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.