# data[].attributes.body
Many studies show students who sleep less suffer academically, as chronic sleep loss impairs the ability to remember, concentrate, think abstractly and solve problems. In one of many studies on sleep and academic performance, Carskadon and her colleagues surveyed 3,000 high school students and found that those with higher grades reported sleeping more, going to bed earlier on school nights and sleeping in less on weekends than students who had lower grades.

# data[].attributes.attachment_link.readable_text
At the same time, today's teens are maturing in an era of ubiquitous electronic media, and they are fervent participants. Some 92 percent of U.S. teens have smartphones, and 24 percent report being online "constantly," according to a 2015 report by the Pew Research Center. Teens have access to multiple electronic devices they use simultaneously, often at night. Some 72 percent bring cellphones into their bedrooms and use them when they are trying to go to sleep, and 28 percent leave their phones on while sleeping, only to be awakened at night by texts, calls or emails, according to a 2011 National Sleep Foundation poll on electronic use. In addition, some 64 percent use electronic music devices, 60 percent use laptops and 23 percent play video games in the hour before they went to sleep, the poll found. More than half reported texting in the hour before they went to sleep, and these media fans were less likely to report getting a good night's sleep and feeling refreshed in the morning. They were also more likely to drive when drowsy, the poll found.

The problem of sleep-phase delay is exacerbated when teens are exposed late at night to lit screens, which send a message via the retina to the portion of the brain that controls the body's circadian clock. The message: It's not nighttime yet.

Yuan, a clinical associate professor of pediatrics, said she routinely sees young patients in her clinic who fall asleep at night with cellphones in hand.

"With academic demands and extracurricular activities, the kids are going nonstop until they fall asleep exhausted at night. There is not an emphasis on the importance of sleep, as there is with nutrition and exercise," she said. "They say they are tired, but they don't realize they are actually sleep-deprived. And if you ask kids to remove an activity, they would rather not. They would rather give up sleep than an activity."

The role of parents

Adolescents are also entering a period in which they are striving for autonomy and want to make their own decisions, including when to go to sleep. But studies suggest adolescents do better in terms of mood and fatigue levels if parents set the bedtime - and choose a time that is realistic for the child's needs. According to a 2010 study published in the journal Sleep, children are more likely to be depressed and to entertain thoughts of suicide if a parent sets a late bedtime of midnight or beyond.

In families where parents set the time for sleep, the teens' happier, better-rested state "may be a sign of an organized family life, not simply a matter of bedtime," Carskadon said. "On the other hand, the growing child and growing teens still benefit from someone who will help set the structure for their lives. And they aren't good at making good decisions."

They say they are tired, but they don't realize they are actually sleep-deprived. And if you ask kids to remove an activity, they would rather not. They would rather give up sleep than an activity.

According to the 2011 sleep poll, by the time U.S. students reach their senior year in high school, they are sleeping an average of 6.9 hours a night, down from an average of 8.4 hours in the sixth grade. The poll included teens from across the country from diverse ethnic backgrounds.

American teens aren't the worst off when it comes to sleep, however; South Korean adolescents have that distinction, sleeping on average 4.9 hours a night, according to a 2012 study in Sleep by South Korean researchers. These Asian teens routinely begin school between 7 and 8:30 a.m., and most sign up for additional evening classes that may keep them up as late as midnight. South Korean adolescents also have relatively high suicide rates (10.7 per 100,000 a year), and the researchers speculate that chronic sleep deprivation is a contributor to this disturbing phenomenon.

By contrast, Australian teens are among those who do particularly well when it comes to sleep time, averaging about nine hours a night, possibly because schools there usually start later.

Regardless of where they live, most teens follow a pattern of sleeping less during the week and sleeping in on the weekends to compensate. But many accumulate such a backlog of sleep debt that they don't sufficiently recover on the weekend and still wake up fatigued when Monday comes around.

Moreover, the shifting sleep patterns on the weekend - late nights with friends, followed by late mornings in bed - are out of sync with their weekday rhythm. Carskadon refers to this as "social jet lag."

"Every day we teach our internal circadian timing system what time it is - is it day or night? - and if that message is substantially different every day, then the clock isn't able to set things appropriately in motion," she said. "In the last few years, we have learned there is a master clock in the brain, but there are other clocks in other organs, like liver or kidneys or lungs, so the master clock is the coxswain, trying to get everybody to work together to improve efficiency and health. So if the coxswain is changing the pace, all the crew become disorganized and don't function well."

This disrupted rhythm, as well as the shortage of sleep, can have far-reaching effects on adolescent health and well-being, she said.

"It certainly plays into learning and memory. It plays into appetite and metabolism and weight gain. It plays into mood and emotion, which are already heightened at that age. It also plays into risk behaviors - taking risks while driving, taking risks with substances, taking risks maybe with sexual activity. So the more we look outside, the more we're learning about the core role that sleep plays," Carskadon said.

Many studies show students who sleep less suffer academically, as chronic sleep loss impairs the ability to remember, concentrate, think abstractly and solve problems. In one of many studies on sleep and academic performance, Carskadon and her colleagues surveyed 3,000 high school students and found that those with higher grades reported sleeping more, going to bed earlier on school nights and sleeping in less on weekends than students who had lower grades.

Sleep is believed to reinforce learning and memory, with studies showing that people perform better on mental tasks when they are well-rested. "We hypothesize that when teens sleep, the brain is going through processes of consolidation - learning of experiences or making memories," Yuan said. "It's like your brain is filtering itself - consolidating the important things and filtering out those unimportant things." When the brain is deprived of that opportunity, cognitive function suffers, along with the capacity to learn.

"It impacts academic performance. It's harder to take tests and answer questions if you are sleep-deprived," she said.

That's why cramming, at the expense of sleep, is counterproductive, said Pelayo, who advises students: Don't lose sleep to study, or you'll lose out in the end.

The panic attack

Chloe Mauvais, 16, hit her breaking point at the end of a very challenging sophomore year when she reached "the depths of frustration and anxiety." After months of late nights spent studying to keep up with academic demands, she suffered a panic attack one evening at home.

"I sat in the living room in our house on the ground, crying and having horrible breathing problems," said the senior at Menlo-Atherton High School. "It was so scary. I think it was from the accumulated stress, the fear over my grades, the lack of sleep and the crushing sense of responsibility. High school is a very hard place to be."

We hypothesize that when teens sleep, the brain is going through processes of consolidation - learning of experiences or making memories. It's like your brain is filtering itself.

Where she once had good sleep habits, she had drifted into an unhealthy pattern of staying up late, sometimes until 3 a.m., researching and writing papers for her AP European history class and prepping for tests.

"I have difficulty remembering events of that year, and I think it's because I didn't get enough sleep," she said. "The lack of sleep rendered me emotionally useless. I couldn't address the stress because I had no coherent thoughts. I couldn't step back and have perspective. ... You could probably talk to any teen and find they reach their breaking point. You've pushed yourself so much and not slept enough and you just lose it."

The experience was a kind of wake-up call, as she recognized the need to return to a more balanced life and a better sleep pattern, she said. But for some teens, this toxic mix of sleep deprivation, stress and anxiety, together with other external pressures, can tip their thinking toward dire solutions.

Research has shown that sleep problems among adolescents are a major risk factor for suicidal thoughts and death by suicide, which ranks as the third-leading cause of fatalities among 15- to 24-year-olds. And this link between sleep and suicidal thoughts remains strong, independent of whether the teen is depressed or has drug and alcohol issues, according to some studies.

"Sleep, especially deep sleep, is like a balm for the brain," said Shashank Joshi, MD, associate professor of psychiatry and behavioral sciences at Stanford. "The better your sleep, the more clearly you can think while awake, and it may enable you to seek help when a problem arises. You have your faculties with you. You may think, 'I have 16 things to do, but I know where to start.' Sleep deprivation can make it hard to remember what you need to do for your busy teen life. It takes away the support, the infrastructure."

Sleep is believed to help regulate emotions, and its deprivation is an underlying component of many mood disorders, such as anxiety, depression and bipolar disorder. For students who are prone to these disorders, better sleep can help serve as a buffer and help prevent a downhill slide, Joshi said.

Rebecca Bernert, PhD, who directs the Suicide Prevention Research Lab at Stanford, said sleep may affect the way in which teens process emotions. Her work with civilians and military veterans indicates that lack of sleep can make people more receptive to negative emotional information, which they might shrug off if they were fully rested, she said.

"Based on prior research, we have theorized that sleep disturbances may result in difficulty regulating emotional information, and this may lower the threshold for suicidal behaviors among at-risk individuals," said Bernert, an instructor of psychiatry and behavioral sciences. Now she's studying whether a brief nondrug treatment for insomnia reduces depression and risk for suicide.

Sleep deprivation also has been shown to lower inhibitions among both adults and teens. In the teen brain, the frontal lobe, which helps restrain impulsivity, isn't fully developed, so teens are naturally prone to impulsive behavior. "When you throw into the mix sleep deprivation, which can also be disinhibiting, mood problems and the normal impulsivity of adolescence, then you have a potentially dangerous situation," Joshi said.

Some schools shift

Given the health risks associated with sleep problems, school districts around the country have been looking at one issue over which they have some control: when school starts in the morning. The trend was set by the town of Edina, Minnesota, a well-to-do suburb of Minneapolis, which conducted a landmark experiment in student sleep in the late 1990s. It shifted the high school's start time from 7:20 a.m. to 8:30 a.m. and then asked University of Minnesota researchers to look at the impact of the change. The researchers found some surprising results: Students reported feeling less depressed and less sleepy during the day and more empowered to succeed. There was no comparable improvement in student well-being in surrounding school districts where start times remained the same.

With these findings in hand, the entire Minneapolis Public School District shifted start times for 57,000 students at all of its schools in 1997 and found similarly positive results. Attendance rates rose, and students reported getting an hour's more sleep each school night - or a total of five more hours of sleep a week - countering skeptics who argued that the students would respond by just going to bed later.

For the health and well-being of the nation, we should all be taking better care of our sleep, and we certainly should be taking better care of the sleep of our youth.

Other studies have reinforced the link between later start times and positive health benefits. One 2010 study at an independent high school in Rhode Island found that after delaying the start time by just 30 minutes, students slept more and showed significant improvements in alertness and mood. And a 2014 study in two counties in Virginia found that teens were much less likely to be involved in car crashes in a county where start times were later, compared with a county with an earlier start time.

Bolstered by the evidence, the American Academy of Pediatrics in 2014 issued a strong policy statement encouraging middle and high school districts across the country to start school no earlier than 8:30 a.m. to help preserve the health of the nation's youth. Some districts have heeded the call, though the decisions have been hugely contentious, as many consider school schedules sacrosanct and cite practical issues, such as bus schedules, as obstacles.

