Clinician's Digest


Clinician's Digest

By Garry Cooper

November/December 2007


In the late 1990s, the large-scale Multimodal Treatment Study of Children with AD/HD (MTA) examined over a 14-month period the effectiveness of four different treatments for the disorder—a combination of medications and behavior therapy, medications alone, behavior therapy alone, and community care (essentially leaving parents on their own to use whatever treatment was available to them). The 1999 report on the study found strong differences between the effectiveness of the treatments, with the combination of medications and behavior therapy being most effective and community care being by far the least effective.

When the 14 months of treatment ended, all families were free to continue the same treatments, switch, taper off, or discontinue them without subsequent monitoring. Two years later, the gap between the effectiveness of the combination treatment and that of the others had narrowed by about 50 percent.

Now, say the researchers, who've just published the results of a three-year follow-up study of the subjects, the differences have been "completely lost"—all four groups have improved significantly and now fare equally well (albeit still not as well as non-AD/HD children). That hopeful news, says lead researcher and Columbia University psychiatrist Peter Jensen, suggests that AD/HD is highly treatable, and that the intensive combination treatment should be sustained beyond 14 months. The gap closed, he says, because many of the children in the intensively…

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