Initiative Description: This study evaluates the effectiveness of school-home notes for increasing academic productivity and on-task behavior of low-income, African American children diagnosed with attention-deficit/hyperactivity disorder (ADHD). Using a withdrawal, alternating treatment design, each student received school-home notes with and without a response cost component where students could lose points based on inappropriate classroom behavior. Inclusion criteria were 1) teacher referral for problematic classroom behavior 2) a diagnosis of ADHD 3) significant levels of off-task behavior during baseline observations (>50% off-task) 4) average scores on 6 subtests of the Woodcock-Johnson Test of Achievement-3rd Ed. 5) member of an ethnic minority group 6) student at an inner-city elementary school primarily serving low-income children. The intervention was implemented in the classroom of each student. Baseline: teachers were instructed to respond to usual appropriate classroom behavior. Daily observations were conducted in the classroom for 30 minutes. School-home note without response cost condition: Notes were placed on the student’s desk at the beginning of the morning work period. The note included the target behaviors “completed coursework satisfactorily” and “used classtime well”. Student performance was rated by the teacher at the end of the work session. The note was taken home at the end of the day and the parents delivered consequences contingent on the criteria set at the beginning of the study. School-Home note with response cost condition: the note was identical with the addition of 5 smiley faces at the bottom of the note and were used in conjunction with the target behavior. Students crossed of a face for each instance of off-task or disruptive behavior during the morning work session. The 2 intervention conditions were randomized across days throughout the treatment intervals.

Study Results: On-task behavior and academic productivity improved in all students under both treatment conditions.

Level of Evidence: Good