Leveraging Technology to Engage Adolescents in Treatment
While evidence-based behavioral treatments targeting executive functioning skills (e.g., organization, time management, planning) for adolescents with attention-deficit/hyperactivity disorder (ADHD) are well-established, these interventions most often fail to generalize across settings and over time. Lack of adolescent motivation and engagement, low between-session skills use, poor reward saliency, and low family involvement are key contributors to these limited effects. In collaboration with key stakeholders and software developers, Dr. Melissa Dvorsky (Principal Investigator) is leveraging digital health technology to develop, refine, and pilot an innovative tool for overcoming these notorious challenges impeding treatment adherence for adolescents with ADHD. She created the ATOM (Advanced Tools for Organization Management) a technology-enhanced organizational skills intervention for improving executive functioning skills acquisition and utilization, delivering in-vivo skills reinforcement, providing opportunities for immediate reinforcement, motivating adolescents with digital rewards, and monitoring students’ progress. The ultimate goal of this research is to develop a novel and scalable adaptive intervention that delivers personalized strategies for optimizing adolescent treatment engagement and skills utilization in real-time.
Funded by a K23 award from the National Institute of Mental Health (K23MH122839; PI: Dvorsky)
and previous funding from a UCSF Pilot Award in Basic and Clinical/Translational Sciences (PI: Dvorsky)
Identifying Risk & Protective Processes
In order for interventions to be most effective, they need to be focused and streamlined, targeting factors that are the most relevant for the functional outcomes of youth and their families. Knowledge of what promotes resilience in youth with attention, behavior, or executive functioning challenges including youth with ADHD is critical to improving and developing adequate intervention and prevention programs. To address this gap, I recently conducted a systematic review and led several empirical studies to help further our understanding of how risk and protective factors affect relation between ADHD and academic adjustment in order to build theoretical models of optimal adjustment that can advance intervention efforts. Across multiple longitudinal studies with adolescents, I have demonstrated the importance of social (e.g., peer support, parent involvement) and internal (e.g., self-perceptions, motivation, reward response) processes for buffering against impairment for youth with ADHD. As part of a recent study funded by Virginia Foundation for Healthy Youth (VFHY), I am longitudinally evaluating promotive and protective factors that buffer against risks for academic, socio-emotional, and alcohol/substance use problems for adolescents with and without ADHD during the transition to college. (PI: Dvorsky)
Web-Based Professional Development for School Mental Health Providers in Evidence-Based Practices for Attention and Behavior Challenges
Dr. Dvorsky is the lead technology and web developer for this project, responsible for creating and managing content and interactive features in the Salesforce Community Site (https://clsprogram.ucsf.edu) The purpose of this Goal 2 project funded by the Institute for Education Sciences (IES) in the US Department of Education is to develop a remote, web-based professional development program for school mental health providers to gain the skills needed to implement evidence-based practices for attention and behavior challenges in elementary school.
Funded by IES, R324A170338, PI: Pfiffner; Role: Consultant
A Digital Health Solution for Improving Parent Adherence to Behavioral Treatment for ADHD
Evidence-based behavioral treatments are well-established for youth with ADHD, but beneficial short and long-term effects depend on caregivers using recommended parenting strategies with their children in daily life contexts. Many barriers can interfere with caregiver adherence (e.g. lack of skill understanding, time constraints, forgetting). Dr. Linda Pfiffner (Principal Investigator) and Dr. Melissa Dvorsky (Co-Investigator) aim to develop, refine, and pilot test a novel and scalable mobile health solution designed to address barriers to caregiver adherence and increase sustained use of evidence-based parenting skills after in-person treatment ends. The tool is intended to engage caregivers through appealing and usable features such as video examples, interactive activities, templated behavior plan documents, automated reminders, navigation for personalized troubleshooting of problem areas, and motivational messaging for skill use. This project will yield feasibility data to inform subsequent larger-scale development and effectiveness projects designed to promote sustained ADHD treatment effects.
Funded by an award from the National Institutes of Mental Health (R34MH122222; PI: Pfiffner; Co-I: Dvorsky) and a UCSF Pilot Award for Established Investigators in Basic and Clinical/Translational Sciences
Current Research Projects
ADHD & Learning Differences Research Lab:
(from left to right: Michelle Harlan, BS, (Research Assistant), Amanda Steinberg, BS (Research Coordinator), Melissa Dvorsky, PhD (Director), Annie Groner (Undergraduate Research Assistant), Claire Huang (High School Student Mentee)
Melissa Dvorsky, PhD chairing a symposium and presenting on the ATOM intervention at the ISRCAP Meeting in London, UK.
