Short-Term Intensive Treatment Doesn't Improve ADHD In Children
Initial positive results gleaned from intensive treatment of childhood attention deficit hyperactivity disorder (ADHD) are unlikely to be sustained over the long term, according to a recent analysis of data from the NIMH-funded Multimodal Treatment Study of Children with ADHD (MTA). The study was published online ahead of print March 2009 in the Journal of the American Academy of Child and Adolescent Psychiatry.
The MTA was the first major multi-site trial comparing different treatments for ADHD in childhood. The initial results of the 14-month study, in which 579 children were randomly assigned to one of three intensive treatment groups (medication alone, psychosocial/behavioral treatment alone, a combination of both) or to routine community care were published in 1999. The researchers found that the intensive medication management alone or in combination with the behavioral therapy produced better symptomatic relief for children with ADHD than just behavioral therapy or usual community care. Children who received the combination treatment fared best in other areas of functioning such as social skills and parent-child relations. About half of the initial benefits of the intensive medication management and combination treatments dissipated by the first follow-up, which was two years after the trial began.
A follow-up study published in August 2007 found that, although most children had maintained improvement three years after the trial began, the initial advantages of intensive medication management alone or in combination with behavioral treatment had waned. The most recent analysis by Brooke Molina Ph.D., of the University of Pittsburgh, and colleagues aimed to characterize the long-term functioning of the children eight years after they were enrolled in the trial.
Results of the Study
Using reports from parents and teachers as well as self-reports from the children, now high school-aged, the researchers found that the youth’s functioning remained improved overall compared to their functioning at the beginning of the study, suggesting that available treatments can still be effective. However, they also found the following:
* The eight-year follow-up revealed no differences in symptoms or functioning among the youths assigned to the different treatment groups as children. This result suggests that the type or intensity of a one-year treatment for ADHD in childhood does not predict future functioning.