Free fatty acid supplementation produced small but significant reductions in ADHD symptoms even with probably blinded assessment s , although the clinical significance of these effects remains to be determined .
Artificial food color exclusion produced larger effects but often in individuals selected for food sensitivities .
OBJECTIVE Nonpharmacological treatments are available for attention deficit hyperactivity disorder ( ADHD ) , although their efficacy remains uncertain .
The authors undertook meta-analyses of the efficacy of dietary ( restricted elimination diets , artificial food color exclusions , and free fatty acid supplementation ) and psychological ( cognitive training , neurofeedback , and behavioral interventions ) ADHD treatments .
A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD.
BACKGROUND Previous studies have demonstrated the short-term efficacy of pharmacotherapy and behavior therapy for attention-deficit/hyperactivity disorder ( ADHD ) , but no longer-term ( i.e. , > 4 months ) investigations have compared these 2 treatments or their combination . METHODS A group of 579 children with ADHD Combined Type , aged 7 to 9.9 years , were assigned to 14 months of medication management ( titration followed by monthly visits ) ; intensive behavioral treatment ( parent , school , and child components , with therapist involvement gradually reduced over time ) ; the two combined ; or st and ard community care ( treatments by community providers ) . Outcomes were assessed in multiple domains before and during treatment and at treatment end point ( with the combined treatment and medication management groups continuing medication at all assessment points ) . Data were analyzed through intent-to-treat r and om-effects regression procedures . RESULTS All 4 groups showed sizable reductions in symptoms over time , with significant differences among them in degrees of change . For most ADHD symptoms , children in the combined treatment and medication management groups showed significantly greater improvement than those given intensive behavioral treatment and community care . Combined and medication management treatments did not differ significantly on any direct comparisons , but in several instances ( oppositional/aggressive symptoms , internalizing symptoms , teacher-rated social skills , parent-child relations , and reading achievement )  combined treatment proved superior to intensive behavioral treatment and /or community care while medication management did not . Study medication strategies were superior to community care treatments , despite the fact that two thirds of community-treated subjects received medication during the study period . CONCLUSIONS For ADHD symptoms , our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication . Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms , but may have provided modest advantages for non-ADHD symptom and positive functioning outcomes
Free fatty acid supplementation produced small but significant reductions in ADHD symptoms even with probably blinded assessment s , although the clinical significance of these effects remains to be determined .
Artificial food color exclusion produced larger effects but often in individuals selected for food sensitivities .
OBJECTIVE Nonpharmacological treatments are available for attention deficit hyperactivity disorder ( ADHD ) , although their efficacy remains uncertain .
The authors undertook meta-analyses of the efficacy of dietary ( restricted elimination diets , artificial food color exclusions , and free fatty acid supplementation ) and psychological ( cognitive training , neurofeedback , and behavioral interventions ) ADHD treatments .