An interventional study of CLS-R-FUERTE in ADHD and Oppositional Defiant Disorder, sponsored by University of California, San Francisco. Completed at 1 site in United States. Open to participants aged 5 Years and older. Per ClinicalTrials.gov, last updated 2025-01-15.
Sponsored by University of California, San Francisco · Not applicable, Interventional, and Treatment
Neurodevelopmental disorders of inattention and disruptive behavior, such as Attention-Deficit/ Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD), are among the most common youth mental health conditions across cultures. An efficacious and feasible solution to improving affected youth's ADHD/ODD is training existing school clinicians to deliver evidence-based intervention with fidelity. Despite initial promising results of training school clinicians to treat ADHD/ODD in settings suffering from high unmet need, such as Mexico, scalability is limited by a lack of researchers with capacity to train, monitor, and evaluate school clinicians in such efforts on a large scale. Thus, there is a need to develop more feasible interventions and training programs for school clinicians, as well as create a system with capacity for scalable training and evaluation, to combat the widespread impact ofADHD/ODD worldwide. Converting interventions and school clinician professional development programs for fully-remote delivery allows for more flexibility, accessibility, affordability, scalability, and promise for ongoing consultation than in-person options. Supporting scalable training for school clinicians could address a significant public health concern in Mexico, as only 14% of Mexican youth with mental health disorders receive treatment and less than half of those treated receive more than minimally adequate care. The study team is uniquely suited for this effort, given that they developed the only known school-home ADHD/ODD evidence-based intervention in Latin America-and-have developed a web-based training for U.S. school clinicians with promising preliminary results. The study team's prior studies and high levels of unmet need make Mexico an ideal location for this proposal; however, lessons learned could be used to expand scalable school clinician training for evidence-based intervention in other settings and/or for other disorders. Thus, this study focuses on comparing the fully-remote CLS-R-FUERTE program vs. care-as-usual in an 8-school clustered randomized controlled trial (RCT). The team predicts: 1) school clinicians trained in the remote program will be satisfied and show improved skills, 2) parents, youth, and teachers treated by school clinicians in the remote program will engage/adhere, and 3) youth in the remote program will show more ADHD/ODD improvements compared to care-as-usual
1,817 studies on the registry are indexed under Attention Deficit Disorder with Hyperactivity; 296 are open to participants now.
This study's enrollment of 163 is above the median of 71 across 1,437 interventional studies indexed under Attention Deficit Disorder with Hyperactivity.
Browse Attention Deficit Disorder with Hyperactivity studies →University of California, San Francisco is the lead sponsor of 2,169 studies on the registry; 372 are open to participants now.
Of its 267 completed or terminated interventional studies of FDA-regulated products, 202 (76%) have results posted.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Students meeting the following criteria are eligible:
Exclusion Criteria:
All Participants: Anyone who does not speak and read Spanish will be excluded, given that all , measurement, and activity procedures will be conducted in Spanish.
Child Participants
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Active program participation in: a remote school clinician training and comprehensive psychosocial intervention designed to improve attention and behavior in Mexican school-aged youth (grades 1-5). via school clinician training by a clinical research team to lead parent skill groups, child skill groups, and teacher consultation in a behavioral classroom management system.
Behavioral: CLS-R-FUERTE
Continued participation in school care-as-usual
The CLS-R-FUERTE program is a remote school clinician training and comprehensive psychosocial intervention designed to improve attention and behavior in Mexican school-aged youth (grades 1-5). It contains the same evidence-based service components to improve youth attention/behavior as the in-person CLS-FUERTE program; specifically, it features school clinician training by a clinical research team to lead parent skill groups, child skill groups, and teacher consultation in a behavioral classroom management system.
Change in Child Symptom Inventory-4 (CSI-4) Parent Checklist ADHD Combined Type Symptom Severity Score
Parents will assess ADHD symptoms using the CSI-4. The CSI-4: Parent Checklist contains 18 symptoms for ADHD, Combined type (ADHD:C; 18 items). Each symptom is rated on a 4-point scale (0= never to 3= very often). The average of ADHD:C scores range from zero to four, with higher scores indicating more severe symptoms.
