In this study, children from four private schools in Barcelona, Spain were recruited to evaluate the efficacy of combined versus pharmacological interventions for the management of core ADHD symptoms in both the school and family settings. The results indicated that both types of treatment were effective; however, higher rates of ADHD symptom normalisation were yielded after multimodal treatment.
A total of 20 children diagnosed with ADHD based on Diagnostic and Statistical Manual of Mental Disorders – 4th Edition – Text Revision (DSM-IV-TR) criteria, alongside their parents (n=40) and teachers (n=40), participated in this study. Ten children (mean age 7.6 years) were assigned to receive methylphenidate pharmacotherapy and the other ten (mean age 7.8 years) received methylphenidate combined with psychosocial therapy. In the combined treatment group, psychoeducational training was administered to parents and teachers. Parents and teachers responded to the ADHD Questionnaire, whereby they rated the frequency of 18 ADHD symptoms defined by the DSM-IV-TR before and after the intervention.
As perceived by both teachers and parents, significant intragroup improvements in the inattentive, hyperactivity and impulsivity symptoms were observed after treatment in both groups (p<0.01). According to the teachers’ assessments, the proportion of children that no longer presented with ADHD symptoms after treatment was 20% in the medication-only group and 30% in the combined treatment group. Based on parents’ ratings, the prevalence of ADHD symptom normalisation was 20% and 90% in the pharmacotherapy and combined groups, respectively.
The small sample size undermines the power of the analysis in this study. Also, the fact that parents and teachers are study participants and assessors of the outcomes compromises the objectivity of their judgement. However, the results still highlight the potential advantage of the combined approach over pharmacotherapy alone, but more follow-up studies are needed to evaluate the long-term effects of these interventions.
Amado L, Jarque S, Ceccato R. Differential impact of a multimodal versus pharmacological therapy on the core symptoms of attention deficit/hyperactivity disorder in childhood. Res Dev Disabil 2016; 59: 93-104.