Self-Management Interventions for Students with and without ADHD: A Meta-Analysis of Differential Effects across Outcome Domains and Student Characteristics

Background and Purpose: Self-management (SM) interventions are commonly used in schools to improve student behavior and academic performance, yet less is known about whether their effects differ for students with versus without attention-deficit/hyperactivity disorder (ADHD), across outcome domains, and by student characteristics (Briesch & Chafouleas, 2009). This gap is important because it limits understanding of for whom and under what conditions SM interventions are most effective. Therefore, this study examined (a) whether the effects of SM interventions differ for students with and without ADHD, (b) the effects of SM interventions specifically for students with ADHD, and (c) whether intervention effects for students with ADHD are moderated by race/ethnicity, gender, and age/grade level.

Methods: This study used outcome-level data from a larger meta-analytic database of school-based self-management (SM) interventions. Multilevel meta-analytic models were estimated to account for dependent effect sizes nested within studies. Analyses examined overall effects across all outcomes and separately by behavioral and academic outcome domains. Meta-regression models were used to evaluate ADHD status as a moderator in the full sample and to examine student-level moderators within the ADHD subsample. Within the ADHD subsample, both multiple- and single-moderator models were estimated to assess variation by race/ethnicity, gender, and age/grade level. All models accounted for clustering of effect sizes within studies and were estimated using restricted maximum likelihood.

Results: Across all outcomes, SM interventions did not differ significantly for students with versus without ADHD, F(1, 451) = 0.09, p = .77. Similarly, no ADHD-status differences were found for behavioral outcomes, F(1, 349) = 0.002, p = .97. However, ADHD status significantly moderated academic outcomes, F(1, 100) = 3.99, p = .049, indicating weaker academic effects for students with ADHD relative to students without ADHD. Within the ADHD subsample, SM interventions showed a significant positive overall effect, b = 0.70, p < .001, and a significant positive academic effect, b = 0.45, p = .003. In the multiple-moderator model across all outcomes for students with ADHD, the overall moderator test was marginal, F(6, 87) = 1.87, p = .096. Hispanic students showed significantly smaller effects than the reference group, b = -0.61, p = .020, and middle school students showed smaller effects than elementary students, b = -0.49, p = .042. Gender was not a significant moderator. For behavioral outcomes within the ADHD subsample, Hispanic students (p = .024) and students in the “Other” race category (p = .029) showed smaller effects.

Conclusions and Implications: Findings suggest that SM interventions are broadly effective, including for students with ADHD, but important differences emerge across academic versus behavioral outcomes and across student subgroups. In particular, academic benefits may be weaker for students with ADHD, and effects may vary by race/ethnicity and developmental stage. These findings support the need for more tailored, equity-informed use of SM interventions in school settings and highlight the importance of examining for whom and under what conditions school-based interventions are most effective.