Objectives-To determine any long-term effects, 6 and 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the Multimodal Treatment Study of Children with ADHD (MTA; N=436); to test whether Attention-Deficit/Hyperactivity Disorder (ADHD) symptom trajectory through 3-years predicts outcome in subsequent years; to examine functioning level of the MTA adolescents relative to their non-ADHD peers (Local Normative Comparison Group or LNCG; N=261).Method-Mixed effects regression models with planned contrasts at 6-and 8-years tested a wide range of symptom and impairment variables assessed by parent, teacher, and youth report.Results-In nearly every analysis, the originally randomized treatment groups did not differ significantly on repeated measures or newly-analyzed variables (e.g., grades earned in school, The other authors report no conflicts of interest. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-Type or intensity of 14 months of treatment for ADHD in childhood (at age 7.0-9.9 years old) does not predict functioning six-to-eight years later. Rather, early ADHD symptom trajectory regardless of treatment type is prognostic. This finding implies that children with behavioral and sociodemographic advantage, with the best response to any treatment, will have the best longterm prognosis. As a group, however, despite initial symptom improvement during treatment that is largely maintained post-treatment, children with Combined-Type ADHD exhibit significant impairment in adolescence. Innovative treatment approaches targeting specific areas of adolescent impairment are needed. NIH Public Access Keywords ADHD; adolescence; clinical trial; longitudinalThe Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (ADHD), abbreviated as MTA, compared four distinct treatment strategies during childhood for 579 children diagnosed with DSM-IV ADHD, Combined type. Children were randomly assigned to 14 months of (a) systematic medication management (MedMgt), which was initial placebo-controlled titration, thrice-daily dosing, seven days per week, and monthly 30-minute clinic visits, (b) multicomponent behavior therapy (Beh), which included 27-session group parent training supplemented with eight individual parent sessions, an 8-week summer treatment program, 12 weeks of classroom administered behavior therapy with a half-time aide and 10 teacher consultation sessions, (c) their combination (Comb), or (d) usual community care (CC).1 -2 This randomized, 6-site, controlled clinical trial, conducted in parallel at 6 performance sites, feat...

The effects of an interactive book reading program were assessed with children from low-income families who attended subsidized day-care centers in New York. The children entered the program with language development in standard English vocabulary and expression that was about 10 months behind chronological age on standardized tests. Children were pretested and assigned randomly within classrooms to 1 of 3 conditions: (a) a school plus home condition in which the children were read to by their teachers and their parents, (b) a school condition in which children were read to only by teachers, and (c) a control condition in which children engaged in play activities under the supervision of their teachers. Training of adult readers was based on a self-instructional video. The intervention lasted for 6 weeks, at which point children were posttested on several standardized measures oflanguage ability that had been used as pretests. These assessments were repeated at a 6month follow-up. Educationally and statistically significant effects of the reading intervention were obtained at posttest and follow-up on measures of expressive vocabulary.According to the 1991 Carnegie Foundation for the Advancement of Teaching report, Ready to Learn: A Mandate for the Nation, 35% of children in the United States enter kindergarten unprepared to learn, with most lacking the vocabulary and sentence structure crucial to school success. Although there are some problems with the methods of this report and inherent difficulties in dichotomizing school readiness, there is no doubt that there are very large individual differences in early educational achievement that have long-term consequences for children and society (Alexander & Entwisle, 1988;Stevenson & Newman, 1986).Why are so many children, particularly those from low-income families, deficient in the skills that are critical to school readiness? Children's preschool experience with books may play an important role. Adams (1990, p. 85) estimated that a typical middle-class child enters first grade with 1,000 to 1,700 hr of one-on-one picture book reading, whereas the correspond-

A comprehensive, empirically based review of the published studies addressing neuropsychological performance in adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) was conducted to identify patterns of performance deficits. Findings from 33 published studies were submitted to a meta-analytic procedure producing sample-size-weighted mean effect sizes across test measures. Results suggest that neuropsychological deficits are expressed in adults with ADHD across multiple domains of functioning, with notable impairments in attention, behavioral inhibition, and memory, whereas normal performance is noted in simple reaction time. Theoretical and developmental considerations are discussed, including the role of behavioral inhibition and working memory impairment. Future directions for research based on these findings are highlighted, including further exploration of specific impairments and an emphasis on particular tests and testing conditions.

