How Best To Treat Attention-Deficit/Hyperactivity Disorder (ADHD)
Source: The National Institute of Mental Health Article

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a significant cause of distress and unhappiness for thousands of American children and their families. ADHD interferes with concentration and activity levels, and ADHD children have problems in school and functioning within their families. Many of these children suffer later difficulties in life and work. ADHD is a social and medical problem that demands our close and continuing attention.

Although ADHD is relatively common, our knowledge of the problem is incomplete. Current ADHD treatment includes a mix of approaches, such as drug therapy, counseling, supportive services in schools and communities—and various combinations of the three. The medical literature offers many studies about shorter treatment periods (three months or less), but a pressing question remains: what’s the best kind of help we can offer ADHD children over a longer term?

Advance: NIH sponsored a 14-month nationwide cooperative study, in collaboration with the Department of Education. The Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder—"MTA" for short—brought together eighteen nationally recognized authorities in ADHD at six different university medical centers and hospitals.

Researchers divided a group of 579 ADHD children, offering them one of four different treatment plans: (1) medication alone, (2) intensive behavioral therapy, (3) medication plus behavioral therapy, or (4) treatment by community providers. Children who did best overall were those who received option #3—medication plus behavioral therapy. Reviewed from both a statistical perspective as well as how the children did in school and family life, medication plus behavioral therapy scored very well.

Implications: This is the first study to look at long-term treatment of ADHD children, filling a crucial gap in our knowledge. The MTA Study tells us that children fare better with treatment plans that include medication and intensive counseling. This study also found that medication alone is a superior option if behavioral therapy is unavailable.

The study does not claim that community-based treatment is ineffective, but rather that a carefully-designed ADHD treatment plan including medication and behavioral therapy works best. Having clear evidence of this as a result of the MTA Study, we are now able to move forward with national-level ADHD planning and treatment strategies.

Beyond that, the MTA study makes a significant step forward in our overall understanding of ADHD. The MTA conclusions offer guidance in planning the continuing education of medical professionals, and help health care administrators at all levels to design and deliver better programs for ADHD children and their families. [Area of Emphasis: New Preventive Strategies Against Disease; GPRA Performance Goal: Develop new or improved approaches for treating disease and disability.