Amanda Steinberg, poster on the stakeholder co-development of ATOM at the 2023 World Congress of ADHD in Amsterdam.
Amanda Steinberg, 2022 Children's National Research Innovation Week
University of Maryland ADHD Lab Meeting, Holiday Celebration (December 2021) https://umdadhd.org/
Publications
* Indicates mentored postdoc, graduate student, or research assistant author under my mentorship
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Dvorsky, M. R., Shroff, D.*, Bond, W. B. L.*, Steinberg, A.*, Breaux, R., & Becker, S. P. (2023). Impacts of COVID-19 on the school experience of children and adolescents with special educational needs and disabilities. Current Opinion in Psychology, 52, 101635. https://doi.org/10.1016/j.copsyc.2023.101635.
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Breaux, R., Cash, A. R., Lewis, J., Garcia, K., Dvorsky, M. R., & Becker, S. P. (2023). Impacts of COVID-19 quarantine and isolation on child and adolescent social functioning. Current Opinion in Psychology, 52, 101613. https://doi.org/10.1016/j.copsyc.2023.101613.
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Langberg, J. M., Dvorsky, M. R., Silvia, P., Labban, J. Anastopoulos, A. D. (2023). Clinical change mechanisms in the treatment of college students with ADHD: Trajectories and associations with outcomes. Behavior Therapy, 54(3), 444-460. https://doi.org/10.1016/j.beth.2022.11.00.
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Pfiffner, L. P., Dvorsky, M. R., Friedman, L. F., Haack, L., Chung, S., Charalel, J. M., Hawkey, E., Spiess, M. (2022). Development of a Web-Based Training Platform for School Clinicians in Evidence-Based Practices for ADHD. School Mental Health, 15, 49-66. https://doi.org/10.1007/s12310-022-09556-9
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Dvorsky, M. R., Breaux, R., Langberg, J. M., & Becker, S. P. (2022). Adolescents with ADHD are at Increased Risk for COVID-19 Vaccine Hesitancy. Journal of Psychiatric Research, 152, 25-30. https://doi.org/10.1016/j.jpsychires.2022.06.005
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Pfiffner, L. J., Dvorsky, M. R., Hawkey, E., Chung, S., Haack, L. M., & Owens, E. (2022). Improving Adherence to Behavioral Parent Training for ADHD Using Digital Health Tools. Journal of Psychiatry and Brain Science. e220005. https://doi.org/10.20900/jpbs.20220005
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Dvorsky, M. R., Breaux, R., Cusick, C. N., Fredrick, J. W., Green, C., Steinberg, A.*, Langberg, J. M., Sciberras, E., & Becker, S. P. (2022). Coping with COVID-19: Longitudinal Impact of the Pandemic on Adjustment and Links with Coping for Adolescents with and without ADHD. Research in Child and Adolescent Psychopathology, 50, 605-619. DOI: 10.1007/s10802-021-00857-2
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Morgan, J. E., Dvorsky, M. R., Meza, J. I, Schumacher, L., & Pfiffner, L. J. (2022). Co-occurring psychopathology moderates social skills improvement in a randomized controlled trial of a collaborative school-home intervention for children with ADHD. Journal of Clinical Child and Adolescent Psychology, 51(4), 543-555. DOI: 10.1080/15374416.2020.1815206
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Barendse, M. E., Flannery, J., Cavanagh, C., Aristizabal, M., Becker, S. P., Berger, E., Breaux, R., Campione-Barr, N., Church, J. A., Crone, E. A., Dahl, R. E., Dennis-Tiwary, T. A., Dvorsky, M. R., Dziura, S., Ho, T. C., Killoren, S., Langberg, J. M., Larguinho, T., Magís-Weinberg, L., Michalska, K. J., Mullins, J. L., Nadel1, H., Aristizabal, M., Porter, B., Prinstein, M. J., Redcay, E., Rose, A., Rote, W., Roy, A. K., Sweijen, S. W., Telzer, E. H., Teresi, G. I., Thomas, A. G., & Pfeifer, J. H. (2022). Longitudinal change in adolescent depression and anxiety symptoms from before to during the COVID-19 pandemic: An international collaborative of 12 samples from 3 countries. Journal of Research on Adolescence, 33(1), 74-91. http://doi.org/10.1111/jora.12781
