School-based services are well suited for youth with chronic conditions who manifest much of their impairment in the school setting, such as youth with attention deficit hyperactivity disorder (ADHD). A significant literature on such programs at the elementary level exists, but little has been developed and tested at the secondary level. The current study is a 3-year treatment outcome study of a school-based training and consultation program for middle school youth with ADHD. Social and academic outcomes for program recipients were compared to that of participants in a community care control group. Findings revealed cumulative long-term benefits for the treatment group as measured by parent ratings of ADHD symptoms and social functioning. Although teacher and parent reports indicated no cumulative academic benefits, within-year analyses suggested a trend toward benefits in student grade point average. Implications for the treatment of ADHD in secondary schools are discussed. (Contains 4 tables and 2 figures.)