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Multimodal Treatment of Children with ADHD (MTA) Study

(1999)

Hypothesis

Children receiving different treatments for Attention-deficit/Hyperactivity Disorder (ADHD) will demonstrate different outcomes. Children receiving medication therapy will show greater behavioral improvement than children not receiving medications. A goal of the study was to update previous studies that have demonstrated short-term efficacy of medication and behavior therapy.

This is an ongoing National Institutes of Mental Health (NIMH) study. The study involves seven research sites: New York State Psychiatric Institute at Columbia University, New York, NY; Mount Sinai Medical Center, New York, NY; Duke University Medical Center, Durham, NC; University of Pittsburgh, Pittsburgh, PA; Long Island Jewish Medical Center, New Hyde Park, NY; Montreal Children's Hospital, Montreal Canada; University of California at Berkeley, CA; and University of California at Irvine, CA.

Subjects

579 children with ADHD Combined Type participated. They were assigned to 14 months of one of four treatment types: (1) medication management; (2) intensive behavioral management; (3) combined medication and behavioral management; (4) standard community care. Children were between 7.9 and 9.9 years of age.

Results

Long-term combination treatments (medication and behavioral therapy) and medication alone significantly improve symptoms associated with ADHD. The authors state that these results are demonstrated in academic performance, oppositionality, parent-child relations and social skills. These effects extended for 14 months. In specific areas of improvement, such as social skills, oppositionality, parent-child relations the combined treatment was found to be significantly better.

Bottom line

The study adds important data to the understanding of long-term effects of medication. It is important to review some of the limitations of the study as well. For example, though the researchers say academic achievement is improved they do not provide data that shows improvement on standardized measures of academic achievement over a period of time.

The bottom line is that parents must work with their children and with the school to determine what works best. For some children medication may be the answer; for others, behavioral therapy. For others a combination of both.

Where to find

To read a critical analysis of the MTA study.

References

References

Click the "References" link above to hide these references.

Green, Ross W; Ablon, Stuart, (2001) What does the MTA study tell us about effective psychosocial treatment for ADHD? Journal of Clinical Child Psychology. 30 (1) 114-121.

Jensen, Peter S. MD; Martin, David, BA; Cantwell, Dennis P. MD, (1997) Comorbidity in ADHD: Implications for research, practice and DSM-IV, Journal of the American Academy of Child & Adolescent Psychiatry, 36 (8), 1065-1079.

MTA Cooperative Group (1999) Moderators and mediators of treatment response for children with Attention Deficit/Hyperactivity Disorder: The multimodal treatment study of children with Attention-Deficit/Hyperactivity Disorder, Archives of General Psychiatry, 56(12), 1088-1096. Study Abstract.