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Comparative treatment studies in children with attention-deficit/hyperactivity disorder (ADHD) are critical not only to clinical knowledge, but also to the controversy about medication. Therefore, the Multimodal Treatment Study of Children With ADHD (MTA)^{1, 2} represents a major contribution. During 14 months, children with ADHD symptoms improved as much when using medication alone as when using medication combined with an ambitious psychosocial treatment, and both were superior to psychosocial treatment alone, which was indistinguishable from treatment in the community.

If informants deliver treatment, as is the case here for psychosocial treatment, objective assessments must be obtained about patients' status to avoid bias owing to cognitive dissonance. The MTA included an objective assessment (classroom observations), which, in treatment studies of ADHD,³ have distinguished methylphenidate from other treatments. The tables¹ indicate their values, but they are not mentioned in the "Results" or "Comments" sections of the article. That this previously validated objective measure failed . . . [Full Text of this Article]

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