The number of children being treated with psychostimulant medication for ADHD has been increasing dramatically for a decade. Although also an evidence-based treatment, behavior modification is not as widely recommended. Primary questions are whether medication is needed by all of the children who take it, whether this need could be reduced if behavioral treatments were employed first, and whether the required dosage varies as a function of the presence of and intensity of behavioral treatments. In an ongoing funded NIMH study, we are examining the relative effects of and interactions between different doses of behavioral (none, low, and high) and pharmacological (pl, .15, .3, and .6 mg/kg MPH t.i.d.) treatments for ADHD children by evaluating their separate and combined effects in a controlled summer program (STP). Our preliminary results (1/3 of the Ss) suggest that average total daily dose of MPH can be reduced from 60 mg to 10-20 mg, depending on the concurrent behavioral treatment. Follow-up in the subsequent school year has shown that the need for medication in both the school and home settings is eliminated for many children if behavioral intervention is provided first. Given recent societal concerns about medication use especially in young children and growing concerns about long-term side effects and the absence of beneficial long-term effects, these findings may have great public health importance. The current application seeks to extend the results from our efficacy study to a regular school setting. We have chosen to concentrate on early school years, in a sample of children who are not yet medicated for ADHD, examining whether ongoing behavioral treatment can reduce the need for medication in those children. Children will begin the study assigned to no, low, or high behavior modification conditions in their regular home and school settings. Children's functioning will be assessed weekly, and medication will be added to their treatment regimen when functioning deteriorates to a predefined level. Because treatment for ADHD must be chronic, treatment will continue at the assigned level for a period of 3 years, with a 1-year follow up at the conclusion of treatment. Beyond current functioning, primary dependent measures will be the length of time survived without medication, medication dose as a function of behavioral treatment level, and costs of treatments. Individual differences including child, family, and teacher characteristics will be examined.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH069614-05
Application #
7646477
Study Section
Special Emphasis Panel (ZMH1-ERB-P (02))
Program Officer
Sherrill, Joel
Project Start
2005-09-13
Project End
2010-03-30
Budget Start
2009-07-01
Budget End
2010-03-30
Support Year
5
Fiscal Year
2009
Total Cost
$206,227
Indirect Cost
Name
State University of New York at Buffalo
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
038633251
City
Buffalo
State
NY
Country
United States
Zip Code
14260
King, Kevin M; Pedersen, Sarah L; Louie, Kristine T et al. (2017) Between- and within-person associations between negative life events and alcohol outcomes in adolescents with ADHD. Psychol Addict Behav 31:699-711
Pedersen, Sarah L; Walther, Christine A P; Harty, Seth C et al. (2016) The indirect effects of childhood attention deficit hyperactivity disorder on alcohol problems in adulthood through unique facets of impulsivity. Addiction 111:1582-9
Meinzer, Michael C; Pettit, Jeremy W; Waxmonsky, James G et al. (2016) Does Childhood Attention-Deficit/Hyperactivity Disorder (ADHD) Predict Levels of Depressive Symptoms during Emerging Adulthood? J Abnorm Child Psychol 44:787-97
Altszuler, Amy R; Page, Timothy F; Gnagy, Elizabeth M et al. (2016) Financial Dependence of Young Adults with Childhood ADHD. J Abnorm Child Psychol 44:1217-29
Rhodes, Jessica D; Pelham, William E; Gnagy, Elizabeth M et al. (2016) Cigarette smoking and ADHD: An examination of prognostically relevant smoking behaviors among adolescents and young adults. Psychol Addict Behav 30:588-600
Page, Timothy F; Pelham 3rd, William E; Fabiano, Gregory A et al. (2016) Comparative Cost Analysis of Sequential, Adaptive, Behavioral, Pharmacological, and Combined Treatments for Childhood ADHD. J Clin Child Adolesc Psychol 45:416-27
Pelham Jr, William E; Fabiano, Gregory A; Waxmonsky, James G et al. (2016) Treatment Sequencing for Childhood ADHD: A Multiple-Randomization Study of Adaptive Medication and Behavioral Interventions. J Clin Child Adolesc Psychol 45:396-415
Lu, Xi; Nahum-Shani, Inbal; Kasari, Connie et al. (2016) Comparing dynamic treatment regimes using repeated-measures outcomes: modeling considerations in SMART studies. Stat Med 35:1595-615
Rosch, Keri S; Fosco, Whitney D; Pelham Jr, William E et al. (2016) Reinforcement and Stimulant Medication Ameliorate Deficient Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder. J Abnorm Child Psychol 44:309-21
Babinski, Dara E; Pelham Jr, William E; Molina, Brooke S G et al. (2016) Maternal ADHD, Parenting, and Psychopathology Among Mothers of Adolescents With ADHD. J Atten Disord 20:458-68

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