Nine months of multicomponent behavioral treatment for ADHD and effectiveness of MTA fading procedures.

Published

Journal Article

We examined 9-month data from the 14-month NIMH Multimodal Treatment Study of Children with ADHD (the MTA) as a further check on the relative effect of medication (MedMgt) and behavioral treatment (Beh) for attention-deficit/hyperactivity disorder (ADHD) while Beh was still being delivered at greater intensity than at 14-month endpoint, and conversely as a check on the efficacy of the MTA behavioral generalization/maintenance procedures. Intention-to-treat analysis at 9 months showed essentially the same results as at 14 months, after Beh had been completely faded; MedMgt and the combination (Comb) of medication and Beh were significantly superior to Beh and community care (CC) for ADHD and oppositional-defiant (ODD) symptoms, with mixed results for social skills and internalizing symptoms. All treatment-group differences examined as changes in slopes from 9 to 14 months were nonsignificant (we found general improvement for all groups). Slopes from baseline to 9 months correlated highly (r > .74, p < .0001) with slopes from baseline to 14 months for all groups. The time function from baseline to 14 months showed a significant linear, but not quadratic, trend for the main outcome measure (a composite of parent- and teacher-rated ADHD and ODD symptoms) for all groups. Findings suggest that in contrast to the hypothesized deterioration in the relative benefit of Beh between 9 and 14 months (after completion of fading), the MTA Beh generalization and maintenance procedures implemented through 9 months apparently yielded continuing improvement through 14 months, with preservation of the relative position of Beh compared to other treatment strategies.

Full Text

Duke Authors

Cited Authors

  • Arnold, LE; Chuang, S; Davies, M; Abikoff, HB; Conners, CK; Elliott, GR; Greenhill, LL; Hechtman, L; Hinshaw, SP; Hoza, B; Jensen, PS; Kraemer, HC; Langworthy-Lam, KS; March, JS; Newcorn, JH; Pelham, WE; Severe, JB; Swanson, JM; Vitiello, B; Wells, KC; Wigal, T

Published Date

  • February 2004

Published In

Volume / Issue

  • 32 / 1

Start / End Page

  • 39 - 51

PubMed ID

  • 14998110

Pubmed Central ID

  • 14998110

Electronic International Standard Serial Number (EISSN)

  • 1573-2835

International Standard Serial Number (ISSN)

  • 0091-0627

Digital Object Identifier (DOI)

  • 10.1023/b:jacp.0000007579.61289.31

Language

  • eng