In Fairfax County, Virginia, it took a decade of debate before the school board voted in 2014 to push back the opening school bell for its 57,000 students. And in Palo Alto, where a recent cluster of suicides has caused much communitywide soul-searching, the district superintendent issued a decision in the spring, over the strenuous objections of some teachers, students and administrators, to eliminate "zero period" for academic classes - an optional period that begins at 7:20 a.m. and is generally offered for advanced studies.

Certainly, changing school start times is only part of the solution, experts say. More widespread education about sleep and more resources for students are needed. Parents and teachers need to trim back their expectations and minimize pressures that interfere with teen sleep. And there needs to be a cultural shift, including a move to discourage late-night use of electronic devices, to help youngsters gain much-needed rest.

"At some point, we are going to have to confront this as a society," Carskadon said. "For the health and well-being of the nation, we should all be taking better care of our sleep, and we certainly should be taking better care of the sleep of our youth."

# data[].attributes.attachment_link.title
Among teens, sleep deprivation an epidemic

# data[].attributes.attachment_link.description
Sleep deprivation increases the likelihood teens will suffer myriad negative consequences, including an inability to concentrate, poor grades, drowsy-driving incidents, anxiety, depression, thoughts of suicide and even suicide attempts.

# data[].attributes.body
during the school year, teens say they experience stress levels higher than those reported by adults, according to a previous American Psychological Association "Stress in America" survey.

Odds are if you ask a teen what's got them so worked up, the subject of school will come up. School can cause a lot of stress, which can lead to other serious problems, like sleep deprivation. According to the National Sleep Foundation, teens need between eight and 10 hours of sleep each night, but only 15 percent are even getting close to that amount. During the school week, most teens only get about six hours of zzz’s a night, and some of that sleep deficit may be attributed to homework.

# data[].attributes.attachment_link.readable_text
Today's teens are under a lot of pressure.

They're under pressure to succeed, to win, to be the best and to get into the top colleges. With so much pressure, is it any wonder today's youth report being under as much stress as their parents? In fact, during the school year, teens say they experience stress levels higher than those reported by adults, according to a previous American Psychological Association "Stress in America" survey.

Odds are if you ask a teen what's got them so worked up, the subject of school will come up. School can cause a lot of stress, which can lead to other serious problems, like sleep deprivation. According to the National Sleep Foundation, teens need between eight and 10 hours of sleep each night, but only 15 percent are even getting close to that amount. During the school week, most teens only get about six hours of zzz's a night, and some of that sleep deficit may be attributed to homework.

When it comes to school, many adults would rather not trade places with a teen. Think about it. They get up at the crack of dawn and get on the bus when it's pitch dark outside. They put in a full day sitting in hours of classes (sometimes four to seven different classes daily), only to get more work dumped on them to do at home. To top it off, many kids have after-school obligations, such as extracurricular activities including clubs and sports, and some have to work. After a long day, they finally get home to do even more work - schoolwork.

Homework is not only a source of stress for students, but it can also be a hassle for parents. If you are the parent of a kid who strives to be "perfect," then you know all too well how much time your child spends making sure every bit of homework is complete, even if it means pulling an all-nighter. On the flip side, if you're the parent of a child who decided that school ends when the last bell rings, then you know how exhausting that homework tug-of-war can be. And heaven forbid if you're that parent who is at their wit's end because your child excels on tests and quizzes but fails to turn in assignments. The woes of academics can go well beyond the confines of the school building and right into the home.

This is the time of year when many students and parents feel the burden of the academic load. Following spring break, many schools across the nation head into the final stretch of the year. As a result, some teachers increase the amount of homework they give. The assignments aren't punishment, although to students and parents who are having to constantly stay on top of their kids' schoolwork, they can sure seem that way.

From a teacher's perspective, the assignments are meant to help students better understand the course content and prepare for upcoming exams. Some schools have state-mandated end of grade or final tests. In those states these tests can account for 20 percent of a student's final grade. So teachers want to make sure that they cover the entire curriculum before that exam. Aside from state-mandated tests, some high school students are enrolled in advanced placement or international baccalaureate college-level courses that have final tests given a month or more before the end of the term. In order to cover all of the content, teachers must maintain an accelerated pace. All of this means more out of class assignments.

Given the challenges kids face, there are a few questions parents and educators should consider:

Many teens may give a quick "no" to this question, but the verdict is still out. Research supports both sides of the argument. Personally, I would say, yes, some homework is necessary, but it must be purposeful. If it's busy work, then it's a waste of time. Homework should be a supplemental teaching tool. Too often, some youth go home completely lost as they haven't grasped concepts covered in class and they may become frustrated and overwhelmed.

For a parent who has been in this situation, you know how frustrating this can be, especially if it's a subject that you haven't encountered in a while. Homework can serve a purpose such as improving grades, increasing test scores and instilling a good work ethic. Purposeful homework can come in the form of individualizing assignments based on students' needs or helping students practice newly acquired skills.

Homework should not be used to extend class time to cover more material. If your child is constantly coming home having to learn the material before doing the assignments, then it's time to contact the teacher and set up a conference. Listen when kids express their concerns (like if they say they're expected to know concepts not taught in class) as they will provide clues about what's happening or not happening in the classroom. Plus, getting to the root of the problem can help with keeping the peace at home too, as an irritable and grumpy teen can disrupt harmonious family dynamics.
How much is too much?
According to the National PTA and the National Education Association, students should only be doing about 10 minutes of homework per night per grade level. But teens are doing a lot more than that, according to a poll of high school students by the organization Statistic Brain. In that poll teens reported spending, on average, more than three hours on homework each school night, with 11th graders spending more time on homework than any other grade level. By contrast, some polls have shown that U.S. high school students report doing about seven hours of homework per week.

Much of a student's workload boils down to the courses they take (such as advanced or college prep classes), the teaching philosophy of educators and the student's commitment to doing the work. Regardless, research has shown that doing more than two hours of homework per night does not benefit high school students. Having lots of homework to do every day makes it difficult for teens to have any downtime, let alone family time.
How do we respond to students' needs?
As an educator and parent, I can honestly say that oftentimes there is a mismatch in what teachers perceive as only taking 15 minutes and what really takes 45 minutes to complete. If you too find this to be the case, then reach out to your child's teacher and find out why the assignments are taking longer than anticipated for your child to complete.

Also, ask the teacher about whether faculty communicate regularly with one another about large upcoming assignments. Whether it's setting up a shared school-wide assignment calendar or collaborating across curriculums during faculty meetings, educators need to discuss upcoming tests and projects, so students don't end up with lots of assignments all competing for their attention and time at once. Inevitably, a student is going to get slammed occasionally, but if they have good rapport with their teachers, they will feel comfortable enough to reach out and see if alternative options are available. And as a parent, you can encourage your kid to have that dialogue with the teacher.

Often teens would rather blend into the class than stand out. That's unfortunate because research has shown time and time again that positive teacher-student relationships are strong predictors of student engagement and achievement. By and large, most teachers appreciate students advocating for themselves and will go the extra mile to help them out.
Can there be a balance between home and school?
Students can strike a balance between school and home, but parents will have to help them find it. They need your guidance to learn how to better manage their time, get organized and prioritize tasks, which are all important life skills. Equally important is developing good study habits. Some students may need tutoring or coaching to help them learn new material or how to take notes and study. Also, don't forget the importance of parent-teacher communication. Most educators want nothing more than for their students to succeed in their courses.

Learning should be fun, not mundane and cumbersome. Homework should only be given if its purposeful and in moderation. Equally important to homework is engaging in activities, socializing with friends and spending time with the family.

Most adults don't work a full-time job and then go home and do three more hours of work, and neither should your child. It's not easy learning to balance everything, especially if you're a teen. If your child is spending several hours on homework each night, don't hesitate to reach out to teachers and, if need be, school officials. Collectively, we can all work together to help our children de-stress and find the right balance between school and home.

# data[].attributes.attachment_link.title
How Much Homework Is Too Much for Our Teens?

# data[].attributes.attachment_link.description
Today's teens are under a lot of pressure. They're under pressure to succeed, to win, to be the best and to get into the top colleges. With so much pressure, is it any wonder today's youth report being under as much stress as their parents?

# data[].attributes.body
ALEXANDRIA, Va., Dec. 11, 2018 – According to new research from the Better Sleep Council (BSC) – the nonprofit consumer-education arm of the International Sleep Products Association – homework, rather than social pressure, is the number one cause of teenage stress, negatively affecting their sleep and ultimately impacting their academic performance.

Seventy-nine percent reported getting 7 hours of sleep or less on a typical school night, more than two-thirds (67%) say they only get 5 to 7 hours of sleep on a school night, and only about one in five teens is getting 8 hours of sleep or more.

# data[].attributes.attachment_link.provider_name
Better Sleep Council | Start every day with a good night's sleep

# data[].attributes.attachment_link.readable_text
ALEXANDRIA, Va., Dec. 11, 2018 - According to new research from the Better Sleep Council (BSC) - the nonprofit consumer-education arm of the International Sleep Products Association - homework, rather than social pressure, is the number one cause of teenage stress, negatively affecting their sleep and ultimately impacting their academic performance.

American teenagers said they spend 15+ hours a week on homework, and about one-third (34%) of all teens spend 20 or more hours a week. This is more than time spent at work, school clubs, social activities and sports. When asked what causes stress in their lives, about three-quarters of teens said grades/test scores (75%) and/or homework (74%) cause stress, more than self-esteem (51%), parental expectations (45%) and even bullying (15%). In fact, according to the American Psychological Association's Stress in America™ Survey, during the school year, teenagers say they experience stress levels higher than those reported by adults.

Further, more than half (57%) of all teenagers surveyed do not feel they get enough sleep. Seventy-nine percent reported getting 7 hours of sleep or less on a typical school night, more than two-thirds (67%) say they only get 5 to 7 hours of sleep on a school night, and only about one in five teens is getting 8 hours of sleep or more. Based on the BSC's findings, the more stressed teenagers feel, the more likely they are to get less sleep, go to bed later and wake up earlier. They are also more likely to have trouble going to sleep and staying asleep - more often than their less-stressed peers.

"We're finding that teenagers are experiencing this cycle where they sacrifice their sleep to spend extra time on homework, which gives them more stress - but they don't get better grades," said Mary Helen Rogers, vice president of marketing and communications for the Better Sleep Council. "The BSC understands the impact sleep has on teenagers' overall development, so we can help them reduce this stress through improved sleep habits."

