The amount of services delivered by school psychologists through consultation is increasing as is the number of students with challenging behaviors in the classroom. In this type of delivery model, the school psychologist works as a consultant to the teacher who will actually deliver the intervention to the student. The purpose of this research was to examine the relationship between participation in a tertiary level behavior intervention program and teacher efficacy, confidence in dealing with challenging behavior, and implementation of behavior interventions. Two studies were conducted to examine a series of research questions. Study 1 used archival data to examine the influence of teacher efficacy before participation in a tertiary level behavior intervention on the amount of coaching necessary for a teacher to implement an intervention with an acceptable level of integrity. To explore sustainability, Study 2 used a survey of teachers who had participated in a tertiary behavior intervention as well as teachers who had not, to determine if they differed on teacher efficacy, confidence in dealing with challenging behaviors, and use of recommended behavioral strategies. Teacher efficacy was not found to be a statistically significant predictor of the amount of coaching time necessary for the teacher to implement the intervention with integrity. It is hypothesized that other factors such as readiness to change may be contributing to the model. PTR participants did not significantly differ from non-participants in any of the proposed areas. It is possible that non-participants over-estimated their knowledge and abilities. Future research should continue to explore the effects of consultation and its sustainability and while considering these additional factors.

Children with ADHD are characterized frequently as possessing underdeveloped executive functions and sustained attentional abilities, and recent commercial claims suggest that computer-based cognitive training can remediate these impairments and provide significant and lasting improvement in their attention, impulse control, social functioning, academic performance, and complex reasoning skills. The present review critically evaluates these claims through meta-analysis of 25 studies of facilitative intervention training (i.e., cognitive training) for children with ADHD. Random effects models corrected for publication bias and sampling error revealed that studies training short-term memory alone resulted in moderate magnitude improvements in short-term memory (d= 0.63), whereas training attention did not significantly improve attention and training mixed executive functions did not significantly improve the targeted executive functions (both nonsignificant: 95% confidence intervals include 0.0). Far transfer effects of cognitive training on academic functioning, blinded ratings of behavior (both nonsignificant), and cognitive tests (d= 0.14) were nonsignificant or negligible. Unblinded raters (d= 0.48) reported significantly larger benefits relative to blinded raters and objective tests (both p < .05), indicating the likelihood of Hawthorne effects. Critical examination of training targets revealed incongruence with empirical evidence regarding the specific executive functions that are (a) most impaired in ADHD, and (b) functionally related to the behavioral and academic outcomes these training programs are intended to ameliorate. Collectively, meta-analytic results indicate that claims regarding the academic, behavioral, and cognitive benefits associated with extant cognitive training programs are unsupported in ADHD. The methodological limitations of the current evidence base, however, leaves open the possibility that cognitive training techniques iv designed to improve empirically documented executive function deficits may benefit children with ADHD.