Objective: To determine the US national prevalence of attention-deficit/hyperactivity disorder (ADHD) and whether prevalence, recognition, and treatment vary by socioeconomic group.Design: Cross-sectional survey. Results: Of the children, 8.7% met DSM-IV criteria for ADHD. The poorest children (lowest quintile) were more likely than the wealthiest (highest quintile) to fulfill criteria for ADHD (adjusted odds ratio [AOR], 2.3; 95% confidence interval [CI], 1.4-3.9). Among children meeting DSM-IV ADHD criteria, 47.9% had a prior diagnosis of ADHD and 32.0% were treated consistently with ADHD medications during the past year. Girls were less likely than boys to have their disorder identified (AOR, 0.3; 95% CI, 0.1-0.8), and the wealthiest children were more likely than the poorest to receive regular medication treatment (AOR, 3.4; 95% CI, 1.3-9.1). Conclusions:Of US children aged 8 to 15 years, 8.7%, an estimated 2.4 million, meet DSM-IV criteria for ADHD. Less than half of children meeting DSM-IV criteria report receiving either a diagnosis of ADHD or regular medication treatment.PoorchildrenaremostlikelytomeetcriteriaforADHD yet are least likely to receive consistent pharmacotherapy.Arch Pediatr Adolesc Med. 2007;161(9):857-864

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The self-perceptions of children with attention-deficit/hyperactivity disorder (ADHD; n = 487) were compared with those of children in a local normative comparison group (n = 287), relative to teacher- and parent-rated perceptions of their competence. Children were participants in the ongoing follow-up portion of the Multimodal Treatment Study of Children with ADHD. Children with ADHD were much more likely than comparison children to overestimate their competence relative to adult report, regardless of who was used as the criterion rater (teacher, mother, or father). Examination by comorbidity subgroups revealed that children with ADHD inflated their self-perceptions the most in domains of greatest deficit. Gender effects also are reported.

Classrooms of 4-year-olds attending Head Start were randomly assigned to an intervention condition, involving an add-on emergent literacy curriculum, or a control condition, involving the regular Head Start curriculum. Children in the intervention condition experienced interactive book reading at home and in the classroom as well as a classroom-based sound and letter awareness program. Children were pretested and posttested on standardized tests of language, writing, linguistic awareness, and print concepts. Effects of the intervention were significant across all children in the domains of writing and print concepts. Effects on language were large but only for those children whose primary caregivers had been actively involved in the at-home component of the program. One linguistic awareness subtest, involving the ability to identify the first letter and first sound of words, showed significant effects. 542This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

et al. (1988) taught mothers specific interactive techniques to use when reading picture books with their preschool-age children. This intervention program, called dialogic reading, produced substantial effects on preschool children's language development. However, the costs of one-on-one training limit the widespread use of dialogic reading techniques. In this study the authors aimed to replicate and extend the results of the original study of dialogic reading by developing and evaluating an inexpensive videotape training package for teaching dialogic reading techniques. Mothers were randomly assigned to receive no training, traditional direct training, or videotape training. Results supported the conclusions of Whitehurst et al.: Dialogic reading had powerful effects on children's language skills and indicated that videotape training provided a cost-effective, standardized means of implementing the program.Literacy development is a complex process that begins well before formal reading instruction (Teale & Sulzby, 1986). Preschool children acquire a wide range of knowledge and skills that correlate with later literacy development and academic success, including language, knowledge about print and its functions, phonemic awareness, and understanding about oral and written language and their distinctions (