Multimodal treatment in children and adolescents with attention-deficit/hyperactivity disorder: a 6-month follow-up
Sammanfattning
Background: Different treatment approaches aimed at reducing attention-deficit/hyperactivity disorder
(ADHD) core symptoms are available. However, factors such as intolerance, side-effects, lack of efficacy,
high new technology costs, and placebo effect have spurred on an increasing interest in alternative or
complementary treatment.
Aim: The aim of this study is to explore efficacy of multimodal treatment consisting of standard stimulant
medication (methylphenidate) and neurofeedback (NF) in combination, and to compare it with the
single treatment in 6-month follow-up in ADHD children and adolescents.
Methods: This randomized controlled trial with 6-month follow-up comprised three treatment arms:
multimodal treatment (NFþ MED), MED alone, and NF alone. A total of 130 ADHD children/adolescents
participated, and 62% completed the study. ADHD core symptoms were recorded pre-/post-treatment,
using parents’ and teachers’ forms taken from Barkley’s Defiant Children: A Clinician’s Manual for
Assessment and Parent Training, and a self-report questionnaire.
Results: Significant ADHD core symptom improvements were reported 6 months after treatment completion
by parents, teachers, and participants in all three groups, with marked improvement in inattention
in all groups. However, no significant improvements in hyperactivity or academic performance
were reported by teachers or self-reported by children/adolescents, respectively, in the three groups.
Changes obtained with multimodal treatment at 6-month follow-up were comparable to those with
single medication treatment, as reported by all participants.
Conclusions: Multimodal treatment using combined stimulant medication and NF showed 6-month
efficacy in ADHD treatment. More research is needed to explore whether multimodal treatment is suitable
for ADHD children and adolescents who showed a poor response to single medication treatment,
and for those who want to reduce the use of stimulant medication.