorders as mental retardation and obvious physical-sensory-motor disorder and chronic illnesses, received medical treatment with equal time and amount and were in 8-9 years age range, 30 individuals along with their parents were selected as research sample and randomly assigned to experimental (N=15) and control (N=15) groups. The therapeutic plan based on the coordinated behavioral intervention of therapist, home, and school was trained to experimental group for eight sessions. Mother as home agent and teacher as school agent must be presented. Therapeutic plan based on coordinated behavioral intervention of therapist, home, and school is derived from Skinner`s theory of operant conditioning (1983) and it`s methods and techniques (such as reinforcement management, token economy, Premack principle) and positive childrearing method that conducted for 8 sessions, weekly twice, every session 2 hours. After finishing training sessions, took post-test from every two groups and they were tested after the follow-up period for the third time. The Conners Parent Rating Scale (CPRS) and the Conners Teacher Rating Scale (CTRS) were used as tools for assessing task avoidance at home and daily school behavior respectively. These questionnaires were used as the most common tools for screening and to diagnosing of ADHD in most world places and had been suitable tools for measuring the intensity of symptoms. Data were analyzed with variance analysis and repeated measurements using SPSS 22 (p<0.05). Also, in order to identify which variables have a significant difference with each other, was used for post hoc tests (LSD) in observing the condition of homogeneity of variances. The results showed that the therapeutic method based on the coordinated behavioral intervention of therapist, home, and the school had a significant effect on changing the daily school behavior (F=21.84, P=0.0001) and reducing task avoidance (F=33.37, P=0.0001). In addition, effect size showed that about 43% of significant difference daily school behavior and 51% of significant difference task avoidance in home between two groups due to training of coordinated plan of therapist, home, and school in experimental group, that is this training has been effective in improving daily school behavior and reducing task avoidance in children with ADHD. Also, the results of a follow-up study showed that daily school behavior and task avoidance in home had significant difference between two groups in every three phases of pretest, post-test and follow-up, that is intervention had stable and effective influence in every three phases and intervention effectiveness ever remained after seven weeks (P<0.001). According to the results of this research that showed the effectiveness of a therapeutic plan based on coordinated behavioral intervention of therapist, home and school on reducing task avoidance and improving daily school behavior and multi-dimensional problems of children with ADHD in home and school and according to advantages of parent intervention and the importance of families-school incorporation and effectiveness of team interventions is recommended that this method uses as multi-dimensional treatment for children with attention deficit-hyperactivity disorder in different educational and therapeutic centers.