ORIGINAL ARTICLE

Self-regulation strategies support children with ADHDto overcome symptom-related behavior in the classroom

Lena Guderjahn • Andreas Gold • Gertraud Stadler •

Caterina Gawrilow

Received: 21 May 2013 / Accepted: 2 September 2013 / Published online: 24 September 2013

� Springer-Verlag Wien 2013

Abstract Children with attention deficit hyperactivity

disorder (ADHD) suffer from self-regulation deficits that

cause inattention, impulsivity, and hyperactivity. Self-reg-

ulation interventions may address these deficits, but to date,

only few empirical studies have examined their benefits for

children with ADHD in everyday life. The present study

investigated three classroom interventions to promote self-

regulation and tested their benefit on self-regulatory com-

petencies (assessed with an ADHD questionnaire) in chil-

dren with ADHD. Students of a special education school

for children with ADHD participated in the intervention

study that included three sessions (Session 1: Goal Inten-

tion or Goal Intention ? If–Then Plan; Session 2: Goal

Intention ? If–Then Plan; Session 3: Goal Intention ? If–

Then Plan ? Self-Monitoring). Teacher-rated self-regula-

tory competencies were assessed both before and after the

intervention sessions. Children with ADHD had better self-

regulatory competencies after their first Goal Inten-

tion ? If–Then Plan Session, but lasting intervention

effects were found only when children started with a mere

goal intention session.

Keywords Children with ADHD � Implementation

intentions � School intervention � Self-regulation

Introduction

Self-regulation refers to the ability to assert control over

what one thinks, feels, and acts upon. Several studies have

demonstrated that people who possess strong self-regula-

tory competencies show increased well-being, better

health, report more satisfying relationships, and have more

academic success (Duckworth et al. 2012; Moffitt et al.

2011; Tangney et al. 2004). Children with attention deficit

hyperactivity disorder (ADHD) often fail in proper self-

regulation—they are inattentive, hyperactive, and impul-

sive. In schools, teachers might describe them as hardly

listening, getting easily distracted by classmates, calling

out without permission, or being restless (DuPaul and

Stoner 2003). A large body of research has examined the

deficits underlying these symptoms, and there is a broad

consensus that ADHD is associated with executive and

motivational dysfunctions (see Shiels and Hawk 2010, for

an overview). With regard to executive functions, deficits

are particularly found for inhibitory control (e.g., Lijffijt

et al. 2005; Sonuga-Barke 2002). According to Barkley

(1997), poor inhibitory control brings about secondary

Electronic supplementary material The online version of thisarticle (doi:10.1007/s12402-013-0117-7) contains supplementarymaterial, which is available to authorized users.

L. Guderjahn (&) � A. Gold

Department of Psychology, Goethe-University,

Frankfurt, Germany

e-mail: guderjahn@paed.psych.uni-frankfurt.de

L. Guderjahn � A. Gold � C. Gawrilow

Center for Research on Individual Development and Adaptive

Education of Children at Risk (IDeA), Frankfurt, Germany

G. Stadler

Department of Psychology, Columbia University, New York,

NY, USA

C. Gawrilow

Department of Psychology, Eberhard Karls University,

Tubingen, Germany

C. Gawrilow

German Institute for International Educational Research,

Frankfurt, Germany

123

ADHD Atten Def Hyp Disord (2013) 5:397–407

DOI 10.1007/s12402-013-0117-7

working memory deficits that constrain, amongst others,

internal information representation, forethought, and plan-

ning ability. Furthermore, goal-setting activities are likely

to be hampered because less positive action consequences

are anticipated in children with ADHD. On a volitional

level, restricted internal information representation and

planning ability impede maintaining goal-directed actions

whenever there are no immediate rewarding consequences

(Barkley 1997). Also, children with ADHD have dimin-

ished self-awareness and so self-monitor their behavior less

than children without ADHD (Pfiffner and Barkley 1998).

Besides executive dysfunctions, ADHD has also been

discussed as being associated with alterations in motiva-

tional functions, especially in reward mechanisms (e.g.,

Sagvolden et al. 2005). The dual pathway model of ADHD

(Sonuga-Barke 2002, 2003) suggests two distinct subtypes

of ADHD (that both show symptoms of inattentiveness and

hyperactivity–impulsivity). One subtype is characterized

by executive dysfunctions (i.e., poor inhibitory control),

while the other subtype shows altered reward mechanisms

(i.e., delay aversion). In this second subtype, the attempt to

avoid reward delay causes a preference for immediate

rewards over bigger rewards that are usually associated

with a prolonged waiting time. In order to reduce perceived

waiting time during delays, children with ADHD either

attend to or produce stimulation that is not related to the

waiting situation—a behavior that is then labeled as inat-

tentiveness or hyperactivity.