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Fredrick, J., Nagle, K., Langberg, J. M., Dvorsky, M. R., Breaux, R., & Becker, S. P. (2022). Rumination as a Mechanism of the Longitudinal Association between COVID-19-Related Stress and Internalizing Symptoms in Adolescents. Child Psychiatry & Human Development. Advanced Online Publication. https://doi.org/10.1007/s10578-022-01435-3
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Lewis, J., Hayakumar, S., Breaux, R., Dvorsky, M. R., Langberg, J. M., & Becker, S. P. (2022). Prospective Examination of Psychological Trauma among Adolescents during the COVID-19 Pandemic. Psychological Trauma: Theory, Research, Practice, and Policy, 15(3), 404-414. https://doi.org/10.1037/tra0001311
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Roy, A. K., Breaux, R., Sciberras, E., Patel, P., Ferrara, E., Shroff, D. M., Cash, A. R., Dvorsky, M. R., Langberg, J. M., Quach, J., Melvin, G., Jackson, A., & Becker, S. P. (2022). A preliminary examination of key strategies, challenges, and benefits of remote learning expressed by parents during the COVID-19 pandemic. School Psychology, 37(2), 147-159. https://doi.org/10.1037/spq0000465
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Breaux, R., Dunn, N., Langberg, J. M., Cusick, C., Dvorsky, M. R., & Becker, S. P. (2022). COVID-19 Resulted in Lower Grades for Male High School Students and Students with ADHD. Journal of Attention Disorders, 26(7), 1011-1017. DOI: 10.1177/10870547211044211
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Groenman, A., Hornstra, P., Steenhuis, L., Aghbati, A., Boyer, B., Buitelaar, J., Chronis-Tuscano, A., Daley, D., Dehkordian, P., Dvorsky, M. R. … Hoofdakker. (2021). An Individual Participant Data Meta-analysis: Behavioral Treatments for Children and Adolescents With Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 61(2), 144-158. DOI: https://doi.org/10.1016/j.jaac.2021.02.024
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Dvorsky, M. R., Tamm, L., Denton, C. A., Epstein, J. N., Schatschneider, C. (2021). Trajectories of response to treatments in children with ADHD and word reading difficulties. Research on Child and Adolescent Psychopathology, 49, 1015-1030. DOI: 10.1007/s10802-021-00815-y.
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Becker, S. P., Dvorsky, M. R., Breaux, R., Cusick, C. N., Taylor, K. P., & Langberg, J. M. (2021). Prospective Examination of Adolescent Sleep Patterns and Disturbances Before and During COVID-19. SLEEP, 44(8), 1-11. DOI: 10.1093/sleep/zsab054
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Breaux, R., Dvorsky, M. R., & Becker, S. P. (2021). ADHD in COVID-19: Risk, Resilience, and the Rapid Transition to Telehealth. The ADHD Report, 21(2), 1-9. DOI: 10.1521/adhd.2021.29.2.1.
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Eddy, L. D., Anastopoulos, A., Dvorsky, M. R., Silvia, P., Labban, J., Langberg, J. M. (2021). An RCT of a CBT Intervention for College Students with ADHD: Functional Outcomes. Journal of Clinical Child and Adolescent Psychology, 50(6), 844-857. https://doi.org/10.1080/15374416.2020.1867989
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Dvorsky, M. R., Friedman, L., Spiess, M. I., & Pfiffner, L. J. (2020). Patterns of Parental Adherence and the Association to Child and Parenting Outcomes Following a Multi-Component School-Home Intervention for Youth with ADHD, Behavior Therapy, 52(3), 745-760. DOI: 10.1016/j.beth.2020.09.007
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Breaux, R., Dvorsky, M. R., Marsh, N. P., Green, C. D., Cash, A. R., Shroff, D. M., Buchen, N., Langberg, J. M., & Becker, S. P. (2021). Prospective Impact of COVID-19 on Mental Health Functioning in Adolescents with and without ADHD: Protective Role of Emotion Regulation Abilities. Journal of Child Psychology and Psychiatry, 62(9), 1132-1139. DOI: 10.1111/jcpp.13382.
