Results From Largest Treatment Study of ADHD

The following information was written by David Rabiner, Ph.D., Senior Research Scientist, Duke University.

There have been preliminary reports of the results from the Multimodal Treatment Study of Children with ADHD (MTA). This is the largest and most comprehensive treatment study of ADHD that has ever been conducted.  A few months ago the initial papers reporting the results of this study were published.

The MTA Study was designed to address 3 fundamental questions about the treatment of ADHD.  These questions are as follows:

1. How do long-term medication and behavioral treatments compare with one another?

2. Are there additional benefits when they are used together?

3. What is the effectiveness of systematic, carefully delivered treatments vs. routine community care? 
 

THE RESULTS

There is a tremendous amount of data presented in these papers and it is really not possible to summarize it all. Below, however, are what I found to be the most important findings.

First, let me list the variety of different outcomes that were assessed and reported.  These include:

* Primary ADHD symptoms - ratings provided by parents and teachers;

* Aggressive and oppositional behavior - ratings provided by parents, teachers, and classroom observers;

* Internalizing symptoms (e.g. anxiety and sadness) - ratings provided by parents, teachers, and children;

* Social skills - ratings provided by parents, teachers, and children;

* Parent-child relations - rated by parent;

* Academic achievement - assessed by standardized tests; (It is unfortunate, I think, that more frequent measures of academic performance in the classroom were not collected.  These tend to be more sensitive to change than scores on standardized achievement tests.  Thus, the reliance on achievement tests alone as the measure of academic performance may not have enabled important changes in academic functioning to be captured).

In considering the results presented below it is important to place them in this overall context: 

Children in all 4 groups (i.e. medication only, behavioral treatment only, combined treatment, and treatment in the community as chosen by parents) showed significant reductions in their level of symptoms over time in most areas. Thus, even though some treatments were clearly superior to others in certain domains, overall, even children receiving the "least effective" treatment tended to show important improvement.  Thus, these data should not be interpreted in a framework of "what worked" and "what did not work".  Instead, it is a matter of what seemed to be most effective among treatments that all showed some positive effects. 

Link to read the rest of this important study: file:///Users/admin/Desktop/Current%20Projects/ADHD-To%20Read/ADHD-Results%20largest%20treatment%20study.webarchive