Nine Months of Multicomponent Behavioral Treatment for ADHD and Effectiveness of MTA Fading Procedures

L. Eugene Arnold, Shirley Chuang, Mark Davies, Howard B. Abikoff, C. Keith Conners, Glen R. Elliott, Laurence L. Greenhill, Lily Hechtman, Stephen P. Hinshaw, Betsy Hoza, Peter S. Jensen, Helena C. Kraemer, Kristen S. Langworthy-Lam, John S. March, Jeffrey H. Newcorn, William E. Pelham, Joanne B. Severe, James M. Swanson, Benedetto Vitiello, Karen C. WellsTimothy Wigal

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


We examined 9-month data from the 14-month NIMH Multimodal Treatment Study of Children with ADHD (the MTA) as a further check on the relative effect of medication (MedMgt) and behavioral treatment (Beh) for attention-deficit/hyperactivity disorder (ADHD) while Beh was still being delivered at greater intensity than at 14-month endpoint, and conversely as a check on the efficacy of the MTA behavioral generalization/maintenance procedures. Intention-to-treat analysis at 9 months showed essentially the same results as at 14 months, after Beh had been completely faded; MedMgt and the combination (Comb) of medication and Beh were significantly superior to Beh and community care (CC) for ADHD and oppositional-defiant (ODD) symptoms, with mixed results for social skills and internalizing symptoms. All treatment-group differences examined as changes in slopes from 9 to 14 months were nonsignificant (we found general improvement for all groups). Slopes from baseline to 9 months correlated highly (r > .74, p < .0001) with slopes from baseline to 14 months for all groups. The time function from baseline to 14 months showed a significant linear, but not quadratic, trend for the main outcome measure (a composite of parent- and teacher-rated ADHD and ODD symptoms) for all groups. Findings suggest that in contrast to the hypothesized deterioration in the relative benefit of Beh between 9 and 14 months (after completion of fading), the MTA Beh generalization and maintenance procedures implemented through 9 months apparently yielded continuing improvement through 14 months, with preservation of the relative position of Beh compared to other treatment strategies.

Original languageEnglish (US)
Pages (from-to)39-51
Number of pages13
JournalJournal of Abnormal Child Psychology
Issue number1
StatePublished - Feb 2004


  • ADHD
  • Fading
  • Generalization
  • Maintenance
  • Treatment

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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