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Becker, S. P., Webb, K. L., & Dvorsky, M. R. (2021). Initial examination of the bidirectional associations between sluggish cognitive tempo and internalizing symptoms in children, Journal of Clinical Child & Adolescent Psychology, 50(2), 258-266. DOI: 10.1080/15374416.2019.1630836.
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Dvorsky, M. R., Breaux, R. & Becker, S. P. (2021). Finding ordinary magic in extraordinary times: Child and adolescent resilience during the COVID-19 Pandemic. European Child & Adolescent Psychiatry, 30, 1829-1831. DOI: 10.1007/s00787-020-01583-8
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Becker S. P., Dvorsky, M. R., Tamm, L., & Willoughby, M (2020). Preschool neuropsychological predictors of school-aged sluggish cognitive tempo and inattentive behaviors. Research on Child and Adolescent Psychopathology, 49, 197-210. DOI: 10.1007/s10802-020-00728-2.
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Becker, S. P., Breaux, R., Cusick, C. N., Dvorsky, M. R., Marsh, N. P., Sciberras, E., & Langberg, J. M. (2020). Remote learning during COVID-19: Examining school practices, service continuation, and difficulties for adolescents with and without ADHD. Journal of Adolescent Health, 67(6), 769-777. DOI: https://doi.org/10.1016/j.jadohealth.2020.09.002
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Friedman, L. M., Dvorsky, M. R., McBurnett, K., & Pfiffner, L. J. (2020). Do Parents’ ADHD Symptoms Affect Treatment for their Children? The Impact of Parental ADHD on Adherence to Behavioral Parent Training for Childhood ADHD. Journal of Abnormal Child Psychology, 48(11), 1425-1437. DOI: 10.1007/s10802-020-00672-1
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Corona, R., Dvorsky, M. R., Romo, S., Parks, A. M., Bourchtein, E., Smith, Z. R., Avila, M., & Langberg, J. M. (2020). Integrating tobacco prevention skills into an evidence-based intervention for adolescents with ADHD: Results from a pilot efficacy randomized controlled trial. Journal of Abnormal Child Psychology, 48, 1439-1453. DOI: 10.1007/s10802-020-00689-6
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Meza, J. I., Friedman, L. M., Dvorsky, M. R., Kass, P., Chabbra, D., & Pfiffner, L. J. (2020). Outcomes of school-home intervention for attention and behavior problems: Teacher adherence matters. School Mental Health, 12, 703-715. DOI.10.1007/s12310-020-09378-7.
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Langberg, J. M., Molitor, S. J., *Oddo, L., *Eadeh, H. M., Dvorsky, M. R., & Becker, S. P. (2020). Prevalence, patterns, and predictors of sleep problems and daytime sleepiness in young adolescents with Attention-Deficit/Hyperactivity Disorder. Journal of Attention Disorders, 24(4), 509-523. DOI: 10.1177/1087054717690810.
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Green*, C. D., Dvorsky, M. R., Langberg, J. M., Jones, H. A., & Floyd, A. L. (2020). The Impact of Social Determinants of Health on the Efficacy of School-Based Interventions for Adolescents with ADHD. School Mental Health, 12, 580-594. DOI.10.1007/s12310-020-09367-w.
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Dvorsky, M. R., Becker S. P., Tamm, L., & Willoughby, M. (2019). Testing the longitudinal structure and change in sluggish cognitive tempo and inattentive behaviors from early through middle childhood. Assessment, 28(2), 380-394. DOI: 10.1177/1073191119872247.
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Friedman, L. M., McBurnett, K., Dvorsky, M. R., Hinshaw, S. P., & Pfiffner, L. J. (2019). Comorbid Specific Learning Disorder confers treatment resistance for children with Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Presentation. Journal of Clinical Child and Adolescent Psychology, 49(6), 854-867. DOI: 10.1080/15374416.2019.1644647.
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Dvorsky, M. R. & Langberg, J. M. (2019). Cigarette and E-Cigarette Use and Social Perceptions over the Transition to College: The Role of ADHD Symptoms. Psychology of Addictive Behaviors, 33(3), 318-330. DOI: 10.1037/adb0000450.
