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

Abstract

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. 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. Both treatment conditions yielded significant improvements on all outcome domains. No significant differences were found between both treatments. No evidence was found for the additive effect of multimodal behavior therapy next to optimally titrated methylphenidate. 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.