CHADD’s CEO Comments on Findings in the Follow-up to the
Multimodal Treatment Study on AD/HD
July 20, 2007
The August edition of the Journal of the American Academy of
Child and Adolescent Psychiatry (JAACAP) is releasing
information on the follow-up to the Multimodal Treatment Study on
Attention-Deficit/Hyperactivity Disorder (MTA). The original study was
published in 1999. An updated analysis was published in 2004.
The findings of the follow-up study will certainly add to our
understanding of how to effectively treat AD/HD to ensure that our
children realize successful outcomes in school and in other
settings.
The following are regarded as areas of consideration by the
leadership of the CHADD Professional Advisory Board:
1) Comprehensive treatment is most
likely to make a long-term difference only if continued with optimal
intensity, and not started or added too late in a child’s clinical
course. There is evidence that early intensive treatment, either
medication or a combination of medication and behavioral treatment,
improves a child’s prognosis. Unfortunately, the follow-up support
usually available in our health care system, for children who continue
to need treatment, appears to be insufficient to achieve optimal
outcomes for children on medication and behavioral intervention;
2) For some children in the study, the
benefits of medication wore off when the intensity of treatment was not
continued;
3) A group of children who consistently
took medicine over the whole three years grew almost an inch less than a
group of children who never took the medicine the whole three years.
4) While children with AD/HD showed
significantly higher than normal rates of delinquency and substance use
than classmates without AD/HD, even when treated, those who received
intensive behavioral treatment experienced a somewhat lower rate of
overall substance use. In contrast to concerns raised by some parents,
clinicians and investigators, there was no evidence to suggest that
early treatment with stimulant medication increases the risk for later
substance use.
It is important for parents of children with AD/HD to work closely
with their health care providers when deciding on appropriate treatment.
Clearly, the MTA follow-up study points to the importance of intense and
consistent treatment for AD/HD as well as improved community and medical
support. CHADD will continue its work to ensure that all families and
professionals are familiar with and practice the latest in
evidence-based medicine. As always, CHADD looks to the National
Institute of Mental Health for the latest evidence-based
information.
E. Clarke Ross
CEO
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More information forthcoming over the next few weeks, including:
• An Ask the Expert Chat for
members.
• Answers from Peter Jensen, MD,
about the MTA follow-up will be available on VideoCHADD. Jensen
will also be presenting at CHADD’s annual conference this year in
the Washington, DC, area.
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