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NIMH Multimodal Treatment Study

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A summary of the study can be found online at the National Institute of Mental Health Multimodal Treatment Study site. The National Institute of Mental Health is sponsoring an ongoing, multisite treatment study of children with ADHD entitled, "The Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder," also known as the MTA study. 

The first findings from this study were published in the article, "A 14-Month Randomized Clinical Trial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder," which was published in the December 1999 issue of Archives of General Psychiatry (Arch Gen Psychiatry, vol. 56, pp. 1073-1086). Authored by the MTA Cooperative Group, this study randomly assigned 579 children with ADHD (aged 7 to 10 years) to receive one of four treatments: 

  • medication management;
  • intensive behavioral treatment;
  • combined medication management and behavioral treatment; or
  • standard community care. 

Results: All 4 groups showed sizable reductions in symptoms over time, with significant differences among them in degrees of change. For most ADHD symptoms, children in the combined treatment and medication management groups showed signficantly greater improvement than those given intensive behavioral treatment alone and community care. Children who received combined treatments or medication management alone did not differ signficantly on any direct comparisons, but in several instances, combined treatment proved superior to intensive behavioral treatment alone and/or community care while medication management alone did not.

Using multiple assessment tools, the study concluded that, for ADHD symptoms, "carefully crafted medication management" yielded superior outcomes to behavioral treatment alone and to routine community care that included medication.  The combined treatment modalities of medication managment and behavioral treatment provided modest improvement in non-ADHD symptoms.

An abstract of this article may be found online at www.archgenpsychiatry.com.

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