How Coaching Impacts The Academic Functioning of University Students with LD and/or ADHD

1. How Coaching Impacts The Academic Functioning of University Students with LD and/or ADHD A Study conducted at The Academic Success Program for Students with LD/ADHD University of North Carolina at Chapel Hill www.unc.edu/asp AHEAD 2011, Seattle, WA Kristen Rademacher, M.Ed, CPCC University of North Carolina at Chapel Hill krademacher@unc.edu David R. Parker, Ph.D. (Research Consultant) CRG, Inc. drdparker@gmail.com

2. Research Team • Dr. Theresa E. Laurie Maitland, CPCC, Principal Investigator University of North Carolina at Chapel Hill, tmaitlan@email.unc.edu • Erica L. Richman, MSW, Social Work Doctoral student, Research Coordinator University of North Carolina at Chapel Hill • Kristen Rademacher, M.Ed, CPCC, Research Assistant University of North Carolina at Chapel Hill krademacher@unc.edu • Dr. David Parker, Research Consultant Children’s Resource Group (CRG), Indianapolis, IN drdparker@gmail.com

3. Literature Review

4. What do we know about college students with LD/ADHD? • Largest and fastest growing group of disabled students on college campuses Harbour, 2004; NCES, 2000; Henderson, 2001 • Take longer to complete degree than non-disabled peers and the rate of sustained enrollment remains low Jorgenson et al., 2003; Newman 2005; Wagner, Newman, Cameto, Garza, & Levine, 2005 • Graduate at a lower rate than non-disabled peers • 64% non disabled, 53% disabled (all types) NCES, 2003; Wagner et al., 2005 • May graduate at a lower rate than peers with other disabling conditions • 13.1% LD/ADHD versus 24.8% other disabling conditions (after 4 years) Beginning Postsecondary Longitudinal Study Second Follow up, 2001

5. What are the possible reasons for their performance problems? • Academic skill weaknesses • Lower GPAs, more likely to be on probation DePaul et al., 2009; Gerber, 1998; Heiligenstein et al., 1999; Rabiner et al., 2008 • Underdeveloped self-determination skills • “A combination of skills, knowledge and beliefs that enable a person to engage in goal-directed, self-regulated, autonomous behavior” Field et al., 1998 • Underdeveloped executive functioning skills • “An umbrella construct reflecting self-regulatory functions that organize, direct, and manage other cognitive activities, emotional responses and behavior” Biederman et al., 2004; Gioia, Isquith, & Guy, 2001 • Coexisting psychological and/or psychiatric issues • Can impact their attitudes, reactions, coping skills and social integration Barkley et al., 2007; DaDeppo, 2009; Hoy et al., 1997

6. Coaching: An emerging intervention model • Coaching : a popular intervention model for individuals with ADHD Hallowell & Ratey,1994; Jaska & Ratey,1999; Quinn et al., 2000 • Proliferation of opinion articles, books, and case reports , but limited research • Points out the lack of any research to evaluate the impact of coaching • Challenged the field to become rigorous about empirical studies Goldstein, 2005

7. What are we learning about the impact of coaching on students with ADHD? • Coaching appears to improve students’ learning and study skills Field et al., 2010; Parker et al., 2011; Reaser, 2008; Swartz et al., 2005; Zwart & Kallemeyn , 2001 • Coaching appears to improve students’ self-regulation skills Field et al., 2010; Parker et al., 2011; Swartz et al., 2005

8. What are we learning about the impact of coaching on students ADHD? • Coaching appears to improve students’ self -awareness • Coaching appears to improve students academic life • improvements in goal setting and goal attainment • Coaching appears to improve students’ overall well- being • Coaching has not yet been shown to have a direct impact on students’ GPA Field et al., 2010; Parker & Boutelle, 2009; Reaser, 2008

9. What are we learning about the impact of coaching on other populations? • Coaching has a statistically significant impact on retention and graduation rates of 1st year students Bettinger & Baker, 2011 • Coaching may significantly improve the functioning of adults with ADHD Kubik, 2010

