Does brief, clinically based, intensive multimodal behavior therapy enhance the effects of methylphenidate in children with ADHD?

Abstract

Objective: The additional value of a short-term, clinically based, intensive multimodal behavior therapy to optimally titrated methylphenidate in children with attention-deficit hyperactivity disorder (ADHD) was investigated.

Method: Fifty children with ADHD (ages 8-12) were randomized to treatment of methylphenidate or treatment with methylphenidate combined with 10 weeks of multimodal behavior therapy. The multimodal behavior therapy consisted of a child and parent behavioral therapy and a teacher behavioral training. Assessments included parent, teacher and child ratings of ADHD symptoms, oppositional and conduct behavior, social skills, parenting stress, anxiety and self-worth.

Results: Both treatment conditions yielded significant improvements on all outcome domains. No significant differences were found between both treatments.

Conclusions: No evidence was found for the additive effect of multimodal behavior therapy next to optimally titrated methylphenidate.

Clinical implications: This study does not support the expectation that optimally dosed stimulant treated children with ADHD should routinely receive psychosocial treatment to further reduce ADHD- and related symptoms.