The BSC recommends that teens between the ages of 13-18 get 8-10 hours of sleep per night. For teens to get the sleep their bodies need for optimal school performance, they should consider the following tips:

Establish a consistent bedtime routine. Just like they set time aside for homework, they should schedule at least 8 hours of sleep into their daily calendars. It may be challenging in the beginning, but it will help in the long run.

Keep it quiet in the bedroom. It's easier to sleep when there isn't extra noise. Teens may even want to wear earplugs if their home is too noisy.

Create a relaxing sleep environment. Make sure the bedroom is clutter-free, dark and conducive to great sleep. A cool bedroom, between 65 and 67 degrees, is ideal to help teens sleep.

Cut back on screen time. Try cutting off screen time at least an hour before bed. The blue light emitted from electronics' screens disturbs sleep.

Examine their mattress. Since a mattress is an important component of a good night's sleep, consider replacing it if it isn't providing comfort and support, or hasn't been changed in at least seven years.

Other takeaways on the relationship between homework, stress and sleep in teenagers include:

Teens who feel more stress (89%) are more likely than less-stressed teens (65%) to say homework causes them stress in their lives.

More than three-quarters (76%) of teens who feel more stress say they don't feel they get enough sleep - which is significantly higher than teens who are not stressed, since only 42% of them feel they don't get enough sleep.

Teens who feel more stress (51%) are more likely than less-stressed teens (35%) to get to bed at 11 p.m. or later. Among these teens who are going to bed later, about 33% of them said they are waking up at 6:00 a.m. or earlier.

Students who go to bed earlier and awaken earlier perform better academically than those who stay up late - even to do homework.

About the BSC
The Better Sleep Council is the consumer-education arm of the International Sleep Products Association, the trade association for the mattress industry. With decades invested in improving sleep quality, the BSC educates consumers on the link between sleep and health, and the role of the sleep environment, primarily through www.bettersleep.org, partner support and consumer outreach.

# data[].attributes.attachment_link.title
Teens, Sleep and Homework Survey Results - Better Sleep Council | Start every day with a good night's sleep

# data[].attributes.attachment_link.description
ALEXANDRIA, Va., Dec. 11, 2018 - According to new research from the Better Sleep Council (BSC) - the nonprofit consumer-education arm of the International Sleep Products Association - homework, rather than social pressure, is the number one cause of teenage stress, negatively affecting their sleep and ultimately impacting their academic performance.

# data[].attributes.body
School can present challenges for many children with ADHD. Because ADHD symptoms include difficulty with attention regulation, hyperactivity, and impulsivity, which can affect planning, organizing, and managing behavior, many children with ADHD struggle with change.

# data[].attributes.attachment_link.provider_name
Centers for Disease Control and Prevention

# data[].attributes.attachment_link.description
How to help children with ADHD with changes in schooling

# data[].attributes.body
Evidence indicates that children with Attention Deficit Hyperactivity Disorder (ADHD) experience acute and prolonged academic impairment and underachievement including marked difficulty with completing homework.

# data[].attributes.attachment_link.readable_text
Abstract

Objective

Evidence indicates that children with Attention Deficit Hyperactivity Disorder (ADHD) experience acute and prolonged academic impairment and underachievement including marked difficulty with completing homework. This study is the first to examine the effects of behavioral, psychostimulant, and combined treatments on homework problems, which have been shown to predict academic performance longitudinally.

Method

Children with ADHD (ages 5-12, N = 75, 71% male, 83% Hispanic/Latino) and their families were randomly assigned to either behavioral treatment (homework-focused parent training and a daily report card; BPT+DRC) or a waitlist control group. Children also participated in a concurrent psychostimulant crossover trial conducted in a summer treatment program. Children's objective homework completion and accuracy were measured as well as parent-reported child homework behaviors and parenting skills.

Results

BPT+DRC had large effects on objective measures of homework completion and accuracy (Cohen's ds from 1.40, to 2.21, p s < .001). Other findings, including unimodal medication and incremental combined treatment benefits, were not significant.

Conclusions

Behavioral treatment focused on homework problems results in clear benefits for children's homework completion and accuracy (the difference between passing failing, on average) whereas long-acting stimulant medication resulted in limited and largely non-significant acute effects on homework performance.

Keywords: ADHD, behavioral treatment, psychostimulants, parent training

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity ( Nigg & Barkley, 2014). Prevalence rates are estimated at around 11% (CDC, 2011), making ADHD the most common mental health disorder among children. Children with ADHD experience widespread, severe functional impairments across social, academic, and behavioral domains throughout development and into adulthood ( Faraone, Biederman, & Mick, 2006; Sibley et al., 2012). Further, ADHD is a major public health concern and is associated with very high societal, familial, and individual costs ( Pelham, Foster, & Robb, 2007; Robb et al., 2011).

One of the most impairing aspects of childhood ADHD is the robust relation with prolonged academic underachievement ( Frazier, Youngstrom, Glutting, & Watkins, 2007; Loe & Feldman, 2007; Molina et al., 2009; Polderman, Boomsma, Bartels, Verhulst, & Huizink, 2010). Elementary aged children with ADHD have severe academic problems characterized by lower seatwork completion, seatwork accuracy, on-task behavior, and homework performance than their peers ( Atkins, Pelham, & Licht, 1985; Mautone, Marshall, Costigan, Clarke, & Power, 2012; Power, Werba, Watkins, Angelucci, & Eiraldi, 2006). Problems continue into later school years as individuals with ADHD in middle and high school have poorer organizational skills, lower report card grades, higher truancy, and higher rates of suspension and grade retention than their peers ( Barkley, Fischer, Smallish, & Fletcher, 2006; Kent et al., 2011; Molina et al., 2009; Robb et al., 2011). Further, significantly fewer individuals with ADHD graduate from high school (68% vs. 100% of controls; Barkley et al., 2006) or enroll in four year colleges and universities than controls (29.5% vs. 76.8% of controls; Kuriyan et al., 2013).

Effective treatment options focused on academic functioning for children with ADHD are of critical importance. Much work has been done evaluating the effects of the three evidence-based treatments for ADHD, stimulant medication, behavioral treatment, and their combination, on academic impairment within school and analog settings. The most widely used evidence based treatment for children with ADHD, psychostimulants ( Visser et al., 2014), has been shown to produce consistent acute improvements across studies in seatwork completion, disruptive behavior, and on-task behavior in the classroom ( Conners, 2002; Pelham et al., 2001). However, existing research shows that these acute salutary effects of stimulants on daily seatwork productivity do not translate into long-term academic gains ( Brak & Brak, 2011; Langberg & Becker, 2012; Loe & Feldman, 2007; Molina et al., 2009), which, in conjunction with the high proportion of children with ADHD who receive stimulant medication as the sole treatment (69% currently medicated; Visser et al., 2014), highlights the importance of researching psychosocial/psychoeducational methods to improve educational outcomes for children with ADHD.

The primary psychosocial evidence-based treatment for ADHD, behavioral modification, consists of classroom management and/or behavioral consultation in the school setting ( Evans, Owens, & Bunford, 2014; Pelham, Wheeler, & Chronis, 1998; Pelham & Fabiano, 2008). Classroom management procedures and interventions, including skills such as setting clear limits and rules, providing contingent positive reinforcement, and using a Daily Report Card (DRC; Dupaul, Eckert, & Vilardo, 2012; Fabiano et al., 2010; Volpe & Fabiano, 2013), have produced short-term improvements in classroom behavior and seatwork completion and accuracy among children with ADHD in classroom and analog classroom settings ( Dupaul et al., 2012; Fabiano et al., 2007, 2009). Combined stimulant and behavioral treatment also leads to improved functioning in the school setting and provides additional benefits. In analog classroom settings, combined treatment at low to moderate doses of each component results in incremental improvements in seatwork completion and classroom behavior, yielding larger effects than either treatment alone ( Fabiano et al., 2007; Pelham et al., 1993, 2005). Further, combining treatments allows for lower doses of each individual treatment than would be needed for either treatment to produce similar beneficial effects ( Fabiano et al., 2007; Pelham et al., 2014). This is critical due to the potential expense of "high doses" of behavioral treatment and the increased side effects at higher doses of stimulant medication.

Though direct intervention in the school is warranted for all children with ADHD, it is potentially advantageous to explore additional ways to intervene around the academic functioning of children with ADHD, such as at the home or parenting level. One underdeveloped area of research is the effect of interventions targeting homework success among children with ADHD across settings. The homework process, as a whole, is abundant with steps that can be especially difficult for a child with ADHD to complete, such as writing down assignments, remembering to bring materials home, sitting down to complete assignments, continuing to work despite a distracting home environment, sustaining effort until work is complete, and remembering to turn in assignments the next day. In fact, children with ADHD exhibit more severe homework problems than typically developing peers ( Epstein et al., 1993, Power et al., 2006), supporting the importance of homework performance as a treatment target and pathway to academic improvement. Though the literature is mixed, studies tend to indicate that, in the general population, homework is positively related to achievement and that the relation is stronger in the middle school and high school ( Cooper, Robinson, & Patall, 2006). However, longitudinal studies show that homework performance in elementary school is a key predictor of later academic success among individuals with ADHD ( Langberg et al., 2011),

The impact of stimulants on homework functioning has rarely been evaluated in a controlled study, and available findings are mixed. When comparing naturalistically defined groups of medicated and unmedicated children with ADHD, no significant differences in homework performance (% accuracy) or parent and teacher reported homework problems have been found ( Mautone et al., 2012). Evans and colleagues (2001) conducted the only study to date manipulating stimulant dose to examine effects on homework. The study was conducted among adolescents with ADHD in a controlled setting (the Summer Treatment Program; STP), and results indicate a small, significant effect of short-acting methylphenidate (MPH) on homework completion in response to the highest late afternoon dose of MPH (15mg; Cohen's d = 0.35).

Evidence-based behavioral treatments, such as behavioral parent training (BPT), are well poised to affect educational outcomes due to their inherent flexibility to target specific problem behaviors in the settings where they occur. Interventions containing a psychosocial component show larger effects on homework problems than interventions lacking that component, and significant improvements are sustained two years post-treatment ( Langberg et al., 2010). Given the positive impact of parental involvement on student motivation and achievement in the general population ( Englund, Luckner, Whaley, & Egeland, 2004; Gonzalez-Dehass, Willems, & Holbein, 2005; Jeynes, 2005), BPT interventions focused on homework problems and facilitating school-home communication may be particularly helpful in improving the academic achievement and performance of children with ADHD.