10. Coaching Definition for UNC-CH A creative, action-oriented partnership based on model created by Whitworth et. al. (2007) in which students: • Set goals in any area of life in which the student desires change (i.e. academics, balance between study and recreation) • Work with their coach to develop systems and structures to reach these goals • Design the format of their coaching sessions (in-person, phone/email check-ins, etc.) • Agree to be held accountable for commitments made during sessions • Deepen their learning about themselves – including their values and ambitions – which helps to define and refine future goals UNC-CH Website: http://www.unc.edu/asp/

11. Background of UNC Coaches • Both coaches have comparable types/amount of coaching training • Theresa Maitland, CPCC and Kristen Rademacher, CPCC were trained and certified through The Coaches Training Institute. http://www.thecoaches.com/coach-training/ • 116 hours of training followed by 6 month certification program requiring successful completion of written and oral competency exams • Theresa earned her certification in 2003 • Kristen earned her certificationin 2007

12. Methodology

13. Methodology: Research Questions 1. Does coaching increase participants’ levels of self-determination? 2. Does coaching improve participants’ executive functioning skills? 3. Does coaching improve participants’ overall academic skills? 4. From students’ perspective, what are the key benefits and limitations of coaching?

14. Methodology: Procedures • Eligible participants: • Total number of potential participants = 354 • All students with documented LD and/or ADHD who are registered at the ASP and were interested in coaching • Willing to be in either Treatment Group of Control Group • Treatment group willing to commit to at least 16 weekly sessions of coaching over fall and spring semesters • Both groups willing to take 3 surveys at the start of fall semester and again at end of spring semester

15. Methodology: Procedures (cont’d) • Recruitment ran for first 2 weeks of fall semester • All ASP students received 2 personal emails • Flyers describing the study were posted in the ASP office • ASP coaches informed students of study during office visits • Incentives: coupons for free coffee, a gift card to UNC Student Stores and entry into a drawing for Student Stores merchandise • Before receiving coaching, each treatment participant took 3 pre-intervention surveys (2 web-based surveys and 1 paper/pencil survey; 45 minutes total time)

16. Methodology: Procedures (cont’d) • Treatment participants received 16 - 20 coaching sessions throughout Fall 2010 and Spring 2011 semesters • After at least 16 total coaching sessions, treatment participants took the 3 post-intervention surveys • Control Group Participants did not receive coaching, but took all 3 surveys at start of fall semester and again at end of spring semester • Project Manger conducted qualitative interviews with purposive sample of 6 participants during Week 9.

17. Methodology: Participants

18. Methodology: Participants (cont’d)

19. Methodology: Study Participants’ Coaching Goals • Improve in approach to academics All students wanted to stay on top of daily and long- term work, plan more regularly and follow plans, become more consistent and active learners, improve work quality and grades. • Improve overall life balance and well-being Most students wanted to balance social life with academics, make time for exercise, sleep, healthier eating and recreation and pursuing talents/interests. • Be more organized with possessions and space A number of students wanted to improve how well they kept order in their environments and kept track of possessions.

20. Methodology: Study Participants’ Coaching Goals (cont’d) • Improve thinking skills Several students set goals to become more intentional and reflective to think critically before completing a task or making a decision. • Prepare for the future Several students set goals to identify possible careers or next steps for life after college.

21. Intervention

22. Intervention • Structure of Coaching Sessions • Student met with coach for initial 60 minute “intake” session. • Focus of meeting: • Student set specific semester goals • Coach asked student to reflect on strengths, values, passions • Coach and student “designed their alliance”

23. Intervention (cont’d) • Student met with coach weekly for 30 minute sessions (face-to-face or phone) • Student and coach reviewed progress on goals • Coach guided students to reflect on both their progress and setbacks within the context of their strengths, values and passions • Coach also guided students to deepen their understanding of their disability as they reflected on their goals • Student set goals for following week

24. Measures

25. Quantitative MeasuresPre- and Post-Intervention Surveys • Self-Determination Student Scale (S-DSS) Hoffman, Field & Sawilowsky, 2004 • 92 item yes or no internet-based, self-report survey measuring self determination • Higher scores indicate greater self-determination • Behavior Rating Inventory of Executive Function – Adult Version (BRIEF-A) Roth, Isquith & Gioia, 2005 • 75 item self-report survey measuring executive functioning • Lower scores indicate higher level of executive functioning • Learning and Study Strategies Inventory (LASSI) Weinstein, Palmer & Shulte, 2002 • 80 item self-report survey measuring learning and study strategies • Higher scores indicate higher level of skill