Self-regulation interventions for children with ADHD

With approximately 3–5 % of school-aged children diag-

nosed, ADHD is one of the most frequent disorders in

childhood and adolescence (American Psychiatric Associ-

ation 2000). Due to the self-regulatory shortfalls in children

with ADHD, academic failure is frequent (e.g., Fried et al.

2013) and tools that aid controlling ADHD symptoms in

school are an important element of treatment. In class-

rooms, various techniques (e.g., antecedent-based behav-

ioral strategies, token economies, and academic

interventions) have been implemented. However, these

techniques do not support self-regulatory competencies (for

a review, see DuPaul and Stoner 2003). Only few attempts

have been made to directly foster self-regulation in chil-

dren with ADHD.

Self-monitoring, self-reinforcement, and self-manage-

ment are the most established cognitive training procedures

(Reid et al. 2005). Self-monitoring is a technique that aims

at increasing the awareness for behavior through observing

and recording specific aspects of one’s own behavior

(Shapiro and Kratochwill 2000). Because self-monitoring

of behavior is an important component of successful self-

regulation that is impeded in children and adolescents with

ADHD (Pfiffner and Barkley 1998), it seems reasonable to

implement a self-monitoring tool in ADHD treatments.

However, few empirical studies have examined whether

self-monitoring is really helpful for children with ADHD.

These studies typically focus on two types of self-moni-

toring procedures: self-monitoring of attention (the child

records whether he/she was paying attention whenever a

signal occurs; e.g., Mathes and Bender 1997) and self-

monitoring of performance (the child records performance

indicators such as accuracy or productivity; e.g., Shima-

bukuro et al. 1999). Both self-monitoring techniques

increase on-task behavior, but self-monitoring of attention

leads to improved academic performance (Harris et al.

2005). Despite some limitations of the available studies

(e.g., small sample sizes), a meta-analysis by Reid et al.

(2005) suggests that self-regulation interventions are

effective treatment elements for children with ADHD.

However, other studies contradict these promising results

and conclude that there is no empirical evidence that either

behavioral (Pelham and Fabiano 2008; Pelham et al. 1998)

or cognitive (Abikoff 1991) interventions are effective for

these children. So far, evidence for the use of self-regula-

tion interventions for children with ADHD is mixed. In the

present study, we add to previous research by investigating

whether children with ADHD benefit from an already

established, empirically supported self-regulation strategy:

forming if–then plans (Gollwitzer 1999).

Fostering self-regulation of goal pursuit through if–then

plans

A goal to which a person feels committed engenders

behavior: The comparison between current and desired

status leads to a change of goal-directed behavior or task

effort (e.g., Locke and Latham 2006). But on the way to

goal realization, one has to resist temptations that may

currently seem more attractive than pursuing goal-directed

behavior. The attainment of a goal one feels committed to

can be effectively improved by the volitional strategy of

forming an if–then plan that specifies when, where, and

how one will act in order to reach the goal (Gollwitzer

1999). If–then plans differ from mere goal intentions in one

important way: While goal intentions state what someone

wishes to attain, if–then plans specify how to attain a goal

by linking a critical situation to a goal-directed action (i.e.,

‘‘If situation X arises, then I will perform action Y!’’).

When goal intentions are strong (Sheeran et al. 2005), if–

then plans promote goal attainment via several processes:

The if part of the plan specifies the situation in which the

planned action should take place; thereby, action control

shifts from the individual to environmental cues. For a

person with an if–then plan, the features of the specified

situation become more accessible and are recognized easily

398 L. Guderjahn et al.

123

when the person encounters them (e.g., Bayer et al. 2009;

Webb and Sheeran 2004, 2008) and action is taken

immediately, without effort, and even outside conscious

intent (e.g., Sheeran et al. 2005). A meta-analysis by

Gollwitzer and Sheeran (2006) determined the effect size

of if–then plans to be of medium to large magnitude

(d = 0.65; Cohen 1992) when compared to mere goal

intentions.

Benefits of if–then plans for children with ADHD

Because if–then plans benefit self-regulation (e.g., Gollw-

itzer and Brandstatter 1997), they seem to be an ideal

technique to support individuals whose self-regulatory

competencies are diminished. Indeed, several studies

showed the facilitating effects of if–then plans for children

with ADHD (Gawrilow and Gollwitzer 2008; Gawrilow

et al. 2011a, b) and at risk for ADHD (Gawrilow et al.

2013). For example, Gawrilow and Gollwitzer (2008)

assessed inhibition performance with a Go/No-Go task in

58 boys with and 28 boys without ADHD. This task

required children to classify pictures with means of trans-

portations but to suppress any reactions for pictures that

were accompanied by a sound. Before the task, children

either formed a goal intention (‘‘I will not press a key for

pictures that have a sound!’’) or an if–then plan (‘‘And if I

hear a tone, then I will not press any key!’’). As expected,

children with ADHD performed worse on this task due to

their inhibitory deficits than children without ADHD.

