MTA at 8 Years - Prospective Follow-up of Children Treated for Combined-Type ADHD in a Multisite Study

Sep 30, 2026

Objectives:Determine long-term effects at 6 and 8 years after randomized 14-month childhood treatments in the NIMH Collaborative Multisite Multimodal Treatment Study of children with ADHD (MTA; N=436);test whether ADHD symptom trajectories through 3 years predict later outcomes;and compare adolescent functioning with a local normative group (N=261). Mixed-effects regression with planned contrasts assessed symptoms and impairments. Results:Randomized treatment groups generally did not differ at follow-up, while early symptom trajectory predicted 55% of outcomes and MTA participants fared worse on 91% of variables. Conclusions:Treatment type or intensity did not predict 6–8 year functioning; early trajectory was prognostic, with combined-type ADHD showing significant adolescent impairment.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages17

Reading Time43 min

AccessFree to download

Abstract

Objectives

Method

Results

Conclusions

# MTA at 8 Years:Prospective Follow-up ofChildren Treated for Combined-Type ADHDin a Multisite Study BROOKE S.G.MOLINA,PH.D.,STEPHEN P.HINSHAW,PH.D.,JAMES M.SWANSON,PH.D., L.EUGENE ARNOLD,M.D.,M.ED.,BENEDETTO VITIELLO,M.D.,PETER S.JENSEN,M.D.,JEFFERY N.EPSTEIN,PH.D.,BETSY HOZA,PH.D.,LILY HECHTMAN,M.D.,HOWARD B.ABIKOFF,PH.D.,GLEN R.ELLIOTT,PH.D.,M.D.,LAURENCE L.GREENHILL,M.D.,JEFFREY H.NEWCORN,M.D.,KAREN C.WELLS,PH.D.,TIMOTHY WIGAL,PH.D.,ROBERT D.GIBBONS,PH.D.,KWAN HUR,PH.D.,PATRICIA R.HOUCK,M.S.,AND THE MTA COOPERATIVE GROUP ## ABSTRACT Objectives:To determine any long-term effects,6 and 8 years atter childhood enrollment,of the randomly assigned14-month treatments in the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder(MTA;N=436);to test whether attention-deficit/hyperactivity disorder (ADHD)symptom tra-jectory through 3 years predicts outcome in subsequent years;and to examine functioning level of the MTA ado-lescents relative to their non-ADHD peers(local normative comparison group;N=261).Method:Mixed-effectsregression models with planned contrasts at 6 and 8 years tested a wide range of symptom and impairment variablesassessed by parent,teacher,and youth report.Results:In nearly every analysis,the originally randomized treatmentgroups did not differ significantly on repeated measures or newly analyzed variables (e.g.,grades earned in school,arrests,psychiatric hospitalizations,other clinically relevant outcomes).Medication use decreased by 62%after the14-month controiled tnial,but adjusting for this did not change the results.ADHD symptom trajectory in the first 3 yearspredicted 55%of the outcomes.The MTA participants fared worse than the local normative comparison group on91%of the variables tested.Conclusions:Type or intensity of 14 months of treatment for ADHD in childhood (at age 7.0-9.9 years)does not predict functioning 6 to 8 years later.Rather,early ADHD symptom trajectory regardless oftreatment type is prognostic.This finding implies that children with behavioral and sociodemographic advantage,with thebest response to any treatment,will have the best long-term prognosis.As a group,however,despite initial symptomimprovement during treatment that is largely maintained after treatment,children with combined-type ADHD exhibitsignificant impairment in adolescence.Innovative treatment approaches targeting specific areas of adolescent impairmentare needed.J.Am.Acad.Child Adolesc.Psychiatry,2009;48(5):484-500.Key Words:ADHD,adolescence,clinical rial,longitudinal.Clinical trial registration information—Multimodal Treatment Study of Children With Attention Deficit andHyperactivity Disorder.URL:http://www.clinicaltrials.gov.Unique identifier:NCTO0000388. University):UO1 MH50467,NO1 MH12007,and HHSN271200800007-C;Long Island-Jewish Medical Center UO1 MH50453;New York University:NO1MH₁2004 and HHSN271200800004-C;University of Pittsburgh:UO1 MH50467,NO₁MH12010,and HHSN271200800008-C;andMcGill University NO₁MH12008 and HHSN271200800003-C.TheOice of Special Education Programs of zhe US.Department of Educa-tion,the Office of Juvenile Justice and Delinquency Prevention of the JusticeDepartment,and the National Institute on Drug Abuse also participatedin funding. The opinions and assertions contained in this report are the private views of theauthors and are not to be construed as official or as refecting the vieus of theDepartment of Health and Human Services,the National Institutes of Health,orthe National Institute of Mental Health. This article is the subject of an editorial by DrPhilip LHazell in this issue. The NIMH Collaborative Multisite Multimodal Treat-ment Study of Children With Attention-Deficit/Hyperactivity Disorder(ADHD),abbreviated asMTA,compared four distinct treatment strategiesduring childhood for 579 children diagnosed withDSM-IV ADHD,combined type.Children wererandomly assigned to 14 months of systematic medica-tion management(MedMg

FAQs

What was the main purpose of the 6- and 8-year follow-up study?

To assess long-term effects after the randomized 14-month childhood treatments, test whether early ADHD symptom trajectories predict later outcomes, and compare adolescent functioning with non-ADHD peers.

Did the originally randomized treatment groups differ at 6 or 8 years?

In nearly every analysis, the randomized treatment groups did not differ significantly on repeated measures or newly analyzed outcomes.

What did the study identify as most prognostic for later outcomes?

The ADHD symptom trajectory during the first 3 years predicted 55% of outcomes, and early trajectory was described as prognostic regardless of treatment type.

Sep 30, 2026

Uploaded by Quinn Holloway