Within the extensive array of BPT programs for children with ADHD, two programs have been developed that target homework functioning: 1) Family School Success Program (FSS; Power, Karustis, and Habboushe, 2001) and 2) Parents and Teachers Helping Kids Organize (PATHKO; Abikoff et al., 2013). Both programs include many efficacious components of BPT (i.e., consistent responding, time out, goal setting, rewards, and positive attention; Kaminski et al., 2008) and have demonstrated efficacy in improving parent-reported problem behaviors during homework time, with moderate to large effect sizes ranging from .52 to 1.51 ( Abikoff et al., 2013; Power et al., 2012). Further, these academic-focused BPTs improved self-reported parenting strategies, teacher reported homework problems, and parent and teacher reported organizational skills. Interestingly, children who happened to be on stimulant medication and received BPT showed greater improvement on parent reported homework management than their unmedicated peers ( Power et al., 2012). However, medication was not controlled or manipulated in this study, and objective measures of homework completion and accuracy were not utilized. No rigorously controlled trials to date have investigated the effect of behavioral treatment, psychostimulant treatment, and their combination on homework performance among children with ADHD.

The current efficacy study aims to address this gap by evaluating single and combined treatment effects in a highly controlled Summer Treatment Program (STP). The STP setting allows for the systematic evaluation of treatment effects on objective measures of homework completion and accuracy in addition to parent-reported problems, which expands further on the current literature. We hypothesize that both behavioral and medication treatments will produce benefits on child homework performance. Additionally, we hypothesize that combined treatment will produce improvements in homework performance beyond that of either unimodal treatment.

Method

Participants

Seventy-five children ages 5 to 12 years (mean age = 7.97 years, SD = 1.71) who were treated in the STP and enrolled in a larger clinical trial to evaluate tolerance to stimulant medication ( MH099030) participated in the current study. All participants met DSM-5 diagnostic criteria for ADHD (77% combined presentation, 20% predominantly inattentive presentation, 3% predominantly hyperactive/impulsive presentation). As is standard in the field, symptoms were considered present if either the parent or teacher endorsed the symptom on the Disruptive Behavior Disorders Rating Scale (DBD; Pelham, Gnagy, Greenslade, & Milich, 1992) or a parent structured clinical interview (DISC IV; Shaffer, Fisher, & Lucas, 1998) and impairment was reported on the Impairment Rating Scale (IRS; Fabiano et al., 2006; Pelham, Fabiano, & Massetti, 2005). Additionally, 58% of participants met criteria for Oppositional Defiant Disorder, and 12% met criteria for Conduct Disorder. Participants were predominantly male (71%) and of Hispanic/Latino ethnicity (83%). In terms of child race, 89% of the sample identified as white, 15% as black, and 1% as American Indian or Alaska Native (categories were not mutually exclusive). Median family income was 48,000 dollars, and average family income was largely skewed by two families earning near 500,000 per year (M = 75,025, SD = 85,887). includes additional demographic information.

Children were excluded from the study if they had an estimated Full-Scale IQ below 80, had a previous diagnosis of Autism Spectrum Disorder (or if parents, teachers, or clinicians observed or reported behaviors consistent with Autism, additional measures were administered), were currently receiving psychotropic medications for conditions other than ADHD, had conditions that could be made worse by stimulant medication (e.g., sustained, severe tics), or had documented intolerability or lack of response to stimulant medication (as evidenced by worsened or not improved symptoms on checklists). Initially, 79 children were randomized to either the behavioral treatment (BPT+DRC) or waitlist control (WL; who received BPT in the fall following the STP) resulting in 40 children being assigned to BPT+DRC and 39 to the WL group. All children were also involved in a three-week double-blind placebo/medication crossover (described below). Collectively, treatment allocation allowed us to conduct analyses across four conditions (i.e., no intervention, medication only, BPT+DRC only, and combined intervention) regarding the effect of behavioral and stimulant treatment on homework. Four children (see ) were not included in analyses as they dropped out prior to baseline data collection and did not receive their assigned treatment.

Research Design

This study was approved by the Institutional Review Board and participants completed consent and assent forms. The children in this study attended the STP from 8am to 5pm, 5 days per week, for 8 consecutive weeks. The STP is an evidence-based, comprehensive behavioral treatment for ADHD that includes a point system, contingent rewards, and social reinforcement for appropriate behavior ( Evans, Owens, & Bunford, 2014; Fabiano, Schatz, & Pelham, 2014; Pelham & Fabiano, 2008). Children spent seven hours per day in recreational settings and two hours per day in an analog classroom setting (divided into two periods). Homework was assigned by teachers in the afternoon classroom and collected in the morning classroom the following day.

The STP setting allowed for systematic control of the homework assigned. Multiple sources of information were used to determine the appropriate grade level and the amount of homework that should be assigned to each child. Grade level was determined by evaluating children's grade equivalencies on achievement testing (Wechsler Individual Achievement Test-3 rd Edition: Numerical Operations and Word Reading subtests) in combination with the STP teacher's input on the feasibility of assignments for each child. The amount of homework assigned was based on nationally representative average teacher expectations for the amount of time children should spend doing homework, separately reported for Math and Reading/Language Arts and for 1 st, 3 rd, and 5 th grade (RLA; see U.S. Department of Education, 2008), with average time expectations for RLA and Math combined varying from 25 to 60 minutes each night across 1 st to 5 th grade. To apply this information to each child, children were timed completing homework assignments in the classroom (during the first two weeks of the STP), and STP teachers were consulted. On Monday through Thursday each week, children were typically assigned 2-4 mathematics worksheets and 1-3 short reading comprehension assignments depending on the child's grade level and the time they took to complete assignments, as described above.

Intervention

Medication

Children underwent a 2-week titration period during which they were randomly assigned to receive three different doses of once-daily, extended-release MPH (Concerta 18, 27, and 36 mg, except for 10 children who received comparable doses of Focalin XR). The lowest dose that produced substantive or incremental efficacy with minimal side effects during the two-week titration was administered during a subsequent medication crossover. Children were randomly assigned to receive medication or placebo for three consecutive weeks, including weekends, and the crossover condition for the final three weeks of the STP. Children were prescribed an average daily dose of 21 mg ( SD = 7.8), or .70 mg/kg/day ( SD = .25). Most children (66.7%) received 18mg Concerta, 5mg Focalin XR, or 10mg of Daytrana, 24% received 27mg of Concerta, 8% received 36mg of Concerta or 10mg of Focalin XR, and 1.3% (one child) received 54mg of Concerta.

Behavioral Treatment

Families were randomly assigned to either the homework-focused behavioral intervention (BPT+DRC) or a waitlist control group (WL). BPT+DRC was a behavioral treatment package largely based on Power's work developing the FSS and the Homework Success Program (HSP; Power, Karustis, & Habboushe, 2001) as well as general parent training content from the Community Parent Education Program (COPE; Cunningham, Bremner, & Boyle, 1995; Cunningham, 1990) and a DRC. The HSP manual was used for all homework-focused sessions and within-session content (e.g., homework routine, when-then contingencies, homework goals). The more general parent training skills (e.g., positive attention, time out) in the current intervention were derived from COPE, the standard BPT program employed in the STP (see for outline of session content). In the COPE style of parent training, families sit in small subgroups of about seven parents each, watch video-taped vignettes of parenting errors, and discuss parenting errors, alternative strategies, potential barriers, and benefits of strategies. After each discussion, parent subgroup leaders report back to the larger group, and BPT clinicians facilitate discussion by reflecting questions back to the group and modeling proposed strategies. Due to the predominantly Hispanic sample, subgroup language could be either English or Spanish, and a Spanish-speaking translator was present in each of the parent training sessions.

BPT+DRC consisted of six, two-hour group sessions were completed in the evenings during the first two weeks of the STP, and one 30 minute, individual session was completed during the subsequent two weeks. Group BPT sessions were facilitated by PhD-level clinicians (authors WEP and EKC) with extensive experience leading the COPE program and co-facilitated by doctoral students (BMM and ARA). Childcare was provided during all sessions. In the individual session, parents discussed individualized homework plans and behavior plans with a group facilitator and generated feasible solutions to improve parenting effectiveness and strategy use. In addition to the individualized DRC goals that were developed for each child as a standard component of the STP, all children in the BPT+DRC group, and no children in the WL group, had a goal stating 'Completes homework with 80% accuracy.' As described above, homework was assigned at each child's level of academic achievement, so this goal was not individualized. In the STP setting, children are often reminded of DRC goals, children earn 'Fun Friday' based on meeting at least 80% of their goals three days, and counselors communicate the child's success in meeting his or her goals to the parent at the end of each camp day. Daily DRC feedback was provided in Spanish if the family preferred.

Measures

Objective Measures

Homework completion (# complete / # assigned) and homework accuracy (# correct / # complete) were assessed separately for Math and Reading/Language Arts (RLA) to evaluate the efficacy of medication and behavioral treatment in improving functional, objective academic outcomes ( Fabiano et al., 2007; Pelham, Gnagy, Greiner, Waschbusch, Fabiano, & Burrows-MacLean, 2010). Completion and accuracy were calculated by totaling the number of problems assigned, completed, and correct for the final week of each crossover phase (STP weeks 5 and 8), and the resulting values were used in subsequent analyses.

Parent-Report Measures

Parents completed measures at baseline, after the first three-week cross-over period, and after the final crossover. As such, parents were asked to reflect on the previous three weeks when completing forms. The Homework Problems Checklist (HPC; Anesko, Schoiock, Ramirez, & Levine, 1987) is a 20-item scale that assesses child homework performance via parent report. Research indicates consistency with coefficient alphas from .90 to .92 ( Anesko et al., 1987). According to multiple factor analyses, the HPC has two factors that measure 1) Completion behaviors (i.e., problem behaviors occurring during homework time; current study α = .91) and 2) Poor materials management (i.e., problems related to bringing homework materials home and turning in assignments; current study α = .83; Langberg et al., 2010; Power, Werba, Watkins, Angelucci, & Eiraldi, 2006).

The Alabama Parenting Questionnaire, Negative/Ineffective Discipline Factor (APQ N/ID; Shelton, Frick, & Wooton, 1996) assesses parent-reported negative parenting strategies such as inconsistent responding and overly harsh responding to child behavior. The validity of the N/ID factor has been examined and supported by previous research ( Hinshaw et al., 2000; current study α = .77). Additionally, the parent reported the time the child took the medication (M = 7:21, SD = 0:20) and completed homework (M = 18:59, SD = 1:19) daily, and this was used to calculate the variable hours since receiving medication (M = 11:27, SD = 1:56). Hours since receiving medication was used as a control variable herein as it is difficulty to interpret the effects given the low variability in time of medication ingestion and the instruction in the BPT classes to begin homework earlier.

