Assessment and intervention for attention-deficit/hyperactivity disorder in the schools. Lessons from the MTA study

Area of Science:

• Pediatric Psychology
• Child Psychiatry
• Behavioral Pediatrics

Background:

• The Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA) aimed to evaluate treatment efficacy.
• Understanding discrepancies in parent and teacher reports is crucial for effective ADHD management.
• The MTA study highlighted potential disconnects between educational and medical services.

Observation:

• Parent and teacher reports, even on standardized instruments, often show significant discrepancies for children with ADHD.
• These discrepancies may contribute to a lack of cohesive understanding and treatment planning.
• Teacher reports are vital for assessing ADHD medication efficacy, while parent reports are key for side effect documentation.

Findings:

• The MTA experience suggests that discrepancies in parent-teacher assessments are expected and require active management.
• Specific inquiry into "source by domain" discrepancies via teacher phone calls can bridge the gap between school and medical settings.
• Teacher reports are essential for documenting the efficacy of ADHD pharmacologic interventions during school hours.

Implications:

• Clinicians should proactively address parent-teacher report discrepancies to improve care for children with ADHD.
• Regular teacher communication is recommended to monitor medication effects (peak and dissipation) during the school day.
• Enhanced communication between diagnosticians and school personnel can optimize treatment implementation and monitoring for pediatric ADHD.