Time frame: Baseline and post treatment (8 weeks)
Change in Child Symptom Inventory-4 (CSI-4) Teacher Checklist ADHD Combined Type Symptom Severity Score
Teachers will assess ADHD symptoms using the CSI-4. The CSI-4: Teacher Checklist contains 18 symptoms for ADHD, Combined type (ADHD:C; 18 items). Each symptom is rated on a 4-point scale (0= never to 3= very often). The average of ADHD:C scores range from zero to four, with higher scores indicating more severe symptoms.
Time frame: Baseline and post treatment (8 weeks)
Change in Child Symptom Inventory-4 (CSI-4) Parent Checklist (Oppositional Defiant Disorder) ODD Symptom Severity Score
Parents will assess ODD symptoms using the CSI-4. The CSI-4: Parent Checklist contains 9 symptoms of ODD. Each symptom is rated on a 4-point scale (0= never to 3= very often). The average ODD scores range from zero to four, with higher scores indicating more severe symptoms.
Time frame: Baseline and post treatment (8 weeks)
Change in Child Symptom Inventory-4 (CSI-4) Teacher Checklist (Oppositional Defiant Disorder) ODD Symptom Severity Score
Teachers will assess ODD symptoms using the CSI-4. The CSI-4: Teacher Checklist contains 9 symptoms of ODD. Each symptom is rated on a 4-point scale (0= never to 3= very often). The average ODD scores range from zero to four, with higher scores indicating more severe symptoms.
Time frame: Baseline and post treatment (8 weeks)
Change Impairment Rating Scale (IRS) Parent Questionnaire Overall Severity Score
Parents will assess impairment using the IRS. The IRS Parent Questionnaire contains 8 items of functional impairment (i.e., academic and peer relations). Each item is rated on a 7-point scale (1= no problem; does not need treatment/services to 7= extreme impairment; definitely needs treatment/services). The average of all IRS scores range from one to seven, with higher scores indicating more severe impairment.
Time frame: Baseline and post treatment (8 weeks)
Change Impairment Rating Scale (IRS) Teacher Questionnaire Overall Severity Score
Teachers will assess impairment using the IRS. The IRS Teacher Questionnaire contains 8 items of functional impairment (i.e., academic and peer relations). Each item is rated on a 7-point scale (1= no problem; does not need treatment/services to 7= extreme impairment; definitely needs treatment/services). The average of all IRS scores range from one to seven, with higher scores indicating more severe impairment.
Time frame: Baseline and post treatment (8 weeks)
| Milestone | CLS-R-FUERTE | Care-As-Usual |
|---|---|---|
| Started | 79 | 84 |
| Completed | 79 | 84 |
| Not completed | 0 | 0 |
Parents will assess ADHD symptoms using the CSI-4. The CSI-4: Parent Checklist contains 18 symptoms for ADHD, Combined type (ADHD:C; 18 items). Each symptom is rated on a 4-point scale (0= never to 3= very often). The average of ADHD:C scores range from zero to four, with higher scores indicating more severe symptoms.
| score on a scale | CLS-R-FUERTE - Students | Care-As-Usual - Students |
|---|---|---|
| Baseline | 1.73 ± 0.63 | 1.90 ± 0.60 |
| Post treatment | 0.96 ± 0.51 | 1.43 ± 0.60 |
Teachers will assess ADHD symptoms using the CSI-4. The CSI-4: Teacher Checklist contains 18 symptoms for ADHD, Combined type (ADHD:C; 18 items). Each symptom is rated on a 4-point scale (0= never to 3= very often). The average of ADHD:C scores range from zero to four, with higher scores indicating more severe symptoms.
| score on a scale | CLS-R-FUERTE - Students | Care-As-Usual - Students |
|---|---|---|
| Baseline | 1.91 ± 0.63 | 1.81 ± 0.59 |
| Post treatment | 1.20 ± 0.74 | 1.69 ± 0.60 |
Parents will assess ODD symptoms using the CSI-4. The CSI-4: Parent Checklist contains 9 symptoms of ODD. Each symptom is rated on a 4-point scale (0= never to 3= very often). The average ODD scores range from zero to four, with higher scores indicating more severe symptoms.
| score on a scale | CLS-R-FUERTE - Students | Care-As-Usual - Students |
|---|---|---|
| Baseline | 0.99 ± 0.63 | 1.31 ± 0.68 |
| Post Treatment | 0.67 ± 0.47 | 1.10 ± 0.53 |
Teachers will assess ODD symptoms using the CSI-4. The CSI-4: Teacher Checklist contains 9 symptoms of ODD. Each symptom is rated on a 4-point scale (0= never to 3= very often). The average ODD scores range from zero to four, with higher scores indicating more severe symptoms.