26. Qualitative Measures • Purposive sample • 6 students (3 per coach) • Balance of characteristics (undergrad/grad, gender, race/ethnicity, GPA) • Individual Semi-Structured Interview • 1 hour, with Project Manager • 13 prompts generated by team • Audio-recorded and transcribed

27. Qualitative Measures (cont’d) • Analysis • Hand-coding by Research Consultant to generate initial set of codes • Initial inter-rater reliability check between Research Consultant and Project Manager • Refinement of codebook, 2nd inter-rater reliability check • Final refinement of emergent themes in consultation with the research team coaches

28. Results

29. Research Question 1:Impact on Self-Determination • Quantitative Results: S-DSS • Scores • Mean pre-intervention score (Treatment): 67 • Mean post-intervention score (Treatment): 72 • Mean pre-test score (Control): 72 • Mean post-test score (Control): 75 • S-DDS (Hoffman, Field & Sawilowsky, 2004)

30. Pre- and Post- S-DSS Total Scores for Treatment Group

31. Pre- and Post- S-DSS Total Scores for Control Group

32. Results of S-DSS Total Scores: Coaching started to close the gap between groups Post-test: Smaller gap d = .41 Pre-test: Medium gap d = .51

33. Research Question 1/QualitativeImpact on Self-Determination • Promoted students’ self-awareness (44) • Promoted students’ self-esteem (24) • Helped students work toward goals more effectively (21) • Helped students establish goals (18) • Encouraged students to stop and reflect (6)

34. Research Question 1/Qualitative Impact on Self-Determination • “Having Kristen really helps me have manageable goals. Whereas in the past, I probably have taken on chunks and didn’t realize... It would just be too much in the end and I would kind of break down.” - DP • “And that the goals that I set need to be realistic…If I never went to class and I skipped every class last semester, and I said, ‘Well, I’m going to go to every class next semester,’ that’s just silly. There’s no way that’s going to happen. It’s much more productive and much more effective and efficient to set a more reasonable goal - go to half of your classes.” - AD • “[Coaching] helped me see, because, in the end of every week I’ve been able to go, ‘This is what worked this week; this is what didn’t work this week; this is where I need to improve; this is where I’m doing okay.’” - JH

35. Research Question 2:Impact on Executive Functioning Skills • Quantitative Results: BRIEF-A • GEC (Global Executive Composite) Scores • Mean pre-intervention score (Treatment): 83 • Mean post-intervention score (Treatment): 78 • Mean pre-test score (Control): 72 • Mean post-test score (Control): 66 **Lower scores indicate greater executive functioning skills** • BRIEF-A (Roth, Isquith & Gioia, 2005)

36. Pre- and Post BRIEF-A GEC* Scores for Treatment Group Lower scores indicate greater executive functioning skills * Global Executive Composite

37. Pre- and Post BRIEF-A GEC Scores for Control Group

38. Research Question 2/QualitativeImpact on Executive Functioning Skills • Enhanced students’ use of self-talk (24) • Helped student regulate their emotions (21) • Helped students problem solve (9) • Helped students plan (8) • Helped students create a more balanced life (7) • Helped students initiate/persist at tasks (3)

39. Research Question 2/QualitativeImpact on Executive Functioning Skills • “But now when I’m about to open a game or whatever, a goof-off page, it dawns on me that I’m making a conscious decision not to do my work and this feels a little uncomfortable. It’s not as easy as before, when I’d just blame it on, ‘Oh, I get really distracted.’ Now it’s like, ‘I have to take accountability for it.’ And it’s a big difference than what it was before.” - LG • “I’m more willing to - rather than just give up on something - to take a deep breath and calm myself down and look at how I am going to approach it.” - AD • “I think I see a strength in being able to do that analytical, reflective type of thing. Being able to just take the parts into pieces and make very specific plans or goals or whatever…. And I think coaching has helped improve that particular skill.” - JH

