A Follow-Up Study of Relational Processes and Consultation Outcomes for Students with Attention Deficit Hyperactivity Disorder.

Abstract The purpose of this study was to link consultant and teacher verbal interaction patterns to consultation outcomes. Participants were 4 consultants, 20 teachers, and 20 elementary school students with attention deficit hyperactivity disorder. Audiotaped Problem Analysis Interviews (PAIs) from Project PASS (Promoting Academic Success in Students) were coded using the Rogers and Farace (1975) relational coding system, and two interpersonal influence measures were calculated. Significant results were as follows: (a) teacher domineeringness (i.e., attempts to influence the consultant) correlated -.66 with treatment integrity; (b) teacher dominance (i.e., successful influence) correlated-. 63 with Behavior Intervention Rating Scale intervention acceptability; (c) teacher dominance correlated -.61 with intervention effectiveness; and (d) consultant dominance correlated .59 with treatment integrity. Unlike Erchul et al. (2007), who found teacher influence within the Problem Identification (initial) Interview to be positively associated with outcomes, here teacher PAI influence was negatively associated with outcomes. Implications include the need to examine consultation as a process and the role of influence within this process. ********** Attention deficit hyperactivity disorder (ADHD) is a diagnosis with significant educational implications. Children with ADHD struggle because of low engagement rates and inconsistent work productivity, and approximately 20-30% are classified as learning disabled because of deficits in the acquisition of specific academic skills (DuPaul & Stoner, 2003). Psychosocial interventions that can assist children with ADHD include those that are teacher, parent, and peer mediated; computer assisted; and self-directed. Until recently, these multiple strategies had not been evaluated in a comprehensive study. However, Project PASS (Promoting Academic Success in Students; DuPaul et al., 2006; Jitendra et al., 2007) has incorporated them within a behavioral consultation approach with teachers (Kratochwill & Bergan, 1990). Project PASS results clearly indicate the utility of behavioral consultation to improve reading and mathematics achievement for students with ADHD over an 18-month period. Behavioral consultation represents a four-stage problem-solving process, and its stages include three separate interviews, each of which contains specific objectives a consultant must address. These four stages are problem identification, problem analysis, plan implementation, and problem evaluation. Although the plan implementation stage does not have a specific interview type associated with it, interviews incorporated into the other stages are the Problem Identification Interview (PII), Problem Analysis Interview (PAI), and Problem Evaluation Interview (Kratochwill & Bergan, 1990). Early behavioral consultation research (Bergan & Tombari, 1976) highlighted the importance of the PII as a critical phase during which a consultant's influence that is displayed through verbal behavior is linked to both proximal (e.g., problem identification) and distal outcomes (e.g., problem resolution). Later research documented positive relationships between consultant influence and various participant perceptions of favorable consultation outcomes within behavioral consultation (see Table 14.5 in Erchul, Grissom, & Getty, 2008). Relatedly, teacher influence during the PII has been associated with negative outcomes (e.g., Erchul & Chewning, 1990). Erchul et al. (2007) recently investigated the connections between verbal interaction patterns and outcomes of behavioral consultation involving students with ADHD. They adopted a relational communication research perspective, evidenced in prior school consultation research (e.g., Grissom, Erchul, & Sheridan, 2003). Two key variables within relational communication research are domineeringness (i.e., directiveness or one's attempts to influence another) and dominance (i. …