The Challenging Horizons Program

The Challenging Horizons Program

 

Overview:

The Challenging Horizons Program (CHP) is a psychosocial intervention program designed to address the academic and social impairments commonly experienced by middle school students with attention-deficit hyperactivity disorder (ADHD).  Originally designed by Dr. Steven W. Evans at James Madison University in Virginia, the CHP has been implemented and tested in public middle school settings by several researchers, including Dr. Josh Langberg at Cincinnati Children’s Medical Center, Dr. Brad Smith at the University of South Carolina, and Dr. Brooke Molina at the University of Pittsburgh.  Two versions of the program—an after-school version and a school consultation version—have been developed since 1999, and efforts are currently underway to determine the relative benefits of each (see descriptions below). 

 

In 2010, the CHP was added to SAMHSA’s National Registry of Evidence-Based Programs (see http://nrepp.samhsa.gov/ViewIntervention.aspx?id=197).

 

 

After-School Version of the CHP:

 

Middle school students who attend the after-school version of the CHP receive direct one-to-one help from counselors (typically undergraduate college students) in the areas of organization, assignment tracking, study skills, note-taking, social problem solving, and self-monitoring in social settings.  In addition, the counselors consult regularly with the students' teachers and hold periodic meetings with the students' parents. The after-school program generally meets two or three times each week during the school year for approximately two-hours per session.  During the program, participants are monitored by staff using a behavior tracking system, and immediate feedback is provided in the form of “behavior calls.”  Performance on the behavior tracking system is rewarded by a step-wise system of privileges and activities.  In this way, the after-school program offers a highly structured and highly rewarding environment that shapes the behavior of participants with the goal of helping them develop socially acceptable ways of meeting typical school demands.  One advantage of the CHP is that these skills are practiced in actual school settings, so that the likelihood that participants will use these skills in their classrooms is increased.

 

Research on the after-school version of the CHP suggests that the program is effective in reducing academic impairment as evidenced by fewer missing assignments, improved performance on organization measures, and better parent and teacher ratings of academic performance when compared to students with ADHD who do not receive the program. 

 

Interested readers are encouraged to review the following studies examining the CHP after-school program:

 

Evans, S. W., Axelrod, J. L., & Langberg, J. M. (2004). Efficacy of a school-based treatment program for middle school youth with ADHD: Pilot data. Behavior Modification, 28(4), 528-547.

Evans, S.W., Schultz, B.K., DeMars, C.E. & Davis, H. (in press). Effectiveness of the Challenging Horizons after-school program for young adolescents with ADHD. Behavior Therapy.

 

Langberg, J. M., Smith, B. H., Bogle, K. E., Schmidt, J. D., Cole, W. R., & Pender, C. A. S. (2007). A pilot evaluation of small group Challenging Horizons Program (CHP): A randomized trial. Journal of Applied School Psychology, 23(1), 31-58.

Molina, B. S. G., Flory, K., Bukstein, O. G., Greiner, A. R., Baker, J. L., Krug, V., et al. (2008). Feasibility and preliminary efficacy of an after-school program for middle schoolers with ADHD: A randomized trial in a large public middle school. Journal of Attention Disorders, 12(3), 207-217.  

 

 

School Consultation Version of the CHP:

 

Based in part on a concern that the after-school program might prove too costly for easy dissemination, researchers also developed a school consultation version of the CHP.  In the school consultation version, trained clinicians (e.g., school or clinical psychologists, social workers) meet regularly with middle school teachers and provide support for CHP interventions to be implemented during the regular school day.  Consultees—referred to as “mentors”—meet on a regular basis (e.g., weekly) with program participants in one-to-one settings, typically between classes, during study halls, or other available time and implement the same types of interventions as those used in the after-school version (described above). 

 

Research on the consultation version of the CHP suggests that the program is effective at improving teacher ratings of classroom performance and academic impairment, as well as reducing the likelihood of academic “crash” (i.e. average grades below passing) over the course of the school year when compared to students with ADHD who do not receive the program.  Moreover, these benefits appear to grow over time, such that students who receive consultation support for two or three school years experience even greater gains relative to their peers. 

 

Interested readers are encouraged to review the following studies of the consultation version of the CHP:

 

Evans, S. W., Serpell, Z. N., Schultz, B. K., & Pastor, D. A. (2007). Cumulative benefits of secondary school-based treatment of students with ADHD. School Psychology Review, 36, 256-273.

 

Schultz, B. K., Evans, S. W., & Serpell, Z. N. (2009). Preventing academic failure among middle school students with ADHD: A survival analysis.  School Psychology Review, 38, 14-27.

 

Serpell, Z. N., Evans, S. W., Schultz, B. K., & Pastor, D. (2008). Incremental benefits of school-based treatment for adolescents with ADHD. ADHD Report, 16, 1-7.

 

 

Current Research on the CHP:

Our current research on the CHP is supported by a research grant from the National Institute of Mental Health, and the work is being completed by teams at Ohio University and the University of Cincinnati College of Medicine (Dr. Josh Langberg). Dr. Brandon Schultz is coordinating the project at Ohio University and working closely with our center manager (Carrie Light) and graduate students (Joey Sadler & Allie Zoromski) along with Dr. Evans (Principal Investigator) to conduct the research. The study involves conducting a cost-benefit analysis of the after-school model of the program with the consultation model with over 300 middle school students