Missing Data Handling

Missingness was low across measures (1-7%). T-tests comparing outcome variables for individuals who had missing and non-missing values did not indicate significant group differences ( ps > .05; variables included IQ, ADHD, ODD, and CD symptoms, age, gender, HPC and APQ baseline score, parent age, and parent income) apart from one comparison. Findings support the assumption that data were missing at random. Item-level multiple imputation in SPSS 20 including all above variables was used to create 10 imputed datasets ( Schafer, 1999). Results were pooled with PROC MI ANALYZE in SAS 9.3. Missing values for items correct indicated that completion was either missing or zero and were therefore not imputed. As homework accuracy was defined as items correct divided by items complete, computation would result in an undefined integer as a result of the denominator (completion) being zero.

Analyses

Generalized Linear Mixed Models (GLMMs; Stroup, 2012) were used to analyze both the objective measures and parent-report measures to accommodate the repeated measures design. PROC GLIMMIX was utilized for analyses of objective measures. For both Math and RLA, completion was analyzed by entering the number of problems completed as the events variable and the number of problems assigned as the trials variable producing a percentage as the outcome variable ( Schabenberger, 2005). Similarly, accuracy for both Math and RLA was analyzed with number of items correct as the events variable and number of completed items as the trials variable. Sequence of medication treatment was controlled for in the model as a random effect. Further, models included the following variables as fixed effects: cross-over period, hours between taking medication and starting homework, medication status, group assignment (BPT+DRC or WL), and the interaction between treatments. Analyses controlled for interactions between cross-over period and treatment variables ( Simpson & Hamer, 1999; Yarandi, 2004).

PROC MIXED was used to analyze the parent-report measures with HPC Completion Behaviors, HPC Materials Management, and APQ N/ID as the outcome variables in three separate models. Random effects were identical to the previous analyses. Fixed effects in these models included the relevant baseline score, cross-over period, medication status, BPT+DRC or WL group, the interaction between treatment variables, and interactions with cross-over period.

Results

Intervention Adherence

Parents in the BPT+DRC group attended an average of 5 of 7 total sessions (group and individual). Modal attendance was 100% of sessions, and the median attendance was 6 of 7 sessions. Of the six group sessions, 19% of families attended 1 to 3 sessions, 49% attended 4 or 5 sessions, and 32% attended all six group sessions. Attendance for the individual, booster session was 80%. Two separate BPT groups were held simultaneously, with 21 families (representing 24 children due to siblings in the study) in one group and 15 families in the second group. Based on the audiotapes of sessions, BPT clinicians implemented 94% of parent training procedures per session on average (SD = 5%), though for one session in one BPT group, the audiorecorder malfunctioned and did not record the session. Medication or placebo was taken daily (depending on the cross-over period), and parents turned in a card each morning stating the time they administered the pill.

Objective Measures

Due to the cross-over design of this study and the inclusion of cross-over period and treatment sequence covariates, we report estimated means and associated statistical tests rather than parameter estimates to aid in clear interpretation. In the text, we report main treatment effects for BPT+DRC and medication controlling for the other treatment and covariates. See for model-estimated means for each treatment group and post-hoc comparisons.

Table 3

Homework Completion

The model analyzing Math completion indicates a non-significant effect of medication, t(114.5) = -1.83, p = .07, and a significant effect of BPT+DRC with a very large effect size (see ), t(95.9) = -8.85, p < .001, in that children in the BPT+DRC group completed about 12% more Math homework than the WL group controlling for medication status. The effect of the interaction between medication and BPT+DRC on Math completion was not significant, and least square mean differences are therefore not described here (see ). F-statistics for the interaction ranged from 0.27 to 2.98 (numerator df = 1, denominator df = 114), with all p-values greater than 0.05. The association between hours since receiving medication and Math completion was not significant, t(11.9) = -2.18, p = .051.

The model analyzing RLA completion similarly indicates a non-significant effect of medication, t(125.3) = -1.76, p = .08, and a significant effect of BPT+DRC, t(95.4) = -6.25, p < .001, such that children in the BPT+DRC group completed just over 10% more RLA homework than the WL group, controlling for medication. The interaction between medication and BPT was not significant, and F-statistics for the interaction ranged from 0.19 to 2.48 (numerator df = 1, denominator df = 114), with all p-values greater than 0.05. The effect of hours since receiving medication was significant, t(12.5) = -2.26, p = .04, such that less time between taking medication and starting homework was related to higher RLA homework completion.

Homework Accuracy

The effect of medication on Math homework accuracy was not significant, t(115) = -1.23, p = .22, and there was a significant effect of BPT+DRC, t(115) = -6.82, p < .001, indicating that children in the BPT+DRC group had about 6% higher Math homework accuracy than the WL group, controlling for medication. However, the interaction between medication and BPT+DRC was significant (see ), F(1, 115) = 7.33, p = .01. Least square mean differences between combined, unimodal, and no treatment groups on Math accuracy were explored due to the significant interaction and indicated that BPT+DRC only and combined treatment were both superior to no treatment, t(115) = -6.70, p < .001, t(115) = -5.94, p < .001, and were both superior to medication only, t(115) = -3.85, p < .001, t(115) = -2.93, p = .004, respectively. Combined treatment was not significantly better than BPT+DRC only, t(115) = 1.04, p = .30. Medication only was significantly superior to no treatment, t(115) = -2.85, p < .001, indicating that children had about 4% higher accuracy on their Math homework when receiving medication compared to the no treatment group. The effect of hours since receiving medication on Math accuracy was not significant, t(115) = 1.79, p = .08.

The effect of medication on RLA homework accuracy was not significant, t(114) = -0.58, p = .56, and the effect of BPT+DRC on RLA accuracy was significant, t(114) = -6.20, p < .001, indicating that children in the BPT+DRC group had about 6% higher RLA accuracy than the WL group. However, the interaction between medication and behavioral treatment was significant (see ), F(1, 114) = 4.05, p = .047. Least square mean differences between combined, unimodal, and no treatment groups on RLA accuracy indicated that BPT+DRC only and combined treatment were both superior to no treatment, t(114) = -5.73, p < .001, t(114) = -5.00, p < .001, and were both superior to medication only, t(114) = -3.83, p < .001, t(114) = -3.00, p = .003, respectively. Combined treatment was not significantly better than BPT+DRC only, t(114) = 1.00, p = .32. There was a trend for improved RLA accuracy in the medication only group compared to no treatment, t(114) = -1.86, p = .07. The effect of hours since receiving medication on RLA accuracy was not significant, t(114) = 0.93, p = .35.

Parent-Report Measures

As stated previously, results display estimated means as opposed to parameter estimates to facilitate clear interpretation, and contains estimated means for each treatment group. In the models predicting each of the parent-report measures (HPC Completion Behaviors, HPC Materials Management, and APQ N/ID) there was not a significant effect of medication, t(117.9) = 1.74, p = .08, t(109.6) = -0.18, p = 89, t(110.1) = 0.84, p = .40, BPT+DRC, t(116.8) = -1.28, p = .21, t(133.6) = -0.28, p = .78, t(128.6) = 1.58, p = .12, or their interaction, F(1, 71) = 0.02, p > .05 ⁵, F(1, 71) = 1.16, p > .05, F(1, 71) = 0.16, p > .05, respectively. Baseline scores significantly predicted post-treatment scores in each of the models, b = 0.32, t(122.2) = 3.27, p < .001, b = 0.32, t(135.11) = 4.51, p < .001, b = 0.58, t(134.7) = 6.40, p < .001, indicating that the individual's baseline HPC Completion Behaviors, HPC Materials Management, and APQ N/ID scores were positively related to their post-treatment scores, respectively.

Discussion

This study provides the first controlled evaluation of the effect of behavioral treatment, long acting stimulant medication, and their combination on homework functioning among children with ADHD. Results indicated that 1) homework-focused BPT with a DRC component results in improved objective homework performance (completion and accuracy) among children with ADHD, 2) long-acting stimulant medication produces small and likely clinically insignificant benefits on homework accuracy only in the absence of homework-focused behavioral treatment, 3) combined behavioral treatment and medication did not produce additional benefit beyond behavioral treatment alone on objective measures of homework performance, and 4) significant treatment effects on parent-report measures were not found. Each finding and its clinical implications are now discussed in turn.

Behavioral Treatment

The BPT+DRC program implemented to improve parental management of child behavior, organization, and productivity during homework time consistently led to substantial, acute improvements in objective measures of homework completion and accuracy. The current study found that children in the homework-focused behavioral treatment group achieved 10-13% higher homework completion and 8% higher accuracy than the WL group. Considering homework completion and accuracy together, children in the BPT+DRC group achieved a 'C' on average (92% correct of 83% complete is a score of about 75%) whereas children who did not receive BPT+DRC and were not on medication achieved an 'F' on average (58% in math and 62% in RLA). Thus, receiving the BPT and DRC treatment program was the difference between passing and failing homework assignments. By influencing a critical predictor of academic success, this study replicates previous research demonstrating the efficacy of behavioral treatment in improving daily academic functioning among children with ADHD (e.g., Fabiano et al., 2007; Power et al., 2012) and expands this research by including objective homework performance.

Efficacy trials investigating similar interventions (i.e., FSS and PATHKO) indicate effect sizes varying from .52 to 1.51 on parent report measures of homework functioning. The results of the current study extend their reports by indicating compelling and meaningful benefits of behavioral treatment on objective measures of homework completion and accuracy (Cohen's ds from 1.40 - 2.26). Compared to parent ratings, objective measures are more face-valid exemplars of a child's actual performance. Though problematic behavior during homework time is a clinical concern among children with ADHD ( Power et al., 2006), homework scores rather than behavior during home work are more directly related to academic success and grades at school.

Another strength of the current study is that the STP setting afforded high experimental control over the homework assigned, grading procedures, and specific intervention components, namely the individualized DRC. The DRC is an existing component of the STP, and children in the BPT+DRC group were necessarily given the DRC goal 'completes homework with 80% accuracy' whereas the WL group did not have this goal. At the end of each day in the STP, children, parents, and counselors review the child's progress on his or her DRC goals and discuss which contingent home reward will be earned that evening. Though the FSS study also included a DRC component, the fidelity and consistency of DRC implementation in the FSS study likely varied by each individual child's teacher and school just as the specific homework assigned and grading procedures would vary.

