Comparing Two Ways to Offer Behavioral Therapy for Children with ADHD from Families with Low Incomes -- The PASS Study

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Attention-deficit/hyperactivity disorder, or ADHD, is a disorder that affects how people learn and relate to others. Students with ADHD may have a hard time paying attention and following classroom rules. ADHD often is treated with medicine by primary care clinicians. Behavior therapy can also help treat ADHD, but families with low incomes may have a hard time obtaining this therapy.

In this study, the research team is comparing two ways to improve access to behavior therapy for children with ADHD in families with low incomes. The first way is a program called Partnering to Achieve School Success, or PASS, which combines behavior therapy with primary care. The second way is usual ADHD primary care plus family education and a referral to community mental health services.

Who can this research help?

Results may help pediatric primary care practices when considering ways to treat children with ADHD in families with low incomes.

What is the research team doing?

The research team is working with primary care clinics to recruit 300 children with ADHD and their caregivers. Children and their caregivers come from families with low incomes. The team is assigning children by chance to one of two groups.

Children in the first group receive the PASS program. PASS uses a team-based approach that combines primary care and behavior therapy services. In this program, caregivers and children receive training from a PASS clinician at a primary care clinic. The program consists of 9 to 12 training sessions over the course of 16 weeks.

PASS clinicians are psychologists and clinical social workers who teach caregivers how to

• Improve their children’s behavior
• Empower themselves to seek help
• Work with teachers to improve behavior at school

Between sessions, a community health worker stays in touch with families to help them keep appointments and use the strategies they learn from PASS.

Children in the second group receive usual ADHD care plus family education. ADHD care may include education on ADHD and ADHD treatments, referral to mental health services, and medicine management. Caregivers in this group have access to two group education sessions about ADHD.

The research team is surveying children, caregivers, and teachers at the start of the study and again four and eight months later. The team is asking about children’s ADHD symptoms, academic progress, behavior, social relationships, and life satisfaction. The team is also looking at medical records to see how often children use healthcare services.

Parents, clinicians, and educators help make decisions about all aspects of the study.

Research methods at a glance