A Preliminary Exploration of Efficacy and Perceptions of Delivery Method in Executive Function Coaching for College Students with Attention-Deficit/Hyperactivity Disorder
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The theoretical framework for analyzing the symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) has progressed in recent years and the deficits witnessed in patients diagnosed with ADHD have been increasingly widely associated with deficient functioning of executive skills. This revolution in thinking has implications for the assessment and clinical management of deficits in executive functioning and researchers and practitioners are challenged to explore a variety of treatment and intervention options that directly address coping with executive dysfunction. Objective: This study describes coaching as an intervention for college students with ADHD and evaluates a program for ADHD coaching, assessing its impact on learning, study, and self-regulation skills. It extends previous research with a preliminary exploration of the effects of varied delivery methods on student outcomes as well as student perceptions of and satisfaction with those methods. The current study also marks the beginning of a series of exploratory studies on the influence of the structure of coach-client interaction in an academic setting on students' executive functioning. Method: A sample of 63 college students with ADHD attending a large 4-year university participated in a study of coaching outcomes conducted over a 13-week period. Students were randomly assigned to participate in coaching or the comparison group of waitlisted controls, completing the Learning and Study Strategies Inventory (Weinstein & Palmer, 2002) before and after the intervention program. Coaching students participated in weekly in person meetings and additional check-ins from the coaches, including phone calls and text message and email reminders, encouragement, and prompts for feedback. All coaches had undergone specific training on addressing the needs of college students with ADHD in an undergraduate academic setting and engaged in extensive preparation for this particular study. Results: Participants who completed the 14-week coaching program showed significant improvement in all 10 areas of study and learning strategies. The coaching group received a statistically higher total LASS I score than the control group, as well as scoring significantly higher on all three LASSI clusters (i.e., Skill, Will, and Self-Regulation). There was no significant effect found based on method of communication in this small preliminary sample. Overall progress in the ADHD coaching sessions was correlated with motivation to be in coaching and students reported that they enjoyed working with the coaches, whom they found to be supportive, amiable, and effective. Students also indicated that coaching helped them become more self-regulated and achieve more balance in their daily lives, which contributed to positive academic experiences and outcomes. The complete report of qualitative results is forthcoming. Conclusion: This study supports previous research by finding ADHD coaching to be effective, using both quantitative and qualitative assessment, in helping students improve their learning and executive functioning skills. Preliminary investigation into the methods of service delivery produced beneficial student responses but should be repeated with a large sample for larger effect sizes. Further evaluation of the efficacy, structure, and components of coaching interventions is warranted, including newly developed assessment measures of executive functions, as it appears coaching has the capacity to promote improved executive functioning in college students with ADHD.