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Commentary on the Multimodal Treatment Study of Children with ADHD

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Abstract

The multimodal treatment study of attention deficit hyperactivity disorder (MTA Study) constitutes a landmark in the history of treatment research in child psychopathology, being the largest single study of its kind ever undertaken. Important findings have emerged from this project, as the papers in the present volume will attest. This commentary focuses on several concerns about the assumptions that appear to have guided the design of the MTA study, particularly its psychosocial treatment component, as well as the manner in which treatment results have been presented to date. In particular, no explicit theory of ADHD appears to have guided the construction of the treatment components, relying instead on implicit theories associated with those treatments, such as the notion that the symptoms of ADHD arise through faulty learning and defective contingencies of reinforcement. Future articles from this study will need to address these and other concerns if the results of the study are to be properly interpreted and the scientific and clinical yield is to be maximized.

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REFERENCES

  • Abikoff, H. (1987). An evaluation of cognitive therapy for hyperactive children: A critical review. In B. Lahey & A. Kazdin (Eds.), Advances in clinical child psychology (Vol. 10, pp. 170-216). New York: Plenum.

    Google Scholar 

  • Abikoff, H., & Hechtman, A. (1994). Methylphenidate and multimodal treatment for ADHD. In B. Geller (Chair), Advanced topics in psychopharmacology. Paper presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry, NewYork.

  • Barkley, R. A., Guevremont, D. G., Anastopoulos, A. D., & Fletcher, K. F. (1992). A comparison of three family therapy programs for treating family conflicts in adolescents with attention deficit hyperactivity disorder. Journal of Consulting and Clinical Psychology, 60, 450-462.

    Google Scholar 

  • Boyle, M. H., Jadad, A. R., & Racine, Y. (1999). Applying lessons from large trials to the MTA study. Canadian Journal of Psychiatry, 44.

  • Diaz, R. M., & Berk, L. E. (1995). A Vygotskian critique of self-instructional training. Development and Psychopathology, 7, 369-392.

    Google Scholar 

  • Hinshaw, S. P. (1994). Attention deficits and hyperactivity in children. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Hinshaw, S. P. (2000). Attention-deficit/hyperactivity disorder: The search for viable treatments. In P. C. Kendall (Ed.), Child and adolescent therapy: Cognitive-behavioral approaches (pp. 88-128). New York: Guilford.

    Google Scholar 

  • Hinshaw, S. P., & Anderson, C. A. (1996). Conduct and oppositional defiant disorders. In E. J. Mash & R. A. Barkley (Eds.), Child psychopathology (pp. 113-152). New York: Guilford.

    Google Scholar 

  • Jacobson, N. S., Roberts, L. J., Berns, S. B., & McGlinchey, J. B. (1999). Methods for defining and determining the clinical significance of treatment effects: Description, application, and alternatives. Journal of Consulting and Clinical Psychology, 67, 300-307.

    Google Scholar 

  • Kendall, P. C., & Braswell, L. (1984). Cognitive therapy for impulsive children. New York: Guilford.

    Google Scholar 

  • Levy, F., Hay, D., McStephen, M., Wood, C., & Waldman, I. (1997). Attention-deficit hyperactivity disorder: A category or a continuum? Genetic analysis of a large-scale twin study. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 737-744.

    Google Scholar 

  • Miller, A. (1999). Appropriateness of psychostimulant prescription to children: Theoretical and empirical perspectives. Canadian Journal of Psychiatry, 44, 1017-1024.

    Google Scholar 

  • Patterson, G. R., Degarmo, D. S., & Knutson, N. (2000). Hyperactive and antisocial behaviors: Comorbid or two points in the same process? Development and Psychopathology, 12, 91-106.

    Google Scholar 

  • Patterson, G. R., Reid, J. B., & Dishion, T. J. (1992). Antisocial boys. Eugene, OR: Castalia.

    Google Scholar 

  • Pelham, W. E. J. (1999a). The NIMH multimodal treatment study for attention-deficit hyperactivity disorder: Just say yes to drugs alone? Canadian Journal of Psychiatry, 44, 981-990.

    Google Scholar 

  • Pelham, W. E. J. (1999b). President's Message: The NIMH Multimodeal treatment study for ADHD: Just say yes to drugs? Cilnical Child Psychology Newsletter, 14(2), 1-10.

    Google Scholar 

  • Shelton, T. L., Barkley, R. A., Crosswait, C., Moorehouse, M., Fletcher, K., Barrett, S., Jenkins, L., & Metevia, L. (2000). Early intervention with preschool children with aggressive and hyperactive-impulsive behavior: Two-year post-treatment follow-up. Journal of Abnormal Child Psychology, 28, 253-266.

    Google Scholar 

  • Sleator, E. S., & Pelham, W. E. J. (1986). Attention deficit disorder. Norwalk, CT: Appleton-Century-Crofts.

    Google Scholar 

  • Speer, D. C., & Greenbaum, P. E. (1995). Five methods for computing significant individual client change and improvement rates: Support for an individual growth curve approach. Journal of Consulting and Clinical Psychology, 63, 1044-1048.

    Google Scholar 

  • Taylor, E. (1999). Development of clinical services for attention-deficit/ hyperactivity disorder. Archives of General Psychiatry, 56, 1097-1099.

    Google Scholar 

  • Thapar, A., Holmes, J., Poulton, K., & Harrington, R. (1999). Genetic basis of attention deficit and hyperactivity. British Journal of Psychiatry, 174, 105-111.

    Google Scholar 

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Barkley, R.A. Commentary on the Multimodal Treatment Study of Children with ADHD. J Abnorm Child Psychol 28, 595–599 (2000). https://doi.org/10.1023/A:1005139300209

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  • DOI: https://doi.org/10.1023/A:1005139300209

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