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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.”...