Evaluating the Effectiveness of an Organizational Skills Training Intervention for Children with Executive Function Difficulties

Statement of Problem

Throughout early schooling, children are expected to increase their organization skills, and by 3rd grade experience a relatively high demand for these skills. Organization, time management and planning (OTMP) skills are behavioral manifestations of executive function, a cognitive ability associated with persistent goal-directed behavior. OTMP skills are strongly connected to a child’s academic progress and lay the foundation for future success. Despite support from teachers to help foster these skills in late elementary school years, some students still struggle to develop OTMP skills, which can put them at increased risk for academic failure. These difficulties are particularly common among children with attention deficit/hyperactivity disorder (ADHD). 

In order to help build these critical skills, our colleagues at New York University developed a clinic-based skills training intervention, known as Organizational Skills Training (OST), for students in 3rd through 5th grades who have ADHD. They initially adapted it for use in schools for a broader population of children. Our team further adapted the OST program in collaboration with the original developers for application in small groups by school professionals (OST for schools, or OST-S), and we are evaluating the effectiveness of this program. 

Description

We’re conducting a cluster randomized controlled trial of OST-S in more than 20 schools serving a diverse population in the Greater Philadelphia region. As part of this project, general education teachers refer 3rd to 5th grade students whose OTMP deficits are particularly impacting their academic performance to OST-S. 

This intervention uses small group child skills training along with consultation to parents and teachers to support a child’s acquisition and use of new skills. The program includes strategies for training and coaching school staff to effectively implement OST-S, as well as guidelines to adapt strategies to meet the needs of each school’s uniquely diverse student body. Student sessions address four key organization challenges: 

  • tracking assignments
  • managing materials
  • managing time
  • planning for long-term assignments

Each session teaches a specific skill that addresses one of the four organizational challenges through homework review to assess: between-session skills implementation; skill-building activities such as modeling, shaping, guided practice and reinforcement for organized behavior; cognitive reframing to support a growth mindset; and activities promoting application of new skills to home and school settings. 

Next Steps

Our team is evaluating whether participation in OST-S improves OTMP skills, homework performance and academic achievement of participating students. In addition, the team is examining whether students respond differently to the intervention based on grade level, resources of the school and child characteristics such as the presence of ADHD. Further, we will examine whether the quality of intervention implementation by school professionals and the degree of engagement by participating students has an effect on outcomes. Our team will also complete a cost analysis to determine the cost to the school to offer this program.  

Improving the OTMP skills of students likely will have important downstream effects, including improved study skills and academic performance in middle and high school, which will increase the likelihood students stay in school and achieve social and occupational success in adulthood. In addition, training school professionals to provide the intervention on their own will  substantially increase the capacity of schools to offer this intervention.  

This project page was last updated in April 2022.

Suggested Citation

Children's Hospital of Philadelphia, PolicyLab. Evaluating the Effectiveness of an Organizational Skills Training Intervention for Children with Executive Function Difficulties [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here].