The Surgeon General's report cites NIMH's study that, in short, says the multimodal approach to treatment works best. Nearly 600 children ages 7-10 were followed for the study. The children studied were in one of four groups-those who only received medication, those who only received behavioral treatment, those who received both medication and behavioral treatment, and those who received whatever treatment was available in their own community. All of the children in the study improved, but there were some significant differences in each of the four groups.
In terms of ADHD symptoms only, hyperactivity, impulsivity, and inattention, medication was the best treatment. When you add other symptoms that are not ADHD symptoms, the combined treatment works better. Many children and adults with ADHD experience anxiety, poor social skills and poor academic performance. These symptoms are not ADHD symptoms, but sometimes stem from having ADHD. The children with the combined treatment showed significant improvement in all of these areas. It is important to note that the children receiving both medication and behavioral treatment were treated with a lower dose of medication.
Most of the community care group also received medication, but they received less follow up. Those in the test medication group were carefully monitored to assure the correct dosage for the child. Each month the physicians sought input from the children's teachers. If there were any problems, the physician could then readjust the child's medication dosage. In the community group, the children generally saw the physician only twice each year, had no interaction with the child's teachers, and prescribed a lower dosage of medication. Careful and constant monitoring seem to be the most effective way to treat children (and adults) with ADHD.
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