However, by using if–then plans, children with ADHD

were able to enhance their performance to the level of

children without ADHD. Only recently, Gawrilow et al.

(2013) investigated the potential of a self-regulation

intervention (i.e., mental contrasting with implementation

intentions) for children at risk for ADHD outside labora-

tory. All participating children first received a learning

style intervention. Half of them additionally took part in a

self-regulation intervention: In this intervention, children

first thought about their most pressing academic concern.

Next, they underwent a mental contrasting procedure, a

technique that involves thinking about positive conse-

quences of solving a concern and obstacles that might

hinder goal realization, in order to increase goal commit-

ment (Oettingen et al. 2001). After this procedure, they

created an if–then plan for how to solve their concern in the

upcoming 2 weeks. As the dependent variable, parents

were asked to rate their children’s self-regulation 2 weeks

after the intervention. Children that had participated in the

self-regulation intervention received higher ratings than

those in the learning style-only intervention. Importantly,

this self-regulation intervention worked best for children

with higher risk for ADHD (i.e., higher ADHD symptom

scores).

The present study

The aim of the present study was to investigate the effec-

tiveness of different self-regulation interventions (i.e., goal

intentions, if–then plans, and self-monitoring) for children

with ADHD in the classroom. The current study is innova-

tive because we addressed several shortcomings of previous

research: First, ADHD treatment studies are frequently

conducted in laboratory settings limiting the generalizability

of their results to applied settings (DuPaul and Weyandt

2006). Hence, we trained teachers how to instruct children

with ADHD to apply self-regulation strategies to their

everyday lives in the classroom. Second, cognitive trainings

usually entail multiple techniques and heterogeneity con-

strains the determination of effective components. Hence,

we chose an intervention strategy in which we added

intervention elements sequentially enabling us to evaluate

the efficacy of components separately.

Because children with ADHD show motivational and

volitional deficits, the intervention integrated strategies that

address both motivation (i.e., goal intention, self-monitor-

ing) and volition (if–then plans). In the first of three

intervention sessions, children either received a goal

intention (GI) or a goal intention ? if–then plan

(GI ? Plan). In the second intervention session, all chil-

dren received a GI ? Plan session (this session served to

create comparable conditions in all children before they

were introduced to the self-monitoring tool in the third

session). In the third intervention session, the GI ? Plan

procedure was accompanied by a self-monitoring tool.

If–then plans facilitate self-regulation in children with

ADHD in experimental settings (e.g., Gawrilow et al.

2011a, b), in children at risk for ADHD outside the labo-

ratory (Gawrilow et al. 2013), and have benefits that go

beyond those of mere goal intentions (e.g., Gollwitzer

1999). Thus, we expected that children with ADHD should

show better self-regulation (as rated by their teachers) after

an if–then plan intervention than after a mere goal intention

intervention (Hypothesis 1). In the third intervention ses-

sion, we added a self-monitoring tool to the GI ? Plan:

After selecting a new GI ? Plan, children were instructed

to keep a diary on the progress of their if–then plan. In the

diary, they monitored their performance, for instance by

rating statements such as ‘‘I frequently acted according to

my plan today.’’ Self-monitoring aims at increasing the

awareness for a behavior—an ability that is impeded in

children with ADHD. Studies demonstrated that children

with ADHD benefit from this technique; however, evi-

dence comes primarily from case studies (Reid et al. 2005).

As if–then plans facilitate volitional competencies, we

hypothesized that children with ADHD would benefit even

more when if–then plans are combined with the motiva-

tional strategy of self-monitoring (Hypothesis 2).

Self-regulation strategies support children with ADHD 399

123

Method

Setting

The study was conducted in a secondary school for chil-

dren with ADHD. At the time of the study, 85 children

attended grades five to eleven, each made up of one class

with 10–15 students. The school has a special educational

approach to account for the needs of children with ADHD

(e.g., teacher and parent trainings; close cooperation

between a team of psychologists and social education

workers and families; token economies that reward active

participation in the classroom).

Participants

Children from grades five to ten (n = 78) were asked to

participate in the intervention. Parents of three children

refused to sign informed consent. One child was not rated

at baseline because he had been ill, and four more children

were excluded from data analysis because they did not

participate in one or more intervention sessions. Due to

illness, one teacher could not rate her class at the 6-week

assessment point, leading to thirteen missing ratings. Thus,

the intention-to-treat sample comprised 57 children (7

girls) between 10 and 18 years (Mage = 14.30 years,

SD = 1.81 years). As a prerequisite for school enrollment,

all children had been diagnosed with ADHD by external

psychiatrists or clinical psychologists according to ICD-10

criteria (WHO 1991; see Table 1 for sample characteris-

tics). Forty-seven participants had been on medication for

ADHD, and medication was continued as usual during

intervention. The study was approved by the local research

ethics committee, and we obtained written informed con-

sent from participating parents and teachers.

