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Educational researchers and school-based practitioners are increasingly infusing Motivational Interviewing (MI) into new and existing intervention protocols to provide support to students, parents, teachers, and school administrators. To date, however, the majority of the research in this area has focused on feasibility of implementation rather than fidelity of implementation. In this manuscript, we will present MI fidelity data from 245 audio-recorded conversations with 113 unique caregivers and 20 coaches, who implemented a school-based, positive parenting intervention. The aggregate fidelity scores across coaches, parents, and sessions provide evidence the training and support procedures were effective in assisting school-based personnel to implement MI with reasonable levels of fidelity in practice settings. Further, results suggest that MI fidelity varied between sessions and coaches and that within-coach variation (e.g., session-level variation in the quality of MI delivered) greatly exceeded between-coach variation. Implications for practice and future research are discussed. [This paper will be published in "Prevention Science."]

This study evaluates a peer-delivered intervention for high school students with impairing ADHD symptoms targeting organization, time management, and planning (OTP) and motivation (Students Taking Responsibility and Initiative through Peer Enhanced Support; STRIPES). A mixed-methods open trial (study 1; N=18) and parallel group randomized controlled trial (study 2; N=72) were conducted to examine acceptability, target mechanisms, student outcomes, population fit, and feasibility. Study 1 established acceptability for STRIPES delivered after-school but identified forgetfulness and competing social activities as population-specific implementation barriers. In study 2, three schools employed unique implementation strategies and results varied. An elective pullout model engaging 12th grade peer interventionists under teacher supervision demonstrated good fidelity, attendance, and population-fit, and significant between group differences in bookbag organization (d=1.11), academic motivation (d=0.85 to 2.05), and class attendance (d=1.47) over time compared to control. When implementation strategy demonstrates population-fit, STRIPES shows promise for preventing declining school engagement across ninth-grade. [This paper will be published in "School Psychology Review."]

Objective: To evaluate support for three hypotheses about the etiology of adolescent-onset ADHD symptoms: (1) a "cool" cognitive load hypothesis, (2) a "hot" rewards processing hypothesis, and (3) a trauma exposure hypothesis. Method: Participants (N=50) were drawn from two public high schools in a culturally diverse metropolitan area. A detailed procedure for identifying and confirming late-onset ADHD cases is described. Adolescents with late-onset ADHD (n=15) were identified and compared to childhood-onset (n = 17) and non-ADHD classmates (n = 18). Adolescents and parents completed measures of neurocognition, rewards processing, clinical profile, and environmental demands. Results: Late-onset cases were clinically and neurocognitively indistinguishable from childhood-onset cases; however, they experienced higher demands from parents (d=1.09). Compared to the non-ADHD group, late-onset cases showed significant deficits in metacognition (d=1.25) and academic motivation (d=0.80), as well as a pronounced history of multiple trauma exposure (OR=11.82). At one-year follow-up, ADHD persisted in 67.7% of late-onset cases. Late-onset cases (26.7%) were more likely than childhood-onset cases (0.0%) to transfer to alternative schools (OR=1.36) by one-year follow-up. Conclusions: Multiple factors may contribute to adolescent-onset ADHD. Adolescents with metacognition and motivation deficits may be at greatest risk for the late-onset ADHD phenotype, particularly in highly demanding environments. Exposure to traumatic stress may play a key role in the exacerbation of existing deficits or onset of new symptoms. Late-onset ADHD was persistent in most cases and associated with higher risk for school disengagement than childhood-onset ADHD. Further work is needed to better understand the etiologies of late-onset ADHD symptoms. [This paper will be published in "European Child & Adolescent Psychiatry."]

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with academic failure in high school; however the underpinnings of these difficulties are insufficiently understood. This study examined deficits in self-regulated learning in a sample of high school students with ADHD (n=32) compared to demographically similar classmates without ADHD (n=18). A multimethod battery of self and parent rating scales and cognitive tasks measured aspects of intrinsic motivation, extrinsic motivation, and goal-directed executive functions. A multiple regression modeled predictors of current Grade Point Average (GPA). Results indicated that high school students with ADHD placed lower value on academics (d = 0.99), were less likely to use goalsetting strategies (d = 0.95), possessed lower levels of metacognition (d = 1.86), and showed significant deficits in task-based cognitive flexibility (d = 0.80). After controlling for covariates, the set of self-regulated learning variables explained 23% of the variance in GPA, with metacognition (6% of variance explained) and cognitive flexibility (7% of variance explained) serving as significant predictors of outcome. Findings suggest that higher-order executive function deficits play a critical role in the academic functioning of high school students and students with ADHD show large deficits in these areas. Thus, interventions that target metacognition and cognitive flexibility (i.e., the ability to think through decisions before acting, inhibit automatic responses, and make effective decisions for a desired goal) may be particularly promising to remediate ADHD-related academic problems in high school. [This paper was published in "Journal of School Psychology" v77 p67-76 2019.]