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Molitor, S. J. & Dvorsky, M. R. (2019). Ethical considerations for assessing parent mental health during child assessment services. Ethics & Behavior, 29(2), 87-100. DOI: 10.1080/10508422.2018.1482746.
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Breaux, R. P, Langberg, J. M., Molitor, S. J., Dvorsky, M. R, Bourchtein, E., Smith, Z., & Green, C. (2019). Predictors and trajectories of response to the Homework, Organization, and Planning Skills (HOPS) intervention for adolescents with ADHD. Behavioral Therapy, 50, 140-154. DOI: 10.1016/j.beth.2018.04.001.
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Dvorsky, M. R., Langberg, J. M., Becker, S. P., & Evans, S. W. (2019). Trajectories of global self-worth in adolescents with ADHD: Associations with academic, emotional, and social outcomes. Journal of Clinical Child and Adolescent Psychology, 48(5), 765-780. DOI: 10.1080/15374416.2018.1443460.
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Dvorsky, M. R., Kofler, M. J., Burns, G. L., Luebbe, A. M., Garner, A. A., Jarrett, M. A., Soto, E. F., & Becker, S. P. (2018). Factor structure and criterion validity of the five Cs model of positive youth development in a multi-university sample of college students. Journal of Youth and Adolescence, 48(3), 537-553. DOI: 10.1007/s10964-018-0938-y.
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Becker. S. P., Dvorsky, M. R., Holdaway, A., & Luebbe, A. (2018). Sleep problems and suicidal behaviors in college students. Journal of Psychiatric Research, 99, 122-128. DOI: 10.1016/j.jpsychires.2018.01.009.
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Langberg, J. M., Dvorsky, M. R., Molitor, S. J., Bourchtein, E., Eddy, L. D., Smith, Z. R., *Oddo, L., & *Eadeh, H. M. (2018). Overcoming the Research-to-Practice Gap: A Randomized Trial with Two Brief Homework and Organization Interventions for Students with ADHD as Implemented by School Mental Health Providers. Journal of Consulting and Clinical Psychology, 86(1), 39-55. DOI: 10.1037/ccp0000265.
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Langberg, J. M., Smith, Z. R., Dvorsky, M. R., Molitor, S. J., Bourchtein, E., Eddy, L. D., *Eadeh, H. M., & *Oddo, L. E (2017). Factor Structure and Predictive Validity of a Homework Motivation Measure for use with Middle School Students with Attention-Deficit/Hyperactivity Disorder (ADHD). School Psychology Quarterly, 33(3), 390-398. DOI: 10.1037/SPQ0000219.
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Dvorsky, M. R., & Langberg, J. M. (2016). A review of factors that promote resilience in youth with ADHD and ADHD symptoms. Clinical Child and Family Psychology Review, 19(4), 368-391. DOI: 10.1007/s10567-016-0216-z.
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Molitor, S. J., Langberg, J. M., Evans, S. W., Dvorsky, M. R., Bourchtein, E., Eddy, L. D., Smith, Z. R., & Oddo, L. E. (2016). Evaluating the factor validity of the Children’s Organizational Skills Scale in youth with ADHD. School Mental Health, 9(2), 143-156. DOI: 10.1007/s12310-016-9205-0.
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Dvorsky, M. R., Langberg, J. M., Evans, S. W., & Becker, S. P. (2016). The protective effects of social factors on the academic functioning of adolescents with ADHD. Journal of Clinical Child and Adolescent Psychology, 47(5), 713-726. DOI: 10.1080/15374416.2016.1138406.
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Dvorsky, M. R., Langberg, J.M., Molitor, S. P., & Bourchtein, E. (2016). Clinical utility and predictive validity of parent and college student symptom ratings in predicting an ADHD diagnosis. Journal of Clinical Psychology, 72(4), 401-418. DOI: 10.1002/jclp.22268.
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Langberg, J. M., Dvorsky, M. R., Molitor, S., Bourchtein, E., Eddy, L., Smith, Z., Schultz, B., & Evans, S.W. (2016). Longitudinal evaluation of the importance of homework completion for the academic performance of middle school students with ADHD. Journal of School Psychology, 55, 27-38. DOI: 10.1016/j.jsp.2015.12.004.