40. Research Question 3: Impact on Academic Functioning Pre- and Post- LASSI Cluster Scores • Skill (Information Processing, Selecting Main Idea, & Test Strategies) • Will (Attitude, Motivation, & Anxiety) • Self Regulation (Self-testing, Study Aids, Time Management & Concentration) LASSI (Weinstein, Palmer & Shulte, 2002)

41. Pre- and Post- LASSI Cluster Scores Treatment Group Control Group

42. Pre- and Post- LASSI Scale Scores (Will Cluster)

43. Pre- and Post- LASSI Scale Scores (Self-Regulation)

44. Research Question 3/QualitativeOverall Academic Skills • Helped students self-advocate (9) • Led to better grades (6) • Helped students write papers (3) • Helped students persist with college/attend full-time (2) • Helped students study better (1) • Helped students turn in assignments on time (1)

45. Research Question 3:Overall Academic Skills (cont’d) • “Like at home, my husband; I often take on tasks because I feel like I’ve got to be the wife. So it’s complicated with school and other things. I take things on and then I’m mad later. So a lot of times now I look at the things and I’ll say, ‘Is this worth my time?’ or ‘Is there something else I need to be doing?’ or ‘Can I ask him for help?’” - DP • “[Coaching] had a tremendous impact [on my grades]. I went from below a 2.0 student who was on the verge of dropping out to somebody who has totally acceptable grades, G.P.A., social life, academic and extracurricular involvement.” - JP • “I think coaching is very much about taking the big picture and putting it into small, workable, manageable things, which is kind of how you would approach a big project. For an example, for a paper, saying, ‘I’m going to do this part and then I’m going to do this part and then I’m going to do this part.’” - JH

46. Research Question 4a:Benefits of Coaching (Students’ Perspective) • Develop new skills/employ them more effectively (35) • Created routine time to stop/focus on my goals (12) • Held me accountable (11) • Provided emotional support/reassurance (9) • Exposed me to different perspectives (8) • Helped me access other services/professionals (4) • Provided non-judgmental listening (3) • A flexible service (3) • Helped me develop healthier habits (2) • Helped me access accommodations (1)

47. Research Question 4a:Benefits of Coaching (Students’ Perspective) • “You know, I’ve had some improvement with that as a result of being more organized and making little steps to reach a larger goal.” - JH • “I’d say the biggest advantage is that it keeps me accountable, because I know that we make certain goals together each week. And when I go the next week, I am going to be held accountable for whatever goals we had created together the week before.” - LG • “Well, it’s a place where I can discuss things but it’s not a mirror. It’s not just, ‘Here, look at yourself.’ It’s maybe a compassionate mirror or it’s another person who has thoughts and feelings but is completely on my side or doesn’t have an agenda.” - AD

48. Research Question 4b:Limitations of Coaching (Students’ Perspective) • Hold me even more accountable (5) • Provide more than 30 minutes a week (2) • Locate the office more centrally (1) • Help me gain access to peer’s experiences (1) • Only focused on college (would like to focus on life after college, too) (1)

49. Research Question 4b:Limitations of Coaching (Students’ Perspective) • “And also, there being a more concrete element [in coaching]. Because so far, when I make the so-called promises, they were very informal. I rarely wrote them down, I wasn’t really required to. But all the stuff would slip my mind and I would not actually do them. So maybe having some sort of a formal element where, at every session, you fill out a post-it that consists of three items or something so that I can carry around and incorporate into my life would be helpful.” - JP • “I think I would want to say the meetings will be longer. Maybe an hour. I don’t know if reading should be twice a week. Because I don’t think that…you want students to want to come. If it becomes something like a burden, then that is a problem. But I think an hour wouldn’t hurt. I think it was more effective for me.” - AD

50. Book Title for Coaching’s Impact on You • “When You Do a Little Bit of Thinking, You Can Do the Things You Didn’t Think You Could.” (BP) • “Coach Leads Student to 4th Quarter Victory” (DP) • “No Day But Today” (JH) • “Going the Extra Mile” (LG) • “Why a Single Is Better than a Home Run” (AD) • “The Day I Found the Door” (JP)