Overall, clinically significant, compelling benefits on objective measures of homework completion and accuracy were found for children whose families received homework-focused parent training and DRC. To the extent that a teacher incorporates homework into a child's grade in a given subject area, the behavioral intervention used herein could have a meaningful impact on the child's grades and academic performance. Improving homework functioning among children with ADHD is critical as homework problems are severe and longitudinally related to important academic outcomes such as grades in this population ( Langberg et al., 2010; Langberg et al., 2011; Power et al., 2006).

Medication

Medication effects were limited and neither clinically nor academically meaningful. Despite achieving about 3-4% higher homework accuracy when receiving medication in the absence of BPT+DRC, children did not complete significantly more homework, and BPT+DRC alone was significantly superior to medication alone in all analyses of homework completion and accuracy. The results indicating a statistically non-significant medication effects on homework completion are surprising given the extensive literature documenting effects on comparable measures in the classroom ( Fabiano et al., 2007; Pelham et al., 2001).

Environmental differences between home and school may be critical to explaining the lack of medication effects on homework completion despite clear effects on seatwork completion in the classroom setting. School and classwork are typically structured with clear expectations, minimal distractions, and a consistent routine. Further, a well-run classroom will include teacher monitoring, classroom rules, and individualized performance feedback. Although these same strategies are taught to parents in homework-focused BPT, it is possible that in the absence of this basic routine and structure, children aren't more likely to work on assignments when receiving medication. It is also likely that parents are less consistent than teachers in implementing routine, structure, and contingencies during academic work.

Additionally, this study may have failed to indicate a positive effect of medication due to the low doses used and the time course of Concerta. The majority of studies showing effects of medication in the classroom setting were conducted with slightly higher doses and during peak hours (i.e., when medication should have its largest effect; Fabiano et al., 2007; Pelham et al., 2001). In this study, homework performance was measured at an average of 11.5 hours post ingestion. Research on the time course of Concerta indicates that effects are clear 12 hours post-ingestion ( Pelham et al., 2001). However, the average dose in that study (35mg) is considerably higher than the average dose of 21mg used in the current study, and the time courses of different doses of Concerta have not been studied. Despite this limitation, the time between medication administration and homework completion reported herein likely represents many families' experiences starting homework after school or when parents return from work. Further, doses were titrated to optimize behavioral performance and productivity in the analog classroom and would be appropriate school-day doses despite potentially being low during homework time. This is the only study to date systematically examining the effects of long-acting stimulant medication on homework among children with ADHD, and available evidence therefore does not indicate a benefit of long-acting stimulant medication on homework performance.

Combined Treatment

Contrary to hypotheses, combined treatment did not provide additional benefit beyond the main effect of BPT+DRC on the objective measures of homework completion and accuracy. Similar to medication effects, it is possible significant results were not found because 1) the dose of medication was too low to affect home behavior, 2) the effects of BPT+DRC were large and overshadowed potential incremental medication effects (ceiling effect), or 3) there is no additional benefit of stimulants on homework performance beyond effective parenting among children with ADHD. It is unlikely that the doses were too low to result in combined effects, as combining the same dose of stimulant and behavioral treatments employed here results in large, positive effects on completion and accuracy in the classroom ( Fabiano et al., 2007).

Additional Limitations

Limitations of psychosocial, psychostimulant, and combined treatments have been discussed above. Additionally, the potential that the STP setting impacted the ability to detect improvements on parent-report measures is a limitation. It is possible that the overall improvement across academic, sports, and peer domains that families report during the course of the STP ( O'Connor et al., 2014; Chronis et al., 2004; Fabiano et al., 2007; Pelham et al., 2014) limited the incremental benefit that parents would perceive from the additional parent training program. For instance, the HPC scores herein fall within a 1.5 standard deviation range of normative scores on the HPC (Factor 1 M = 9.82, SD = 6.45; Factor 2 M = 2.97, SD = 2.79; Power et al., 2006) and scores in this study are within a similar range to post-treatment scores from the Multimodal Treatment of ADHD study ( Langberg et al., 2010). The beneficial effects on objective measures are impressive given the extensive cross-domain treatment the children were receiving. Although the beneficial effects on homework may have been difficult for parents to detect, the magnitude of improvement was the difference between passing and failing homework assignments, on average. This effect would impact a child's academic grades to the extent that treatment gains transfer to the school year and the child's teachers integrate homework scores into their grading procedures. Additionally, it is important to note that further work is needed to maximize effects on homework performance as the highest average grade (considering accuracy of homework completed) was about 75-80% which is in the C to B- range in typical grading scales.

Homework assignments were determined based upon national guidelines, achievement scores, and the classroom teachers' knowledge about each individual child's abilities. Thus, we are confident that our homework volume and difficulty level closely matched what children were receiving in their regular classrooms. However, whether our belief is accurate remains an empirical question. This trial was conducted in a highly-controlled STP setting, and, though that is a strength of an efficacy trial, future research may need to adapt treatment design to transport less controlled settings. In doing so, it may be beneficial to ensure that the DRC is implemented with fidelity, as it is in the STP, and as has been shown to be important in community settings ( Fabiano et al., 2010). The extent to which findings can be generalized may also be impacted by the high proportion of minority families in the current study (83% Hispanic), as this is not representative of the United States population. The treatment itself was not specifically adapted in this study. However, the COPE model (which promotes and reinforces parental empowerment to develop the parenting strategies themselves and work together in small groups) may allow for the cultural diversity to be accommodated without altering the intervention, and the positive results indicate that the non-modified version of the intervention was efficacious in this population. Lastly, parent training attendance varied in the current study, and future studies may find larger effects if attendance were improved.

Conclusions

This study indicates that behavioral treatment in the form of parent skills training and a DRC goal focused on child homework problems results in statistically significant and academically meaningful acute improvements in homework performance among children with ADHD. Children's homework performance was, on average, about two letter grades higher when considering their accuracy of completed work if they received the BPT+DRC intervention compared to the WL group. The most commonly used treatment for children with ADHD, stimulant medication, did not have a significant effect on homework completion and resulted in very limited improvement on homework accuracy, which remained lower than accuracy in the BPT+DRC group. There is currently no evidence to support the recommendation that physicians commonly give to parents guiding them to use long-acting stimulant medication in order to improve their child's homework success and performance (cf. pharmaceutical advertisements for long-acting stimulants claiming such benefits: adpharm.net, 2009). This study suggests that BPT that includes a well-implemented DRC would be a superior treatment recommendation for homework problems among children with ADHD. Finally, this study was an efficacy study conducted in a controlled setting, and replication in regular school settings is the logical next step in this research.

​

This study provides additional evidence that behavioral treatment is efficacious in improving homework performance among children with ADHD. Despite being advertised as beneficial, long-acting stimulant medication is not recommended for the remediation of homework problems at this time.

Acknowledgments

Author Note: This research was conducted within a grant funded by the National Institute of Mental Health (R01-MH099030). Dr. Pelham was also supported in part by grants from the Institute of Education Sciences (R324J060024, R324B060045, R324A120136, R324A120169, LO3000065A), the National Institute of Mental Health ( MH092466, MH101096, MH083692), and the National Institute of Alcohol Abuse and Alcoholism (AA11873), and the National Institute on Drug Abuse (DA12414).

Footnotes

¹ Data from weeks 5 and 8 were used because the BPT+DRC individual session occurred during weeks 3 and 4.

² As Langberg et al., 2010 recommends, item #18 was omitted from the HPC factors due to low factor loadings.

³The only significant comparison indicated that missing baseline HPC data was related to IQ and hyperactive/impulsive symptoms due to one case ( p < .05; significance changed to p > .05 with case removed). Analyses on parent-report measures were completed with this individual and without, and results did not change.

⁴ The SAS procedure used to run the models on objective measures, PROC GLIMMIX, does not pool F-statistics when using PROC MIANALYZE and does not allow the user to manually pool F-statistics as is possible in PROC MIXED which was used herein for parent-report measures.

⁵Using PROC MIXED, the information necessary to manually pool F-statistics for interaction terms was able to be collected ( Wang, Fang, & Jin, 2014). Due to manual pooling, results were compared to an F-table, and specific p-values cannot be provided.

References

Fabiano GA, Schatz NK, Pelham WE. Summer Treatment Programs for youth with Attention-deficit/Hyperactivity Disorder. Child and Adolescent Psychiatric ... 2014 Retrieved from [http://www.sciencedirect.com/science/article/pii/S1056499314000443. PMC free article] [PubMed]

Pelham WE, Burrows-Maclean L, Gnagy EM, Fabiano GA, Coles EK, Tresco KE, et al. Hoffman MT. Transdermal methylphenidate, behavioral, and combined treatment for children with ADHD. Experimental and Clinical Psychopharmacology. 2005 doi: 10.1037/1064-1297.13.2.111. [[PubMed] [CrossRef] Google Scholar]

Pelham WE, Burrows-Maclean L, Gnagy EM, Fabiano GA, Coles EK, Wymbs BT, et al. Waschbusch DA. A dose-ranging study of behavioral and pharmacological treatment in social settings for children with ADHD. Journal of Abnormal Child Psychology. 2014 doi: 10.1007/s10802-013-9843-8. [[PMC free article] [PubMed] [CrossRef] Google Scholar]

Power TJ, Mautone JA, Soffer SL, Clarke AT, Marshall SA, Sharman J, et al. Jawad AF. A family-school intervention for children with ADHD: results of a randomized clinical trial. Journal of Consulting and Clinical Psychology. 2012;80(4):611-23. [[PMC free article] [PubMed] Google Scholar]

Power TJ, Werba BE, Watkins MW, Angelucci JG, Eiraldi RB. Patterns of parent-reported homework problems among ADHD-referred and non-referred children. School Psychology Quarterly. 2006 doi: 10.1521/scpq.2006.21.1.13. [[CrossRef] Google Scholar]

U.S. Department of Education. Issue brief: expectations and reports of homework for public school students in the first, third, and fifth grades. NCES 2009-033. 2008 Retreived from http://nces.ed.gov/pubs2009/2009033.pdf.

Wang B, Fang Y, Jin M. Combining type-iii analyses from multiple imputations. 2014 Retrieved from http://support.sas.com/resources/papers/proceedings14/1543-2014.pdf.

Yarandi H. Crossover Designs and Proc Mixed In SAS, 1-11. 2004 Retrieved from http://analytics.ncsu.edu/sesug/2004/SD04-Yarandi.pdf.

# data[].attributes.attachment_link.title
Improving Homework Performance Among Children with ADHD: A Randomized Clinical Trial

# data[].attributes.attachment_link.description
Evidence indicates that children with Attention Deficit Hyperactivity Disorder (ADHD) experience acute and prolonged academic impairment and underachievement including marked difficulty with completing homework. This study is the first to examine the effects of behavioral, psychostimulant, and combined treatments on homework problems, which have been shown to predict academic performance longitudinally.