| score on a scale | CLS-R-FUERTE - Students | Care-As-Usual - Students |
|---|---|---|
| Baseline | 1.19 ± 0.69 | 1.20 ± 0.90 |
| Post Treatment | 0.88 ± 0.77 | 0.89 ± 0.86 |
Parents will assess impairment using the IRS. The IRS Parent Questionnaire contains 8 items of functional impairment (i.e., academic and peer relations). Each item is rated on a 7-point scale (1= no problem; does not need treatment/services to 7= extreme impairment; definitely needs treatment/services). The average of all IRS scores range from one to seven, with higher scores indicating more severe impairment.
| score on a scale | CLS-R-FUERTE - Students | Care-As-Usual - Students |
|---|---|---|
| Baseline | 4.03 ± 1.59 | 4.03 ± 1.33 |
| Post treatment | 1.72 ± 0.80 | 2.36 ± 0.98 |
Teachers will assess impairment using the IRS. The IRS Teacher Questionnaire contains 8 items of functional impairment (i.e., academic and peer relations). Each item is rated on a 7-point scale (1= no problem; does not need treatment/services to 7= extreme impairment; definitely needs treatment/services). The average of all IRS scores range from one to seven, with higher scores indicating more severe impairment.
| score on a scale | CLS-R-FUERTE - Students | Care-As-Usual - Students |
|---|---|---|
| Baseline | 5.01 ± 1.22 | 5.18 ± 1.08 |
| Post treatment | 2.90 ± 1.51 | 3.59 ± 1.46 |
Collected over Through study completion, an average of 10 weeks.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| CLS-R-FUERTE | 0/79 (0%) | 0/79 (0%) | 0/79 (0%) |
| Care-As-Usual | 0/84 (0%) | 0/84 (0%) | 0/84 (0%) |
Total CLS-R-FUERTE N = 79 Total Care-As-Usual N = 84
| Age, Categorical(Participants) | CLS-R-FUERTE -Students | CLS-R-FUERTE -Parents | CLS-R-FUERTE -Teachers | CLS-R-FUERTE -School Clinicians | Care-As-Usual - Students | Care-As-Usual - Parents | Care-As-Usual - Teachers | Care-As-Usual - School Clinicians | Total |
|---|---|---|---|---|---|---|---|---|---|
| <=18 years | 27 | 0 | 0 | 0 | 30 | 0 | 0 | 0 | 57 |
| Between 18 and 65 years | 0 | 27 | 18 | 7 | 0 | 30 | 19 | 5 | 106 |
| >=65 years | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Sex: Female, Male(Participants) | CLS-R-FUERTE -Students | CLS-R-FUERTE -Parents | CLS-R-FUERTE -Teachers | CLS-R-FUERTE -School Clinicians | Care-As-Usual - Students | Care-As-Usual - Parents | Care-As-Usual - Teachers | Care-As-Usual - School Clinicians | Total |
|---|---|---|---|---|---|---|---|---|---|
| Female | 4 | 27 | 18 | 6 | 11 | 30 | 16 | 4 | 116 |
| Male | 23 | 0 | 0 | 1 | 19 | 0 | 3 | 1 | 47 |
| Ethnicity (NIH/OMB)(Participants) | CLS-R-FUERTE -Students | CLS-R-FUERTE -Parents | CLS-R-FUERTE -Teachers | CLS-R-FUERTE -School Clinicians | Care-As-Usual - Students | Care-As-Usual - Parents | Care-As-Usual - Teachers | Care-As-Usual - School Clinicians | Total |
|---|---|---|---|---|---|---|---|---|---|
| Hispanic or Latino | 27 | 27 | 18 | 7 | 30 | 30 | 19 | 5 | 163 |
| Not Hispanic or Latino | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Region of Enrollment(Participants) | CLS-R-FUERTE -Students | CLS-R-FUERTE -Parents | CLS-R-FUERTE -Teachers | CLS-R-FUERTE -School Clinicians | Care-As-Usual - Students | Care-As-Usual - Parents | Care-As-Usual - Teachers | Care-As-Usual - School Clinicians | Total |
|---|---|---|---|---|---|---|---|---|---|
| Mexico | 27 | 27 | 18 | 7 | 30 | 30 | 19 | 5 | 163 |
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