Comprehensive Treatment and Monthly 2 Year Follow-Up in Children With ADHD: Randomized Controlled Prospective Study

ObjectivesTo evaluate the efficacy of regular monthly follow up in maintaining treatment gains versus follow up as needed in the community for children ages 6 to 12 years with ADHD.MethodsOne hundred and eighty six children, age 6 to 13 with DSM-IV diagnosed Attention Deficit Hyperactivity Disorder (ADHD) (combined presentation) received 3 months of comprehensive treatment which included long-acting stimulant medication titrated to optimal dose (via parent and teacher reports) and weekly parent training groups and child social skills and academic training. After the 3 months of treatment, children were randomized to either monthly follow up by the research team (treatment group) or follow up as usual in the community (control group). Comprehensive evaluations occurred at 3 months at the end of the comprehensive treatment, and at 6, 12, 18, and 24 month follow-up.ResultsChildren in both groups improved significantly in all domains after the 3 months of intensive comprehensive treatment. Treatment gains were maintained during the 2 year follow up period in both groups. However, the Hyperactive/Impulsive rating in Conners scale by parent report and some teacher reports were worse in the community group during the follow-up period.ConclusionThe importance of the initial intensive comprehensive 3 month treatment cannot be underestimated as these treatments resulted in significant improvements which were maintained for 2 years in both groups. Factors such as social economic status and available community treatment which may have influenced these results are discussed.