Academic achievement and emotional status of children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment.
OBJECTIVE
To test the hypothesis that intensive multimodal psychosocial intervention (that includes academic assistance and psychotherapy) combined with methylphenidate significantly enhances the academic performance and emotional status of children with attention-deficit/hyperactivity disorder (ADHD) compared with methylphenidate alone and with methylphenidate combined with nonspecific psychosocial treatment (attention control).


METHODS
One hundred three children with ADHD (ages 7-9), free of conduct and learning disorders, who responded to short-term methylphenidate were randomized for 2 years to receive one of three treatments: (1) methylphenidate alone, (2) methylphenidate plus psychosocial treatment that included academic remediation, organizational skills training, and psychotherapy as well as parent training and counseling and social skills training, or (3) methylphenidate plus attention control treatment. Children's function was assessed through academic testing, parent ratings of homework problems, and self-ratings of depression and self-esteem.


RESULTS
No advantage was found on any measure of academic performance or emotional status for the combination treatment over methylphenidate alone and over methylphenidate plus attention control. Significant improvement occurred across all treatments and was maintained over 2 years.


CONCLUSIONS
In stimulant-responsive young children with ADHD without learning and conduct disorders, there is no support for academic assistance and psychotherapy to enhance academic achievement or emotional adjustment. Significant short-term improvements were maintained over 2 years.
Hechtman
Lily
L
Department of Psychiatry, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada. MD43@musica.mcgill.ca
Abikoff
Howard
H
Klein
Rachel G
RG
Weiss
Gabrielle
G
Respitz
Chara
C
Kouri
Joan
J
Blum
Carol
C
Greenfield
Brian
B
Etcovitch
Joy
J
Fleiss
Karen
K
Pollack
Simcha
S
D000339:Affect; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000627:therapeutic use*; D011613:Psychotherapy / Q000379:methods*; D012649:Self Concept; D012720:Severity of Illness Index
D000697:Central Nervous System Stimulants; D008774:Methylphenidate