Fabiano’s ‘first job’ training continues work with ADHD adolescents

They’re called “developmental transitions,” and if anyone knows how important they are for ADHD adolescents, it’s UB faculty member Gregory Fabiano, a nationally prominent expert on treating and educating children with ADHD.

Developmental transitions are times in the lives of adolescents when they must jump from one level of functioning to another, says Fabiano, associate dean for interdisciplinary research in the Graduate School of Education.

And those transitions can be especially rough on young adults with ADHD, he says.

Fabiano took on a common and challenging developmental transition nearly a decade ago when he used a state-of-the-art driving simulator developed by Kevin Hulme, senior research associate in UB’s Motion Simulation Laboratory, to not only teach adolescents with ADHD to drive better, but to improve their relationships with their parents as well. His more recent research showed how positive parental and teacher behavioral supports brought better results than if children with ADHD took medication first.

Now, add to Fabiano’s track record another project that examines what he calls a final developmental transition for adolescents: getting their first job.

“Unfortunately, we know that people with ADHD wind up in lower prestige jobs, they make less money and they aren’t in school, so there is less chance for advancement.

“We think that your first job is a building block for how you are going to do in your career,” he notes. “And the most common job for someone with a disability like ADHD is food service and delivery, so we want them to be successful no matter where they start.

“So we’re hoping to use the laboratory here at UB to understand how we can help these people be successful.”

Fabiano’s study explored whether there were differences between those with ADHD and those without regarding how they performed on job applications, interviews and performance on job-related tasks.

Participants in the study went through mock job interviews, as well as a scenario in which they were employed delivering pizzas using UB’s driving simulator.

Fabiano observed how the participants approached the task of putting together orders for delivery, planned their route and drove around the neighborhood to deliver pizzas and sandwiches. Researchers could then evaluate whether the right order got to the right address, whether the driver returned with the correct change for each transaction and whether traffic safety rules were followed.

Study results, which have been accepted for publication by the journal Human Performance — show ADHD children had much more difficulty interviewing for their first job than children of similar ages who did not have ADHD.

The research also showed the somewhat counterintuitive result that these ADHD students perform at least equivalent to their non-ADHD counterparts on first-day job tasks.

But the difficulty with interviewing would be a tough obstacle for many of these ADHD adolescents looking to be hired.

“As more adolescents with ADHD are transitioning to the workforce at the beginning of a career,” Fabiano wrote in the Human Performance paper, “it is important to understand the type and intensity of functional problems within workplace settings, with an eventual goal of developing treatments to prevent and reduce occupational impairment and identify necessary skills for training.”

In the paper, Fabiano noted that individuals with ADHD appeared to have a particularly difficult time in job interviews. “Even in this brief time period of observation, masked observers noted significant increases in the exhibition of ADHD symptoms. Further, the review of the observers following the observation of the interview suggested the individuals with ADHD were less employable than those without ADHD, simply based on the responses to the standard questions.”

The study on ADHD job performance was funded by an Innovative MicroPrograms Accelerating Collaboration in Themes (IMPACT) grant from the UB Office of the Vice President for Research.

Fabiano is now working on a study to determine if medication helps 16-to-25-year-olds with ADHD approach these job interviews in a more productive way and whether their behavior differs if they are on medication or not.

The official name of the study — “Efficacy of Lisdexamfetamine Dinesylat for Promoting Occupational Success in Young Adults With ADHD Disorder — refers to the generic name of the stimulant medication commonly prescribed for this age group. The study, which Fabiano hopes to have completed in the next few months, is funded by Shire Pharmaceuticals by an investigator-initiated award.

Fabiano’s research group has been actively recruiting and interviewing adolescents and young adults between the ages of 16 and 25 to participate in the study. Those interested in applying can call 716-829-5974.