Evidence, Interpretation, and Qualification From Multiple Reports of Long-Term Outcomes in the Multimodal Treatment Study of Children With ADHD (MTA): Part I: Executive Summary

Objective: To review the primary and secondary findings from the Multimodal Treatment study of ADHD (MTA) published over the past decade as three sets of articles. Method: In a two-part article—Part I: Executive Summary (without distracting details) and Part II: Supporting Details (with additional b...

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Bibliographic Details
Published in:Journal of attention disorders 2008-07, Vol.12 (1), p.4-14
Main Authors: Swanson, James, Arnold, L. Eugene, Kraemer, Helena, Hechtman, Lily, Molina, Brooke, Hinshaw, Stephen, Vitiello, Benedetto, Jensen, Peter, Steinhoff, Ken, Lerner, Marc, Greenhill, Laurence, Abikoff, Howard, Wells, Karen, Epstein, Jeffery, Elliott, Glen, Newcorn, Jeffrey, Hoza, Betsy, Wigal, Timothy
Format: Article
Language:English
Subjects:
Attention Deficit Disorder with Hyperactivity - diagnosis
Attention Deficit Disorder with Hyperactivity - drug therapy
Attention Deficit Disorder with Hyperactivity - therapy
Attention Deficit Disorders
Behavior Modification
Central Nervous System Stimulants - therapeutic use
Child
Combined Modality Therapy
Consensus
Drug Therapy
Humans
Hyperactivity
Outcomes of Treatment
Program Effectiveness
Psychotherapy
Randomized Controlled Trials as Topic
Stimulants
Therapy
Treatment Outcome
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Summary:Objective: To review the primary and secondary findings from the Multimodal Treatment study of ADHD (MTA) published over the past decade as three sets of articles. Method: In a two-part article—Part I: Executive Summary (without distracting details) and Part II: Supporting Details (with additional background and detail required by the complexity of the MTA)—we address confusion and controversy about the findings. Results: We discuss the basic features of the gold standard used to produce scientific evidence, the randomized clinical trial, for which was used to contrast four treatment conditions: medication management alone (MedMgt), behavior therapy alone (Beh), the combination of these two (Comb), and a community comparison of treatment “as usual” (CC). For each of the three assessment points we review three areas that we believe are important for appreciation of the findings: definition of evidence from the MTA, interpretation of the serial presentations of findings at each assessment point with a different definition of long-term, and qualification of the interim conclusions about long-term effects of treatments for ADHD. Conclusion: We discuss the possible clinical relevance of the MTA and present some practical suggestions based on current knowledge and uncertainties facing families, clinicians, and investigators regarding the long-term use of stimulant medication and behavioral therapy in the treatment of children with ADHD. (J. of Att. Dis. 2008; 12(1) 4-14)
ISSN:1087-0547
1557-1246
DOI:10.1177/1087054708319345