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Molitor, S. J., Langberg, J. M., Bourchtein, E., Eddy, L. D., Dvorsky, M. R., Evans, S. W. (2015). Writing Abilities Longitudinally Predict Academic Outcomes of Adolescents with ADHD. School Psychology Quarterly, 31(3), 393-404. DOI: 10.1037/spq0000143.
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Eddy, L. D., Dvorsky, M. R., Molitor, S. J., Bourchtein, E., Smith, Z., *Oddo, L. E., *Eadeh, H. M., & Langberg, J. M. (2015). Longitudinal evaluation of the cognitive-behavioral model of ADHD in a sample of college students with ADHD. Journal of Attention Disorders. Advance online publication. DOI: 10.1177/1087054715616184.
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Girio-Herrera, E., Dvorsky, M. R., Owens, J. S. (2015). Mental health screening in kindergarten youth: A multi-study examination of the concurrent and diagnostic validity of the impairment rating scale. Psychological Assessment, 27, 215-227. DOI: 10.1037/a0037787.
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Langberg, J. M., Dvorsky, M. R., *Kipperman, K. L., Molitor, S. J., & Eddy, L. D. (2015). Alcohol use longitudinally predicts adjustment and impairment in college students with ADHD: The role of executive functions. Psychology of Addictive Behaviors, 29(2), 444-454. DOI: 10.1037/adb0000039.
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Dvorsky, M. R. & Langberg, J. M. (2019). Predicting impairment in college students with Attention-Deficit/Hyperactivity Disorder: The role of executive functions. Journal of Attention Disorders, 23(13), 1624-1636. DOI: 10.1177/1087054714548037.
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Langberg, J. M., Dvorsky, M. R., Becker, S. P., & Molitor, S. J. (2014). School maladjustment and external locus of control predict the daytime sleepiness of college students with ADHD. Journal of Attention Disorders. Advance online publication. DOI: 10.1177/1087054714529818.
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Langberg, J. M., Becker, S. P., Dvorsky, M. R., & Luebbe, A. M. (2014). Are sluggish cognitive tempo and daytime sleepiness distinct constructs? Psychological Assessment, 26(2), 586-597. DOI: 10.1037/a0036276.
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Becker, S. P., Langberg, J. M., Luebbe, A. M., Dvorsky, M. R., & Flannery, A. J. (2014). Sluggish cognitive tempo is associated with academic functioning and internalizing symptoms in college students with and without attention-deficit/hyperactivity disorder. Journal of Clinical Psychology, 70, 388-403. DOI: 10.1002/jclp.22046.
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Langberg, J. M., Dvorsky, M. R., Becker, S. P., & Molitor, S. J. (2014). The impact of daytime sleepiness on the school performance of college students with ADHD: A prospective longitudinal study. Journal of Sleep Research, 23, 318-325. DOI: 10.1111/jsr.12121.
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Langberg, J. M., Becker, S. P., & Dvorsky, M. R. (2014). The association between sluggish cognitive tempo and academic functioning in youth with Attention-Deficit/Hyperactivity Disorder (ADHD). Journal of Abnormal Child Psychology, 42, 91-103. DOI: 10.1007/s10802-013-9722-3.
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Langberg, J. M., Dvorsky, M. R., & Evans, S. W. (2013). What specific facets of executive function are associated with the academic functioning in youth with Attention-Deficit/Hyperactivity Disorder? Journal of Abnormal Child Psychology, 41(7), 1145-1159. DOI: 10.1007/s10802-013-9750-z.
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Langberg, J. M., Dvorsky, M. R., Marshall, S., & Evans, S. W. (2013). Clinical implications of daytime sleepiness for the academic performance of middle school age adolescents with ADHD. Journal of Sleep Research, 22(5), 542-548. DOI: 10.1111/jsr.12049.
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Splett, J. W., Fowler, J., Weist, M. D., McDaniel, H. L., & Dvorsky, M. R. (2013). The critical role of school psychology in the school mental health movement. Psychology in the Schools, 50(3), 245-258. DOI: 10.1002/pits.21677.
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DeLoach, K. P., Dvorsky, M. R., George, M. R., Miller, E., Weist, M. D., Kern, L. (2012). Interdisciplinary collaboration in launching a large-scale intervention research study in schools. School Psychology Communique, 40(6), 10-11.