Comparing treatments for children with ADHD and word reading difficulties: A randomized clinical trial.
OBJECTIVE
This trial compared attention-deficit/hyperactivity disorder (ADHD) treatment alone, intensive reading intervention alone, and their combination for children with ADHD and word reading difficulties and disabilities (RD).


METHODS
Children (n = 216; predominantly African American males) in Grades 2-5 with ADHD and word reading/decoding deficits were randomized to ADHD treatment (medication + parent training), reading treatment (reading instruction), or combined ADHD + reading treatment. Outcomes were parent and teacher ADHD ratings and measures of word reading/decoding. Analyses utilized a mixed models covariate-adjusted gain score approach with posttest regressed onto pretest.


RESULTS
Inattention and hyperactivity/impulsivity outcomes were significantly better in the ADHD (parent Hedges's g = .87/.75; teacher g = .67/.50) and combined (parent g = 1.06/.95; teacher g = .36/41) treatment groups than reading treatment alone; the ADHD and Combined groups did not differ significantly (parent g = .19/.20; teacher g = .31/.09). Word reading and decoding outcomes were significantly better in the reading (word reading g = .23; decoding g = .39) and combined (word reading g = .32; decoding g = .39) treatment groups than ADHD treatment alone; reading and combined groups did not differ (word reading g = .09; decoding g = .00). Significant group differences were maintained at the 3- to 5-month follow-up on all outcomes except word reading.


CONCLUSIONS
Children with ADHD and RD benefit from specific treatment of each disorder. ADHD treatment is associated with more improvement in ADHD symptoms than RD treatment, and reading instruction is associated with better word reading and decoding outcomes than ADHD treatment. The additive value of combining treatments was not significant within disorder, but the combination allows treating both disorders simultaneously. (PsycINFO Database Record
Department of Pediatrics, Cincinnati Children's Hospital Medical Center.
Leanne
L
Tamm
Department of Pediatrics, University of Texas Health Science Center at Houston.
Carolyn A
CA
Denton
Department of Pediatrics, Cincinnati Children's Hospital Medical Center.
Jeffery N
JN
Epstein
Department of Psychology, Florida State University.
Christopher
C
Schatschneider
Department of Pediatrics, University of Texas Health Science Center at Houston.
Heather
H
Taylor
Department of Psychiatry, Ohio State University.
L Eugene
LE
Arnold
Boston Children's Hospital, Harvard Medical School.
Oscar
O
Bukstein
Department of Pediatrics, Cincinnati Children's Hospital Medical Center.
Julia
J
Anixt
Department of Pediatrics, Cincinnati Children's Hospital Medical Center.
Anson
A
Koshy
Department of Pediatrics, Cincinnati Children's Hospital Medical Center.
Nicholas C
NC
Newman
Department of Education, Mount St. Joseph University.
Jan
J
Maltinsky
Department of Pediatrics, University of Texas Health Science Center at Houston.
Patricia
P
Brinson
Department of Pediatrics, Cincinnati Children's Hospital Medical Center.
Richard E A
REA
Loren
Department of Pediatrics, University of Texas Health Science Center at Houston.
Mary R
MR
Prasad
Department of Pediatrics, Cincinnati Children's Hospital Medical Center.
Linda
L
Ewing-Cobbs
Department of Pediatrics, Cincinnati Children's Hospital Medical Center.
Aaron
A
Vaughn
D001741:Black or African American; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D004410:Dyslexia / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D007858:Learning; D008297:Male; D010290:Parents; D010349:Patient Compliance; D011932:Reading; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants