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4. Non-Pharmacological interventions

4.5 Organisation / School-Based Interventions

Clinical Questions

What educational/school/teacher interventions are possible, and are they effective?

Summary of evidence review

No evidence was identified from studies in children aged under 5 years. NICE identified very limited evidence in children and adolescents (5–18 years of age) and no new studies were identified in the updated review. Please see other sections for details of studies that include organisation/school-based components in conjunction with other intervention approaches.

Organisation/School-based versus waitlist/usual care

No new evidence was found. NICE previously identified 8 RCTs comparing organisation/school-based interventions to waitlist/usual care ranging from very low to high quality. There were benefits in inattention symptoms by parent but not teacher report. There were no benefits in parent or teacher-rated ADHD total symptoms, hyperactivity symptoms, and broader functioning/behaviour. There was limited evidence of improvements in terms of academic literacy/numeracy or academic performance outcomes.

Organisation/School-based versus Non-specific supportive therapy

No new evidence was found. NICE previously identified one very low-quality RCT (Molina et al., 2008). There was a clinically important benefit for adolescent-rated other symptoms but no clinically important benefit for emotional dysregulation.

Evidence-to-recommendation statement

Currently, there is insufficient research on organisation and school-based interventions for people with ADHD to warrant any recommendations. It is noted that in the studies included above where the intervention included components of teaching organisational skills, organisational skills were not specifically measured in studies.

There was some evidence of improved parent-reported inattention symptoms associated with organisational/school-based interventions. It should be noted that elements of cognitive behavioural interventions and ADHD coaching draw on principles that help people with organisational skills. Organisational skills may potentially be more helpful for adolescents (and adults with ADHD) however, this review included children and adolescents together.

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