# data[].attributes.body
Latino parents should not be delegated the school's responsibilities of teaching children academics. These enlarged responsibilities exasperate socioeconomic, linguistic, and schooling inequities rather than alleviate them.

# data[].attributes.body
The End of Homework: How Homework Disrupts Families, Overburdens Children, and
Limits Learning by Kralovec and Buell (2000), considered by many to be the first high-profile
attack on homework, asserted that homework contributes to a corporate-style, competitive U.S.
culture that overvalues work to the detriment of personal and familial well-being. The authors
focused particularly on the harm to economically disadvantaged students, who are
unintentionally penalized because their environments often make it almost impossible to
complete assignments at home.

# data[].attributes.body
https://www.jstor.org/stable/pdf/40503382.pdf

# data[].attributes.body
Homework demanded that parents spend
significant amounts of time with children on
schoolwork, but these interactions were frequently
tense and frustrating for both parents and their
children.

# data[].attributes.body
A new study by the Stanford Graduate School of Education and colleagues found that students in high-performing schools who did excessive hours of homework “experienced greater behavioral engagement in school but also more academic stress, physical health problems, and lack of balance in their lives.”

Those health problems ranged from stress, headaches, exhaustion, sleep deprivation, weight loss and stomach problems, to psycho-social effects like dropping activities, not seeing friends or family, and not pursuing hobbies they enjoy.

# data[].attributes.attachment_link.readable_text
A new study by the Stanford Graduate School of Education and colleagues found that students in high-performing schools who did excessive hours of homework "experienced greater behavioral engagement in school but also more academic stress, physical health problems, and lack of balance in their lives."

Those health problems ranged from stress, headaches, exhaustion, sleep deprivation, weight loss and stomach problems, to psycho-social effects like dropping activities, not seeing friends or family, and not pursuing hobbies they enjoy.

In the Stanford Report story about the research, Denise Pope, a senior lecturer at the Stanford Graduate School of Education and a co-author of the study published in the Journal of Experimental Education, says, "Our findings on the effects of homework challenge the traditional assumption that homework is inherently good."

The study was based on survey data from a sample of 4,317 students from 10 high-performing high schools in California communities in which median household income exceeded $90,000. Of the students surveyed, homework volume averaged about 3.1 hours each night.

"It is time to re-evaluate how the school environment is preparing our high school student for today's workplace," says Neville Golden, MD, chief of adolescent medicine at Stanford Medicine Children's Health and a professor at the School of Medicine. "This landmark study shows that excessive homework is counterproductive, leading to sleep deprivation, school stress and other health problems. Parents can best support their children in these demanding academic environments by advocating for them through direct communication with teachers and school administrators about homework load."

# data[].attributes.attachment_link.title
Health Hazards of Homework - Stanford Medicine Children's Health Blog

# data[].attributes.attachment_link.description
A new study found that students who did excessive hours of homework "experienced greater behavioral engagement but also more academic stress, physical health problems, and lack of balance in their lives."

# data[].attributes.body
How does extra homework impact families: “A lot of irritability, a lot of snapping, a lot of arguments, arguments between parents and children, arguments between parents. Homework has gotten to the point now where it really affects the whole family every evening and it really spoils evenings.”

# data[].attributes.attachment_link.readable_text
News

Families that do not have a parent with a college degree or families where English was not the first language have about two and half times the levels of family stress.

Listen

When it comes to homework, experts recommend a 10-minute rule. That means ten minutes of homework for each grade level. So first graders start with ten minutes, and the time gradually increases, up to two hours for seniors in high school.
Here are some highlights from their conversation:
But recent studies show that even young students are assigned much more than that. News 88.7 Education Reporter Laura Isensee recently sat down with therapist and author Stephanie Donaldson-Pressman to talk about the increasing homework load for children and their parents.

What is the actual homework load: " In primary school, which is kindergarten through the third grade, children are getting about three times as much homework that they should be."

What's the role for parents: "Parents now really are expected to be able to help their children with homework. That's not supposed to be the job of the parent. A parent's 'homework' should be making sure their child has plenty of fresh air and exercise, getting outside for neighborhood play, for pick-up play."

How does extra homework impact families: "A lot of irritability, a lot of snapping, a lot of arguments, arguments between parents and children, arguments between parents. Homework has gotten to the point now where it really affects the whole family every evening and it really spoils evenings."

Which families feel it the most: "Families that do not have a parent with a college degree or families where English was not the first language have about two and half times the levels of family stress as other families."

What can families do to reduce their stress: "Parents go out and get a cute little timer. The timer is set for the recommended amount of time. The child needs to get to their homework place, which needs to be a special place that they go every day, preferably at the same time every day. And when that timer goes off, if they have not been able to finish their homework, and they really have been focusing and trying to do it, then it's very important that the parent write a note, if the child is old enough to do that, that the child to write a note, and say, 'I worked hard for 20 minutes, 30 minutes, an hour and I had problems with it. This is as far as I got.' But most teachers will be receptive because they are fully aware of how difficult all this homework is."

Subscribe to Today in Houston

Fill out the form below to subscribe our new daily editorial newsletter from the HPM Newsroom.

# data[].attributes.attachment_link.title
How Homework Overload Stresses Out Families | Houston Public Media

# data[].attributes.attachment_link.description
Families that do not have a parent with a college degree or families where English was not the first language have about two and half times the levels of family stress. When it comes to homework, experts recommend a 10-minute rule. That means ten minutes of homework for each grade level.

# data[].attributes.headline
Source 9 Stephanie Donaldson-Pressman clinical director of the New England Center for Pediatric Psychology. 

# data[].attributes.subject
Source 9 Stephanie Donaldson-Pressman clinical director of the New England Center for Pediatric Psychology. 

# data[].attributes.body
“Parents may find it hard to evaluate the homework,” she says. “They think, if this is coming home, my child should be able to do it. If the child can’t, and especially if they feel like they can’t help, they may get angry with the child, and the child feels stupid.” That’s a scenario that is likely to lead to more arguments, and an increased dislike of the work on the part of the child.

# data[].attributes.body
Family stress was examined in the context of children's homework load and parents' perception of their capacity to assist their children with homework. Homework load was measured utilizing the 10 Minute Rule promulgated by the National Education Association. Family stress, measured by self-report, increased as homework load increased and as parent's perception of their capacity to assist decreased. Contrary to the 10 Minute Rule, primary school children received about three times the recommended load of homework. The amount of homework load reported also varied significantly between English and Spanish speakers, as it did between parents with limited education and those with advanced education.

# data[].attributes.attachment_link.readable_text
Family stress was examined in the context of children's homework load and parents' perception of their capacity to assist their children with homework. Homework load was measured utilizing the 10 Minute Rule promulgated by the National Education Association. Family stress, measured by self-report, increased as homework load increased and as parent's perception of their capacity to assist decreased. Contrary to the 10 Minute Rule, primary school children received about three times the recommended load of homework. The amount of homework load reported also varied significantly between English and Spanish speakers, as it did between parents with limited education and those with advanced education.

# data[].attributes.attachment_link.title
Homework and Family Stress: With Consideration of Parents' Self Confidence, Educational Level, and Cultural Background

# data[].attributes.attachment_link.description
Family stress was examined in the context of children's homework load and parents' perception of their capacity to assist their children with homework. Homework load was measured utilizing the 10 Minute Rule promulgated by the National Education Association. Family stress, measured by self-report, increased as homework load increased and as parent's perception of their capacity to assist decreased.

# data[].attributes.body
Several studies show elementary students who do homework fare no better in school than students who do not. There is a slight uptick in higher grade levels, but the impact is minimal. However, Dr. Liew says homework can be beneficial to learning and achievement – because some subjects and school projects require more practice or time to complete than others.

# data[].attributes.attachment_link.title
Analyzing Homework's Impact - Education and Human Development

# data[].attributes.attachment_link.description
Close to one in five students in Texas struggles with English - a nearly 50 percent increase over the last decade. Because of a teacher shortage...

# data[].attributes.body
Both the survey data and student responses indicate that spending too much time on homework meant that students were “not meeting their developmental needs or cultivating other critical life skills,” according to the researchers. Students were more likely to drop activities, not see friends or family, and not pursue hobbies they enjoy.

# data[].attributes.attachment_link.title
Stanford research shows pitfalls of homework

# data[].attributes.attachment_link.description
A Stanford researcher found that students in high-achieving communities who spend too much time on homework experience more stress, physical health problems, a lack of balance and even alienation from society.

# data[].attributes.body
children in disadvantaged areas are more likely headed to work after school, taking care of siblings while their parents work or dealing with an unstable home life. Adding homework into the mix is one more thing to deal with — and if the student is struggling, the task of completing homework can be too much to consider at the end of an already long school day.

# data[].attributes.attachment_link.readable_text
Schools are getting rid of homework from Essex, Mass., to Los Angeles, Calif. Although the no-homework trend may sound alarming, especially to parents dreaming of their child's acceptance to Harvard, Stanford or Yale, there is mounting evidence that eliminating homework in grade school may actually have great benefits, especially with regard to educational equity.

In fact, while the push to eliminate homework may come as a surprise to many adults, the debate is not new. Parents and educators have been talking about this subject for the last century, so that the educational pendulum continues to swing back and forth between the need for homework and the need to eliminate homework.

The Problem with Homework: It Highlights Inequalities

One of the most pressing talking points around homework is how it disproportionately affects students from less affluent families. The American Psychological Association (APA) explained:

"Kids from wealthier homes are more likely to have resources such as computers, internet connections, dedicated areas to do schoolwork and parents who tend to be more educated and more available to help them with tricky assignments. Kids from disadvantaged homes are more likely to work at afterschool jobs, or to be home without supervision in the evenings while their parents work multiple jobs."
[RELATED] How to Advance Your Career: A Guide for Educators >>
While students growing up in more affluent areas are likely playing sports, participating in other recreational activities after school, or receiving additional tutoring, children in disadvantaged areas are more likely headed to work after school, taking care of siblings while their parents work or dealing with an unstable home life. Adding homework into the mix is one more thing to deal with - and if the student is struggling, the task of completing homework can be too much to consider at the end of an already long school day.

While all students may groan at the mention of homework, it may be more than just a nuisance for poor and disadvantaged children, instead becoming another burden to carry and contend with.

Beyond the logistical issues, homework can negatively impact physical health and stress - and once again this may be a more significant problem among economically disadvantaged youth who typically already have a higher stress level than peers from more financially stable families.

Yet, today, it is not just the disadvantaged who suffer from the stressors that homework inflicts. A 2014 CNN article, "Is Homework Making Your Child Sick?", covered the issue of extreme pressure placed on children of the affluent. The article looked at the results of a study surveying more than 4,300 students from 10 high-performing public and private high schools in upper-middle-class California communities.

"Their findings were troubling: Research showed that excessive homework is associated with high stress levels, physical health problems and lack of balance in children's lives; 56% of the students in the study cited homework as a primary stressor in their lives," according to the CNN story. "That children growing up in poverty are at-risk for a number of ailments is both intuitive and well-supported by research. More difficult to believe is the growing consensus that children on the other end of the spectrum, children raised in affluence, may also be at risk."

When it comes to health and stress it is clear that excessive homework, for children at both ends of the spectrum, can be damaging. Which begs the question, how much homework is too much?

How Much Homework Is Too Much Homework?

The National Education Association and the National Parent Teacher Association recommend that students spend 10 minutes per grade level per night on homework. That means that first graders should spend 10 minutes on homework, second graders 20 minutes and so on. But a study published by The American Journal of Family Therapy found that students are getting much more than that.

While 10 minutes per day doesn't sound like much, that quickly adds up to an hour per night by sixth grade. The National Center for Education Statistics found that high school students get an average of 6.8 hours of homework per week, a figure that is much too high according to the Organization for Economic Cooperation and Development (OECD). It is also to be noted that this figure does not take into consideration the needs of underprivileged student populations.

In a study conducted by the OECD it was found that "after around four hours of homework per week, the additional time invested in homework has a negligible impact on performance." That means that by asking our children to put in an hour or more per day of dedicated homework time, we are not only not helping them, but - according to the aforementioned studies - we are hurting them, both physically and emotionally.

What's more is that homework is, as the name implies, to be completed at home, after a full day of learning that is typically six to seven hours long with breaks and lunch included. However, a study by the APA on how people develop expertise found that elite musicians, scientists and athletes do their most productive work for about only four hours per day. Similarly, companies like Tower Paddle Boards are experimenting with a five-hour workday, under the assumption that people are not able to be truly productive for much longer than that. CEO Stephan Aarstol told CNBC that he believes most Americans only get about two to three hours of work done in an eight-hour day.

When Does Homework Actually Help?

In the scope of world history, homework is a fairly new construct in the U.S. Students of all ages have been receiving work to complete at home for centuries, but it was educational reformer Horace Mann who first brought the concept to America from Prussia.

Since then, homework's popularity has ebbed and flowed in the court of public opinion. In the 1930s, it was considered child labor (as, ironically, it compromised children's ability to do chores at home). Then, in the 1950s, implementing mandatory homework was hailed as a way to ensure America's youth were always one step ahead of Soviet children during the Cold War. Homework was formally mandated as a tool for boosting educational quality in 1986 by the U.S. Department of Education, and has remained in common practice ever since.
Homework improves student achievement. Homework helps reinforce classroom learning. Homework helps students develop good study habits and life skills.
School work assigned and completed outside of school hours is not without its benefits. Numerous studies have shown that regular homework has a hand in improving student performance and connecting students to their learning. When reviewing these studies, take them with a grain of salt; there are strong arguments for both sides, and only you will know which solution is best for your students or school.
Homework allows parents to be involved with their children's learning.
Being responsible for completing at-home assignments helps students practice organization, time management, following directions, critical thinking and independent problem-solving.

Parents can see what their children are learning and working on in school every day.

Parents can participate in their children's learning by guiding them through homework assignments and reinforcing positive study and research habits.

Homework observation and participation can help parents understand their children's academic strengths and weaknesses, and even identify possible learning difficulties.

Negative Effects of Homework for Students
Students with too much homework have elevated stress levels. Students with too much homework may be tempted to cheat. Homework highlights digital inequity.
While some amount of homework may help students connect to their learning and enhance their in-class performance, too much homework can have damaging effects.

Today, homework often requires a computer and/or internet connection, which many students do not have access to outside of school.
Homework does not help younger students.
Students in low-income families are disproportionately affected by a lack of internet access, which further exacerbates the social and economic divide between them and their more affluent peers.

How Teachers Can Help

To help students find the right balance and succeed, teachers and educators must start the homework conversation, both internally at their school and with parents. But in order to successfully advocate on behalf of students, teachers must be well educated on the subject, fully understanding the research and the outcomes that can be achieved by eliminating or reducing the homework burden. There is a plethora of research and writing on the subject for those interested in self-study.
YOU'RE INVITED! Watch Free Webinar on USD's Online M.Ed. Program >>
For teachers looking for a more in-depth approach or for educators with a keen interest in educational equity, formal education may be the best route. If this latter option sounds appealing, there are now many reputable schools offering online master of education degree programs to help educators balance the demands of work and family life while furthering their education in the quest to help others.

# data[].attributes.attachment_link.title
Is Homework Necessary? Education Inequity and Its Impact on Students

# data[].attributes.attachment_link.description
Does homework help students? Discussing the pros and cons of homework, plus discerning how much homework is too much.

# data[].attributes.body
Many students get home and the first thing they do is homework. They’re pressured by their parents to do their homework while simultaneously being encouraged to spend time with family, eat, spend time with friends, go outside, participate in sports or other extracurricular activities, and sleep for 7+ hours. Rather than motivating students to master material and learn efficiently, homework negatively impacts students by taking away from personal time that is necessary for them to lead balanced lives.

# data[].attributes.attachment_link.title
Homework or Personal Lives? — Science Leadership Academy @ Center City

# data[].attributes.attachment_link.description
Many students get home and the first thing they do is homework. They’re pressured by their parents to do their homework while simultaneously being encouraged to spend time with family, eat, spend time with friends, go outside, participate in sports or other extracurricular activities, and sleep for…

# data[].attributes.body
. Families in the United States have drastically changed over the past 20 years.
More mothers work, more households are run by single parents, and caregivers often
work long hours (Kravolec & Buell, 2000). After long work days, parents often find
themselves battling their children to finish homework. Children may perceive this
homework battle as controlling, which creates conflict and affects individuals’ wellbeing, as well as family relationships. Trautwein et al. (2009) defined homework as a
20
“double-edged sword,” when it comes to the parent-child relationship. While some
parents can provide students with beneficial homework support, parental support can also
be intrusive. When students receive support that is perceived as overbearing, homework
help is likely to have negative effects on a student’s self-concept. For example, this may
send negative messages to children and adolescents regarding their abilities. When
examining parental homework styles, the study found a controlling approach was
negatively associated with effort and emotions toward homework

# data[].attributes.body
Student data indicate that completing homework at home generates various
feelings among students. A substantial percentage of students do not feel happy (82.6%)
or dedicated (89.7%) while completing homework; however, 22.6% of parents and 37.5%
of teachers reported homework has positive effects on students’ social-emotional health.
Based on the data collected, the most common feelings students reported were “Bored”
(41.3%), “Annoyed” (29.1%), “Smart” (24.9%), and “Frustrated” (23.0%). While parent
and teacher responses suggest homework does not affect students’ social-emotional
health, student data indicate homework does affect how they feel. Specifically, children
likely experience feelings of boredom and annoyance toward completing homework at
46
home. These findings are consistent with results from Bennett and Kalish (2006), which
indicate homework is often “minimally challenging” or used as “busy work.” If the
purpose of homework is to enhance student achievement and foster learning, educators
must re-evaluate homework assignments to align with best practices, as indicated by
Vatterott (2009). For example, homework should be differentiated by the level of
difficulty, as well as the amount of time it takes for completion for each student.

# data[].attributes.body
Parent involvement can be both positive or negative, depending on teaching style, some may help, other may hurt by having standards way beyond the students capability, and some parents may just plainly give the answers.

# data[].attributes.attachment_link.readable_text
Homework is the cause of more friction between schools and home than any other aspect of education and becomes the prime battlefield when schools, families, and communities view one another as adversaries. This comprehensive fourth edition tackles all the tough questions: What's the right amount of homework? What role should parents play in the homework process? What is the connection between homework and achievement?

This essential reference offers all stakeholders-administrators, teachers, and parents-the opportunity to end the battle and turn homework into a cooperative endeavor to promote student learning.

# data[].attributes.attachment_link.description
Homework is the cause of more friction between schools and home than any other aspect of education and becomes the prime battlefield when schools, families, and communities view one another as adversaries. This comprehensive fourth edition tackles all the tough questions: What's the right amount of homework?

# data[].attributes.body
according to Professor Cooper's 2001 review of over 120 studies of HW There is little correlation to the academic achievement and homework on students performance in elementary, only a moderate correlation in MS, and even in HS giving too much HW ca deminish its affectivness and even be counter productive for the student.

# data[].attributes.attachment_link.readable_text
Does assigning fifty math problems accomplish any more than assigning five? Is memorizing word lists the best way to increase vocabulary-especially when it takes away from reading time? And what is the real purpose behind those devilish dioramas?

The time our children spend doing homework has skyrocketed in recent years. Parents spend countless hours cajoling their kids to complete such assignments-often without considering whether or not they serve any worthwhile purpose. Even many teachers are in the dark: Only one of the hundreds the authors interviewed and surveyed had ever taken a course specifically on homework during training.

The truth, according to Sara Bennett and Nancy Kalish, is that there is almost no evidence that homework helps elementary school students achieve academic success and little evidence that it helps older students. Yet the nightly burden is taking a serious toll on America's families. It robs children of the sleep, play, and exercise time they need for proper physical, emotional, and neurological development. And it is a hidden cause of the childhood obesity epidemic, creating a nation of "homework potatoes."

In The Case Against Homework, Bennett and Kalish draw on academic research, interviews with educators, parents, and kids, and their own experience as parents and successful homework reformers to offer detailed advice to frustrated parents. You'll find out which assignments advance learning and which are time-wasters, how to set priorities when your child comes home with an overstuffed backpack, how to talk and write to teachers and school administrators in persuasive, nonconfrontational ways, and how to rally other parents to help restore balance in your children's lives.

Empowering, practical, and rigorously researched, The Case Against Homework shows how too much work is having a negative effect on our children's achievement and development and gives us the tools and tactics we need to advocate for change.

Also available as an eBook

# data[].attributes.attachment_link.description
Does assigning fifty math problems accomplish any more than assigning five? Is memorizing word lists the best way to increase vocabulary-especially when it takes away from reading time? And what is the real purpose behind those devilish dioramas? The time our children spend doing homework has skyrocketed in recent years.