Design

The study compared the effects of self-regulation inter-

ventions over 6 weeks from baseline to 2, 4, and 6 weeks

(see Fig. 1). In order to compare goal setting (GI) to if–

then plans (GI ? Plan), we formed two intervention

groups: In Session 1, Intervention Group 1 set a goal

intention and Intervention Group 2 set a goal intention that

was furnished with an if–then plan. In Session 2, both

intervention groups received a GI ? Plan session; in Ses-

sion 3, the GI ? Plan session was additionally boosted

with a self-monitoring tool (GI ? Plan ? SM).

To achieve a comparable age distribution but avoid

intervention spillover between students in the same class,

we assigned whole classes and their class teachers to one of

the two intervention groups. Classes 5, 8, and 9 were

assigned to Intervention Group 1, and classes 6, 7, and 10

were assigned to Intervention Group 2.

Measures

Self-regulatory competencies

As our main dependent variable, we assessed teachers’

ratings of self-regulatory competencies using a standard-

ized German ADHD questionnaire (FBB-ADHS; Dopfner

et al. 2008). We used the FBB-ADHS because the items

reflect prototypical self-regulation problems of children

with ADHD (e.g., ‘‘Is easily distracted’’), and it is sensitive

to behavior changes. The FBB-ADHS contains 20 items on

the subscales inattentiveness, hyperactivity, and impulsiv-

ity that are rated on a 4-point scale (1 = never or rarely–

4 = very often). Reported Cronbach’s alpha is .96, and

test–retest reliability is r = .90 (Breuer et al. 2009). We

assessed the dependent variable four times: before and after

the three intervention sessions, respectively. Prior to the

Table 1 Characteristics of the sample

Variables Intervention groups Group

differences

p valueIntervention

group 1

(n = 35)

Intervention

group 2

(n = 22)

Age (Myears)a 14.15 (1.85) 14.54 (1.75) .43

Gender (female/male) 5/30 2/20 .44

ICD-10 diagnosis (n) .70

F 90.0b 18 9

F 90.1c 10 8

F 90.8d 1 0

F 98.8e 6 5

Medication (yes/no) 30/5 17/5 .49

Goal focus Session 1 (n)f .67

Inattention 28 10

Impulsivity/

hyperactivity

5 3

Goal focus Session 2 (n)f .27

Inattention 26 5

Impulsivity/

hyperactivity

7 8

Goal focus Session 3 (n)f .15

Inattention 26 6

Impulsivity/

hyperactivity

7 7

a Standard deviations are in parenthesesb Disturbance of activity and attention (ADHD)c Hyperkinetic conduct disorderd Other hyperkinetic disorderse Attention deficit disorder without hyperactivityf n = 46

400 L. Guderjahn et al.

123

first intervention session, we asked the teachers to rate the

preceding two-week interval for each child separately as a

baseline measure for self-regulatory competence (baseline

assessment point). Subsequently, ratings were done for

each two-week interval following Intervention Sessions

1–3 (2-week assessment point, 4-week assessment point,

and 6-week assessment point).

Commitment

Commitment toward the chosen goal was assessed with

three items on a five-point scale (1 = I do not agree at all–

5 = I fully agree). The items were German translations of

already established items to assess commitment: ‘‘I feel

committed to strive toward my goal’’ (Bayer and Gollw-

itzer 2007), ‘‘I would feel disappointed if my concern did

not come to a happy ending,’’ and ‘‘It would be bad for me

if my concern did not come to a happy ending’’ (Oettingen

et al. 2009).

Procedure

Determining goal intentions and if–then plans

Prior to our main study, we conducted a survey with all

teachers (n = 14) of the participating school. In a ques-

tionnaire with four open-ended questions (e.g., ‘‘Which

behaviors are most disruptive during your lessons?’’), we

asked the teachers to give us information about their most

pressing concerns with regard to the children’s behavior in

the classroom and insight into the strategies children

already used. Based on the six most frequently named self-

regulatory problems, we formed six goal intentions for the

training (e.g., ‘‘I want to be less distracted by others’’). As

previous studies showed that if–then plans are effective in

breaking habits when they entail an action that replaces the

habitual response (e.g., Adriaanse et al. 2011), we formed

if–then plans that comprised alternative actions as soon as a

critical situation comes up (e.g., ‘‘If a classmate talks to

me, then I will focus more intently on the lesson’’; see

supplementary table for all goals and plans used in the

study).

