The results revealed that findings are becoming increasingly nuanced with variations in levels of evidence related to ages of the children and characteristics of the specific treatment .
In addition , we focused our critique on generalization of treatment effects across setting s and time and on sample diversity ( with regard to ethnicity and levels of parent education ) in relation to the population .
Children of parents with higher levels of education than average appear to be overrepresented in the literature .
The purpose of this research was to up date the series of articles on evidence -based treatment for children and adolescents with attention deficit/hyperactivity disorder that have appeared in this journal ( Evans , Owens & Bunford , 2014 ; Pelham & Fabiano , 2008 ; Pelham , Wheeler , & Chronis , 1998 ) .
Treatment Sequencing for Childhood ADHD: A Multiple-Randomization Study of Adaptive Medication and Behavioral Interventions
Behavioral and pharmacological treatments for children with attention deficit/hyperactivity disorder ( ADHD ) were evaluated to address whether endpoint outcomes are better depending on which treatment is initiated first and , in case of insufficient response to initial treatment , whether increasing dose of initial treatment or adding the other treatment modality is superior . Children with ADHD ( ages 5–12 , N = 146 , 76 % male ) were treated for 1 school year . Children were r and omized to initiate treatment with low doses of either ( a ) behavioral parent training ( 8 group sessions ) and brief teacher consultation to establish a Daily Report Card or ( b ) extended-release methylpheni date ( equivalent to .15 mg/kg/dose bid ) . After 8 weeks or at later monthly intervals as necessary , insufficient responders were rer and omized to secondary interventions that either increased the dose/intensity of the initial treatment or added the other treatment modality , with adaptive adjustments monthly as needed to these secondary treatments . The group beginning with behavioral treatment displayed significantly lower rates of observed classroom rule violations ( the primary outcome ) at study endpoint and tended to have fewer out-of-class disciplinary events . Further , adding medication secondary to initial behavior modification result ed in better outcomes on the primary outcomes and parent/teacher ratings of oppositional behavior than adding behavior modification to initial medication . Normalization rates on teacher and parent ratings were generally high . Parents who began treatment with behavioral parent training had substantially better attendance than those assigned to receive training following medication . Beginning treatment with behavioral intervention produced better outcomes overall than beginning treatment with medication
The results revealed that findings are becoming increasingly nuanced with variations in levels of evidence related to ages of the children and characteristics of the specific treatment .
In addition , we focused our critique on generalization of treatment effects across setting s and time and on sample diversity ( with regard to ethnicity and levels of parent education ) in relation to the population .
Children of parents with higher levels of education than average appear to be overrepresented in the literature .
The purpose of this research was to up date the series of articles on evidence -based treatment for children and adolescents with attention deficit/hyperactivity disorder that have appeared in this journal ( Evans , Owens & Bunford , 2014 ; Pelham & Fabiano , 2008 ; Pelham , Wheeler , & Chronis , 1998 ) .