TABLE 1.

Review of Interventions for ADHD

Author, YearStudy TypeNo. of Subjects RandomizedDiagnosis ModelInterventionsDurationQuality Assessment Score (of 5)Outcomes of Interest MeasuredOutcome Results
Anderson et al,85 1981Crossover12 boys (IQ low-average)ClinicalMPH, self-control, placebo2 wk2Sustained attention, Conners, CCTMPH > placebo; MPH > no medication; MPH > self-control; self-control = NS
Klassen et al,73 1998Meta-analysis999 (26 trials)DSM-III: ADD, ADD-H, ADHDMPH, BTVariableMetaCTRS*, CPRS*, CAP, HSQ, IowaMPH > BT; BT = NS; MPH = combined
Pfiffner and McBurnett,74 1997Parallel27DSM-III-RSS with and without parent generalization8 wk2SSRS, UCI-SSS, CLAM, SNAP-R, TRFBoth groups > null
Horn et al,75 1991Parallel117 (96 evaluated, 78 completed; referrals)DSM-III-RMPH high dose, MPH low dose, placebo (each group with and without [PT + SC])12 wk4CBCL, SNAP, Conners, CTRS, SOAPSMPH high or low dose > placebo; MPH alone = MPH + PT + SC, except teacher ratings (for which MPH low dose + PT + SC = MPH high dose); parent ratings improved in all study groups including placebo alone
Carlson et al,47 1992Crossover24 boys (summer medication program)DSM-III-RMPH high dose, MPH low dose, BM versus none, placebo8 wk3Class observation, self-rating, academicsMPH high dose > MPH low dose > placebo. For on-task and disruptive behavior: MPH high dose > BM + placebo; MPH low dose > BM + placebo. For classroom points: BM > none
Abikoff and Gittelman,51 1985Parallel50 (44 MPH, 3 DEX, and 3 PEM)Conners: CTRS ≥ 1.8/3.0Med, Med + CT, Med + control16 wk + 4-wk placebo follow-up4CTRS Hillside, Hahneman, parent reports, achievement, cognitiveCT = NS; Med > Med + control; achievement = NS. For classroom behavior: CT > control. Placebo follow-up: CT = NS
Hall and Kataria,76 1992Parallel + Crossover21 (referrals)Gordon: Children's Intervention Rating ProfileCT, BM, control (all groups with and without MPH)6–8 wk2Gordon, BDSFor impulsivity: MPH + CT > MPH alone; MPH + CT > CT alone. For vigilance: CT = NS; BM = NS
Brown,45 1986 AHRQ Dl-row 3Parallel40 (33 complete; referral)DSM-IIIMPH + CT, MPH + AC, placebo + CT, placebo + AC3 mo4Cognitive, achievement (parent and teacher rating)MPH > placebo; CT = NS
Pelham et al,53 1993Parallel32 (30 evaluated)DSM-III, CTRS*, CPRS*MPH + SS/BT, MPH + BT, placebo + SS/BT, placebo + BT, SS alone9 mo11CTRS*, CPRS*, achievement (classroom observation)MPH + BT > placebo + BT; BT > control; BT + MPH = BT; BT + SS = BT
Kolko et al,77 1999Crossover16 boys (all with comorbidity + partially hospitalized)DSM-III-RBM + MPH (alternating) (all with STEP intensive medication)9 wk3CTRS, peer conflict, positive mood/behaviorMPH > placebo; BM > placebo; MPH + BM = MPH = BM
Klein and Abikoff,78 1997 AHRQ C1-row 5†Parallel89OtherMPH MPH + CT placebo + CT8 wk1CTRS, CPRS, Hillside, NIMH, classroom observationMPH + CT, MPH > placebo + CT; MPH vs MPH + CT = NS; core/global = NS except MPH + CT > CT; depression = NS
Ialongo et al,79 1993 (see row 4, “Horn et al,75 1991”Parallel71 (from original 78 studied by Horn et al75; referrals)DSM-III-RMPH high dose, MPH low dose, placebo (each group with and without [PT + child training])9-mo follow-up4CBCL, SNAP, Conners, CTRS, SOAPSCombined treatment did not offer long-term improvement; parent ratings improved
Greene, 1997Study not relevant
HoagwoodStudy not relevant
Horn, 1983Study not relevant
  • AC indicates attention control; ADD, attention-deficit disorder; ADD-H, attention-deficit disorder with hyperactivity; BM, behavioral modification; BT, behavioral therapy or training; CBCL Child Behavior Checklist; CCT, Children's Checking Test; CPRS, Conners' Parent Rating Scale; CPT, Continuous Performance Test; CT, cognitive testing; CTRS, Conners' Teacher Rating Scale; DSM-III, Diagnostic and Statistical Manual of Mental Disorders, Third Edition; DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised; Med, stimulant medication (DEX, PMH, or PEM); NIMH, National Institute of Mental Health Children's Psychiatric Rating Scale; NS, not significant; PT, parent training; SOAPS, Structured Observation of Academic and Play Settings; SC, self-control training.

  • * Abbreviated version of test