Training session for teachers

Participating teachers received a 1-hour training session.

In this session, two experimenters (an interventionist and

a co-interventionist) used a 36-slide presentation that

explained the self-regulation interventions. Teachers were

encouraged to ask upcoming questions. After an intro-

duction that explained the concept of self-regulation, the

model of action phases (Heckhausen and Gollwitzer

1987) was introduced. Using this model, the intervention

sessions were explained as giving support in different

stages of goal pursuit. To avoid teachers being biased

toward one or the other intervention, the interventionists

emphasized that (a) all three interventions were effective

and (b) there was no evidence that one of them was

superior to the others. Subsequently, the interventionists

provided an overview of the intervention materials

(booklets and diaries) and the timetable. Finally, the

experimenters explained how and when to fill in the

questionnaires on self-regulatory competencies, and

teachers received a print version of the presentation as

well as a two-page overview to take with them to the

intervention sessions.

time (weeks)0 1 2 3 4 5 6

Intervention Group 1

Intervention session

Assessment of dependent variablea

GI GI + Plan GI + Plan + SM

Baseline 2-week assessment point 4-week assessment point 6-week assessment point

time (weeks)0 1 2 3 4 5 6

Intervention Group 2

Intervention session

Assessment of dependent variablea

GI + Plan GI + Plan GI + Plan + SM

Baseline 2-week assessment point 4-week assessment point 6-week assessment point

Fig. 1 Study design. Whole classes were assigned to either Intervention Group 1 or Intervention Group 2. GI = goal intention; Plan = if–then

plan; SM = self-monitoring. aTeacher-rated self-regulatory competencies of the preceding 2 weeks

Self-regulation strategies support children with ADHD 401

123

Self-regulation intervention

Teachers conducted the self-regulation intervention in

three sessions at intervals of 2 weeks. The sessions

replaced regular lessons of the teacher on either Monday or

Tuesday. On days with intervention sessions, two inter-

ventionists were present at school to provide support to the

teachers if necessary. The intervention sessions were

standardized by means of a booklet that the teachers han-

ded out to and read through with their students. In the

intervention session GI, the booklet stated that goal setting

is an effective strategy to change behavior. Children were

offered six goals and asked to select the one that would fit

their behavioral problems best. To ensure consolidation of

goal intentions, children wrote down the selected goal three

times in their booklet and on a sticker that they kept on

their desk for the upcoming 2 weeks. This sticker thus

served as a reminder for them to work on their goal. The

same goals were presented in Intervention Sessions 1, 2,

and 3, and children were free to select whether they wanted

to change or maintain their goals. In the intervention ses-

sion GI ? Plan, children were instructed to choose one out

of six goals as in the GI-only session. In a second step,

however, they additionally selected an if–then plan that

corresponded to their goal. Children then wrote down the

if–then plan in their booklet three times and on a sticker

that they kept on their desk for the next 2 weeks. The

intervention session GI ? Plan ? SM followed the same

procedure as in the GI ? Plan session. However, children

were additionally introduced to keep a diary for the next

2 weeks. In this diary, children were asked to rate today’s

performance with regard to the progress of their plan. The

diaries were handed out to them each day after lunch break

and contained ten statements concerning the realization of

the selected if–then plan (e.g. ‘‘Today, it was easy for me to

behave according to my plan’’) that children rated on a

five-point scale (I do not agree at all–I fully agree). Fur-

thermore, they had to answer four open-ended questions

about their goal progress and were asked to describe a

situation today in which they had behaved according to

their plan. At the end of all the intervention sessions,

children filled out a short questionnaire to assess goal

commitment.

Data analysis

To ensure successful randomization, the intervention

groups were compared on demographic data. The inter-

vention effect was calculated using a 2 9 4 [Group

(Intervention Group 1, Intervention Group 2) 9 Time

(baseline assessment point, 2-week assessment point,

4-week assessment point, and 6-week assessment point)

repeated measures ANOVA on teacher-rated self-

regulatory competencies. Assuming that missing data were

missing at random (due to illness of a teacher], we checked

for differences on baseline demographic data between

participants with full data and drop outs. We then con-

ducted sensitivity analysis using missingness predictors as

covariates and filled in missing data using two intention-to-

treat approaches (last observation carried forward and

baseline carried forward).

Results

Demographic data

The intervention groups were comparable in age,

t(55) = 0.43, ns, and gender, v 2(1) = 0.34, ns. Further-

more, there were no group differences in the frequencies of

ADHD subtype diagnosis, v2(3) = 4.42, ns, or concerning

the medication with methylphenidate, v2(1) = 0.67, ns, all

p values [.27 (see Table 1).

