page contents

Multimodal Treatment Study of Children with ADHD (MTA Study)

Summary and Review by Matt Barcellona  Penn State College of Medicine 2002 Goal of study: 3 Questions 1) How do long term and behavioral treatments compare with one another? 2) Are there additional benefits of combining medicinal and behavioral treatments? 3) How does careful systematic treatment compare to routine community care?   Study Design: 4 Groups (Strategies) 1) Medication management 2) Behavioral Treatment 3) Combined Treatment 4) Community Care number of children = 579 over 14 month period   6 Major Outcome Domains 1) ADHD core symptoms (inattention, impulsivity, hyperactivity) 2) Oppositional/Aggressive symptoms 3) Social skills 4) Internalizing symptoms 5) Parent-Child relations 6) Academic achievement   Results & Conclusions – All groups showed marked reductions in symptoms over time, with significant differences in degrees of change. – Med management superior to behavioral treatment in controlling core symptoms of ADHD (parents/teachers). No significant difference on other domains. – Combined treatment and med management were superior to behavioral treatment in controlling core symptoms (parents/teachers) while Community Care was NOT. – No significant advantage of combined therapy versus medications alone on any domain -combined treatment consistently used lower doses than med management – Combined treatment superior to behavioral treatment on 4 domains:          1) Inattention (parents/teachers), Hyperactivity-Impulsivity (parents)          2) Oppositional/Aggressive behaviors (parents)          3) Internalizing symptoms (parents)          4) Academic achievement (reading) – Combined treatment was superior to Community Care on all 6 domains (parents). – Treatment satisfaction scores for parents of combined and behavioral treatments were superior to Med management parents.     Presentation References 1) Abukoff, HB, et al. “A 14-Month Randomized Clinical Trial of Treatment Strategies for ADHD.”...

Children and Psychiatric Medication – a multimodal presentation

Medications for the Child a multimodal presentation A Presentation from Penn State College of Medicine   Highlights of the presentation on psychiatric medication for the child include: Medication in ADHD, Anxiety and Depression Multimodal Treatment Study of Children with ADHD (MTA) Pediatric OCD, Treatment of OCD, and Cognitive Behavioral Therapy Treatment of Adolescent Depression Study (TADS)...

Helping Children Cope After A Disaster

Issues related to disaster and trauma intervention are addressed in the following booklet.  This booklet is to assist parents and professionals in helping children after a disaster.  The Child Advocate is devoted to children and the parents and professionals that work with them and advocate for them.  If you have questions about the information presented here, please consult a physician, mental health professional, the resources listed or other professional in your area.  References on the items listed here are available on request. Booklet for parents and professionals on Helping Children Cope After A Disaster from the Penn State Hershey Medical Center and the College of Medicine.  This booklet is designed to be printed on regular 8 1/2 by 11 paper on both sides and stapled into a booklet.  The two links below allow you to download and print the booklet.  Note that you will have to follow the page numbers to place the pages in the correct order after you print the booklet.  The Acrobat Reader is free and is needed to download the booklet.  You may already have this reader installed on your computer.  If you do not have the Reader, then use the link to download and install it.  The booklet may be printed for educational purposes, if properly cited, and distributed without profit to the individual or agency.  No further permissions are necessary and you should feel free to print and distribute this booklet as needed. Disaster Booklet in PDF...

Listen to the Children Interview

These are questions to ask children that are directly or indirectly involved in trauma to determine their awareness, knowledge, needs and misconceptions.  These questions are helpful whether the child was closely or distantly involved in the trauma. Where were you at the time of the disaster/attack/bombing? What happened where you were? How did it happen? Why did it happen? What were your thoughts and feelings, then and now? What did you do to help yourself – then and now? What did others do to help you – then and now? Dealing with Children’s Reactions What can help a child to deal with injury, loss and distress around trauma? Reassure that the event is over and they are “safe”. Repeat that you are “helping people”. Tell the child what you are doing. Warn them of painful procedures and that they (children) are “good”. Explain the expected procedures and who people are. Answer questions about the child reassuringly but honestly. Do not initially allow the child to hear others’ stories of accidents. Avoid telling the child about serious trauma of a friend or family member, unless the child seems capable to hear. Trauma Intervention At the time of the trauma what can help immediately? Protect children from excitement such as onlookers. Reunite children with parents immediately for comfort. Coordinate with other caregivers. Support parents in dealing with events. Pain and Fear Management What type of interventions are helpful to calm a child when a therapist or professional is involved? Distraction Guided imagery Suggestion Thought stopping Self-instruction Relaxation Trauma Factors from the Hurricane Hugo Disaster Factors to use in assessing potential risk...

The Affordable Care Act’s Impact for Former Foster Youth

By: Cara Baldari One of the most popular and bipartisan parts of the Affordable Care Act (P.L. 111–148, P.L. 111–152) is the provision allowing youth up to age 26 to remain on their parents’ health insurance. Yet there are thousands of youth who “age out” of foster care (meaning they no longer qualify for foster care services) each year and cannot take advantage of this option. Details at: First...

Divorce Effects on Children

Divorce is an intensely stressful experience for all children, regardless of age or developmental level; many children are inadequately prepared for the impending divorce by their parents based on 1980 and 1990 studies.

Risperidone Tolerability in Children

Presented at the American Psychiatric Association, 2002 Annual Meeting Hong Chen, M.D., Department of Psychiatry, Hershey Medical Center; Christopher A. Petersen, M.D. Introduction: Little published data is available to determine the tolerability of Risperidone in children in an acute setting. Method: In this prospective pilot study, hospitalized children (n = 10) with age range of 7 to 10 year, were administered Risperidone gradually to 0.04 mg/kg/day as clinically indicated and only if tolerated. Side effect rating scales were completed at baseline, within 24 hours of first dose to assess acute change, at 0.04mg/kg/day if possible to assess effects of therapeutic dosage, and prior to discharge. The average study period is 10 days. Results: Among 10 hospitalized children with newly started on Risperidone, three (30%) developed mild degree of loss of appetite with one also had diarrhea, one (10%) developed mild rigidity, drooling, slurred speech within 24 hours of first dose, one(10%) had mild sedation. In terms of short term weight change by discharge, three (30%) children gained average weight of 0.9 kg, one (10%) lost 0.7 kg. Nine children were discharged on Risperidone without remaining problems of loss of appetite, diarrhea and sedation except weight change, and one child had to discontinue and switch to another neuroleptics. Conclusion: The study demonstrated unexpected high rate of side effect but with short duration and mild severity in children who take Risperidone. More studies regarding long term sequelea of weight change, and presence of EPS symptoms in children on Risperidone are needed in future...
Page 13 of 13« First...910111213