The NIMH-funded Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) study was a multi-site study designed to evaluate the leading treatments for ADHD, including behavior therapy, medications, and the combination of the two. The study's primary results were published in 1999. Follow-up data continues to be published.[]
In this NIMH-sponsored trial, 579 children with ADHD Combined Type, aged 7 to 9.9 years, were randomly assigned to 14 months of:
- medication management (titration, starting with methylphenidate BID, followed by monthly visits);
- behavioral treatment (parent training, child-focused treatment, and a school-based intervention with therapist involvement gradually reduced over time);
- the two combined;
- or standard community care (treatments by community providers). (Arch. Gen. Psych., 1999)
- "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 significantly greater improvement than those given intensive behavioral treatment and community care. Combined and medication management treatments did not differ significantly on any direct comparisons, but in several instances (oppositional/aggressive symptoms, internalizing symptoms, teacher-rated social skills, parent-child relations, and reading achievement) combined treatment proved superior to intensive behavioral treatment and/or community care while medication management did not.
- Study medication strategies were superior to community care treatments, despite the fact that two thirds of community-treated subjects received medication during the study period."
Type or intensity of 14 months of treatment for ADHD in childhood (at age 7.0–9.9 years) does not predict functioning 6 to 8 years later. (Molina B. et.al. JAACAP 2009:48)
The MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry. 1999 Dec;56(12):1073-86.