Self-regulatory competencies

We found no pre-intervention group differences on our

main dependent variable (i.e., teacher-rated self-regulatory

competencies), t(55) = 0.25, ns. The ANOVA showed no

main effect of time, F(2.24, 123.06) = 2.38, ns, and no

significant effect of group, F(1, 55) = 1.37, ns. However,

the Time 9 Group interaction was significant, F(2.24,

123.06) = 15.43, p \ .001, gp2 = 0.22. Using pairwise

comparisons, we found no change after the first interven-

tion session in Intervention Group 1 (GI; Mbaseline assessment

point = 0.95, SD = 0.77; M2-week assessment point = 0.92,

SD = 0.78). Thus, GI alone did not benefit these children’s

self-regulatory competencies. However, after the

GI ? Plan session (M4-week assessment point = 0.69,

SD = 0.74), teacher rated ADHD symptoms as lower (i.e.,

better self-regulatory competencies), p \ .001, gp2 = 0.22,

while the administration of GI ? Plan ? SM did not bring

about further changes (M6-week assessment point = 0.64,

SD = 0.68). In Intervention Group 2, we found a symptom

decrease from baseline (M = 1.00, SD = 0.69) to 2-week

assessment point (M = 0.89, SD = 0.74), p \ .05,

gp2 = 0.06. Thus, GI ? Plan again yielded an increase in

self-regulatory competencies. However, we found a relapse

after the second GI ? Plan session; ratings at 4-week

assessment point (M = 1.14, SD = 0.77) as well as

6-week assessment point (M = 1.06, SD = 0.67) were

comparable to baseline.

In additional analyses, we compared subjects with

complete and missing data on baseline demographic data

and found that participants with missing data were

younger, t(72) = -2.67, p \ .01. However, sensitivity

402 L. Guderjahn et al.

123

analysis using the missingness predictor (i.e., age) as a

covariate yielded the same pattern of results. The pattern of

results remained also the same when missing data were

filled in either with a last observation carried forward or a

baseline carried forward method (see supplementary

material for more details).

Additional analysis

Chosen goal focus

Due to missing data, chosen goal focus was available for

analysis in 46 participants. In all intervention sessions,

children chose goals focusing on deficits in being attentive

(Session 1: n = 38, Session 2: n = 31, Session 3: n = 32),

rather than changing impulsive/hyperactive behavior

(Session 1: n = 8, Session 2: n = 15, Session 3: n = 14).

However, the distribution of goal focus did not differ

between the groups (Session 1: v2(1) = 0.41, ns; Session 2:

v2(1) = 1.44, ns; Session 3: v2(1) = 2.87, ns), and groups

were comparable in the tendency to stay with or change

goal focus during the intervention, v2(1) = 0.49, ns.

Commitment

Due to missing data, we could only analyze commitment

data for a subgroup of our sample (n = 35). As Cronbach’s

Alpha for the commitment items was sufficiently high

(a = 0.84 at Session 1; a = 0.78 at Session 2; a = 0.94 at

Session 3), we created an index of the three items (range

from 0 to 100). A 2 9 3 (Group [Intervention Group 1,

Intervention Group 2] 9 Time [Session 1, Session 2, Ses-

sion 3]) repeated measures ANOVA on goal commitment

scores revealed a significant main effect of time, F(1.63,

53.82) = 5.33, p \ .05, gp2 = 0.14. Pairwise contrasts

showed that goal commitment significantly dropped from

Intervention Session 1 (M = 59.28, SD = 29.42) to

Intervention Session 2 (M = 46.60, SD = 25.33), p \ .05,

gp2 = 0.10, but not from Intervention Session 2 to Inter-

vention Session 3 (M = 42.91, SD = 28.62). There was no

main effect of group, F(1, 33) = 0.05, ns, and no Time x

Group interaction, F(1.63, 53.82) = 0.30, ns. Thus, levels

of commitment and commitment changes over time were

comparable between the intervention groups.

Discussion

In the present study, we investigated whether a well-

established volitional self-regulation technique (i.e., if–

then plans) known to be helpful for children with ADHD in

experimental settings (Gawrilow and Gollwitzer 2008;

Gawrilow et al. 2011a, b) would foster self-regulatory

competencies of children with ADHD in the school con-

text. Because ADHD is associated with volitional and

motivational shortfalls, we further examined whether a

combination of volitional (i.e., if–then plans) and motiva-

tional (i.e., self-monitoring) elements would additionally

boost intervention effects. For this purpose, we assigned

whole classes to two different intervention groups that

received three sessions by their teachers (Intervention

Group 1: GI, GI ? Plan, GI ? Plan ? SM; Intervention

Group 2: GI ? Plan, GI ? Plan, GI ? Plan ? SM) and

assessed teacher-rated self-regulatory competencies (i.e.,

ADHD symptoms).

