Fact versus fancy concerning the Multimodal Treatment Study for Attention-Deficit Hyperactivity Disorder

Peter S. Jensen

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Findings from the Multimodal Treatment Study of Children With Attention- Deficit Hyperactivity Disorder (ADHD), the MTA, have been much discussed but frequently misinterpreted or mischaracterized. Misinterpretations regarding the specific nature of and rationale for the study design, the effectiveness of the behavioural treatment arm, the possible advantages of combined treatments over single-component (medication management or behavioural therapy) interventions, and the feasibility and applicability of MTA treatments for 'real-world' practitioners are addressed. Careful interpretation of the MTA findings suggests that for ADHD symptoms, carefully crafted medication-management approaches are superior to behavioural treatment and to routine community care that includes medication. For non- ADHD areas of functioning (for example, social skills, academic performance), combined treatments may offer modest advantages over single-component approaches. Longer-term outcomes past 14 months of intensive MTA treatments (as well as their relative effectiveness with respect to each other) remain unknown, pending further MTA analyses. The MTA treatments by and large consisted of evidence-based 'best practices.' Thus, rather than characterizing these treatments as infeasible, the substantially superior outcomes of these treatments (versus routine clinical care) across diverse settings should help set the standard for future treatment practices in real- world settings. Despite important study limitations, the MTA study, by virtue of its size, scope, and length; parallel-groups design; explicit use of manualized, evidence-based treatments; and comprehensive range of outcome assessments sets an important benchmark for future trials testing new treatments for childhood ADHD and defines a new standard for optimal outcomes that can be achieved with the best of clinical care.

Original languageEnglish (US)
Pages (from-to)975-980
Number of pages6
JournalCanadian Journal of Psychiatry
Volume44
Issue number10
StatePublished - 1999
Externally publishedYes

Fingerprint

Combined Modality Therapy
Pemetrexed
Attention Deficit Disorder with Hyperactivity
Therapeutics
Benchmarking
Evidence-Based Practice
Practice Guidelines
Outcome Assessment (Health Care)

Keywords

  • Attention-deficit hyperactivity disorder
  • Clinical trial
  • Effectiveness
  • Efficacy
  • Multimodal treatment
  • Outcome

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Fact versus fancy concerning the Multimodal Treatment Study for Attention-Deficit Hyperactivity Disorder. / Jensen, Peter S.

In: Canadian Journal of Psychiatry, Vol. 44, No. 10, 1999, p. 975-980.

Research output: Contribution to journalArticle

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