The Relation Between Change in Symptoms and Functioning in Children with ADHD Receiving School-Based Mental Health Services

This study examined the relation between reliable change in symptoms and reliable change in functioning in children with attention deficit hyperactivity disorder (ADHD; N = 64) who were enrolled in a school-based mental health program that included a daily report card intervention, teacher consultation, and behavioral parenting sessions. Parents and teachers completed the disruptive behavior disorders rating scale and the impairment rating scale at pre- and post-treatment. Group-level analyses indicated that symptom improvers demonstrated significant improvement in multiple domains of functioning, whereas symptom no-changers and deteriorators did not. However, individual-level analyses revealed that up to 40% (depending on the domain and the informant) of children achieved reliable symptom change without reliable improvement in functioning, and up to 16% achieved reliable change in functioning without reliable change in symptoms. The results have implications for measurement of treatment outcome. © 2009, Springer Science + Business Media, LLC.