Children with ADHD did not benefit from a mere goal

intention session: Setting the goal to reduce ADHD-related

behavior (e.g., ‘‘I want to pay more attention’’) did not lead

to better self-regulatory competencies. Our finding repli-

cates results by Gawrilow et al. (2011b) who found that

children with ADHD did not benefit from mere goal

intentions when performing a delay of gratification task but

considerably improved when given further support by if–

then plans. Thus, when goals get challenging, they require

additional support in order to be reached (Gollwitzer and

Sheeran 2006). Accordingly, participants in both our

intervention groups benefited from the first GI ? Plan

session (i.e., Session 2 in Intervention Group 1 and Session

1 in Intervention Group 2): Furnishing a goal with an if–

then plan (e.g., ‘‘If I think of something that is not related

to the lesson, then I will refocus and contribute something

to the lesson’’) boosted self-regulatory competencies. Our

study is the first to show that if–then plans work for chil-

dren with ADHD when they are applied at school and thus

extends previous experimental research (e.g., Gawrilow

et al. 2011a, b; Paul et al. 2007; Paul-Jordanov et al. 2010).

In the third session, children were additionally intro-

duced to keep diaries on their plan progress (self-moni-

toring tool). However, we found no change in self-

regulatory competencies after this session. To date, only

few studies examined the efficacy of self-monitoring for

children with ADHD (Reid et al. 2005). Our results support

the assumption that children with ADHD do not benefit

from self-monitoring (e.g., Hodgson et al. 2012). Self-

monitoring may facilitate behavior change through the

evaluation of an actual state and its comparison to a goal

state. Thus, biased self-evaluations (as they often occur in

children with ADHD, e.g., Hoza et al. 1993) might hamper

the effectiveness of self-monitoring. Self-evaluations of

children with ADHD are less congruent with their actual

behavior than in children without ADHD in terms of a

positive illusionary bias (e.g., Owens et al. 2007). There-

fore, future studies should investigate whether children

with ADHD benefit from self-monitoring if they are sup-

ported in conducting proper self-evaluation (e.g., by their

teachers).

Self-regulation strategies support children with ADHD 403

123

An important finding of our study concerns the stability

of the effects of if–then plans. The first GI ? Plan session

benefited self-regulatory competencies in both intervention

groups. These beneficial effects were stable in Intervention

Group 1 (i.e., ADHD symptoms remained on the dimin-

ished level until after Session 3) but relapsed to baseline

level in Intervention Group 2. We assume that a successive

procedure that includes goal setting as a first step (as in

Intervention Group 1) might be an important prerequisite to

ensure sustainable effects of if–then plans. According to

Heckhausen and Gollwitzer (1987), the decision to pursue

a goal is followed by a search for information to clarify

which action to take in order to reach that goal. By forming

an if–then plan, the situation specified in the if part of the

plan can be recognized more easily when it is encountered

(Webb and Sheeran 2004). At the same time, the awareness

for situations other than the one specified in the if–then

plan is reduced (Parks-Stamm et al. 2007) and individuals

might stop looking for alternative routes to goal attainment

when they have made a specific plan (Masicampo and

Baumeister 2012). In our study, children selected goals that

focused on changing inattention, impulsivity, or hyperac-

tivity apparent in various school settings. In Intervention

Group 2, the simultaneous introduction of GI ? Plan might

have reduced awareness for problematic situations that

were not entailed in the if–then plan. However, the inter-

vention session GI in Intervention Group 1 has probably

encouraged the children to take more time to explore which

situations are relevant for changing their behavior. Thus,

they might have chosen goals and if–then plans in the

second session that better fitted their individual situation

and thereby had more long-term benefits. However, future

studies are needed to investigate this hypothesis, for

instance by assessing the number of opportunities to act

children with ADHD perceive after a GI versus a

GI ? Plan session.

The present findings have important implications for

ADHD interventions: Academic underachievement in

children with ADHD is not primarily caused by cognitive

deficits, but rather determined by ADHD symptoms (Barry

et al. 2002). Our study is the first to show that if–then plans

have the potential to strengthen self-regulation in children

with ADHD and thereby reduce ADHD symptoms in the

classroom. In our study, teachers were able to apply the

concept of goal setting and if–then plans in their class-

rooms after a brief training session. Thus, this intervention

meets important criteria for the acceptance of school

interventions (DuPaul 2007): The intervention is inexpen-

sive, imposes minimal work load on teachers, and is easy to

establish. Furthermore, and in contrast to widely used

token economies, students with ADHD can use if–then

plans on their own. Thus, teaching students how to create

if–then plans also increase the students’ responsibility for

the intervention outcome and can be applied in many dif-

ferent situations.

Limitations and future directions

Although our study provides encouraging results, it has

several limitations. Children in our study did not form

goals and if–then plans on their own but were given pre-

defined ones. In doing so, we aimed at creating goals and

plans that include the participants’ everyday behavioral

problems by conducting a teacher survey before running

the main study. However, ADHD symptoms are hetero-

geneous, and the range of problem behavior of children

with ADHD goes far beyond those entailed in our study.

Because children with ADHD usually benefit from close

interactions (Barkley 1998), an implementation in a one-

on-one setting, where a teacher works with one child

exclusively, seems particularly promising. Thus, future

research should aim at using individualized materials and

might want to develop and evaluate school-based if–then

plan interventions that allow students to form if–then plans

by themselves. Moreover, tailoring the intervention to the

individual needs of each child might create goal commit-

ment that is necessary to create lasting intervention effects

(Stadler et al. 2010).

An important limitation of our study is the drop of

commitment during the intervention. Initial commitment

was in medium to large range, and thus, we assume that our

participants were motivated and accepted the intervention.

However, commitment dropped from Intervention Session

1 to Intervention Session 2. Thus, one might wonder

whether the drop in commitment might be the reason why

the GI ? Plan ? SM session did not lead to behavior

change. However, both Intervention Groups 1 and 2 ben-

efited from the first GI ? Plan session (i.e., despite

decreased commitment in Intervention Group 1), and thus,

commitment cannot fully account for the inefficacy of the

GI ? Plan ? SM tool. Nevertheless, we cannot entirely

rule out that insufficient commitment influenced our

results, and thus, particularly with regard to the SM tool,

further research is necessary that examines a combined

GI ? Plan ? SM procedure when students maintain high

commitment. To boost commitment, including intervention

materials with varying designs, goals, and plans rather than

standardized booklets for all intervention sessions might be

helpful because children with ADHD need more stimula-

tion than peers without ADHD (Antrop et al. 2000) and do

also get more easily bored, especially when they are con-

fronted with repetitive tasks (Zentall 2005). Interventions

might also include a mental contrasting procedure in which

participants first think about positive consequences and

obstacles of goal realization (e.g., Oettingen et al. 2001).

404 L. Guderjahn et al.

123

Mental contrasting increases goal commitment and helps

people to identify personally important situations for

behavior change that can afterward be included in the if–

then plan (Adriaanse et al. 2010).

Furthermore, we did not systematically assess treatment

integrity of the participating students and their teachers.

However, with regard to the students, the measurement of

treatment integrity in if–then plan interventions is rather

difficult, as if–then plans are assumed to work even outside

conscious intent (Sheeran et al. 2005). However, the

teachers delivered the intervention using a booklet that

standardized the implementation of the intervention, and an

interventionist was present at school during the interven-

tion period. Further studies should include observations of

intervention deliverance (e.g., by video taping). Addition-

ally, we did not assess whether the benefits of our inter-

vention would expand to other behavioral domains. While

interventions often reduce ADHD-related behaviors, they

frequently do not improve academic outcomes (DuPaul and

Eckert 1997). Because children with ADHD are at high risk

for academic failure, interventions that provide effects on

school achievement are urgently needed. In the past, there

has been evidence that if–then plans benefit performance in

academic tasks in children without ADHD (e.g., Bayer and

Gollwitzer 2007; Parks-Stamm et al. 2010). Thus, if–then

plans might also benefit academic performance in children

with ADHD.

The present study was conducted at a school for children

with ADHD, and the heterogeneity of the sample reflects

patient populations of children with ADHD: a high

comorbidity between ADHD and conduct problems (e.g.,

aggressive behavior; Witthoft et al. 2010) as well as fre-

quent occurrence of ADHD without symptoms of hyper-

activity (e.g., Willcutt 2012). However, it should be noted

that our findings might generalize to special school con-

texts only. Thus, future studies might want to investigate

the intervention also in a sample of children with ADHD

(and their peers and teachers) in general schools.

Conclusion

The present study expands existing research by demon-

strating that a teacher-delivered intervention using goal

intentions and if–then plans benefits self-regulatory com-

petencies in children with ADHD. However, only when the

introduction of if–then plans followed a session with focus

on mere goal setting, the effects lasted until the end of the

intervention (i.e., 6 weeks). In the current study, a self-

monitoring tool did not add to the intervention effects. As

the improvement of academic achievement is a main

objective of interventions for children with ADHD, future

studies might want to examine whether the effects

observed in our study transfer to school performance. In

conclusion, if–then plans are an easy-to-establish tool to

promote everyday behavior of children with ADHD in the

classroom.

Acknowledgments This research was funded by Robert Bosch

Foundation, Stuttgart, Germany, and by the Center for Research on

Individual Development and Adaptive Education of Children at Risk,

Frankfurt, Germany.

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