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A 14-Month Randomized Clinical Trial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder

Archives of General Psychiatry, 1999 · paper · Clinical trials

A randomized trial of 579 children with ADHD comparing 14 months of medication management, intensive behavioral treatment, both combined, or community care. Medication management beat behavioral treatment and community care for core ADHD symptoms; combination offered modest extra benefits on other outcomes.

13 findings

Substance Results p6 ("medication management and be-havioral treatment were superior to community care on 1 domain only (teacher-reported social skills ...)"), Comment p8 and Figure legend C ("Combined treatment and medication management were more effective than community care") say MM beat CC on teacher-rated social skills, but Table 5 prints "Med Mgt ≈ CC" P=.009 for SSRS teacher, and the Abstract lists teacher-rated social skills among outcomes where medication management did not prove superior.
  • p. 1 Abstract, Results
    teacher-rated social skills, parent-child relations, and reading achievement) combined treatment proved superior to intensive behavioral treatment and/or community care while medication management did not
  • p. 6 Results, third study question
    medication management and be-havioral treatment were superior to community care on 1 domain only (teacher-reported social skills
  • p. 12 Figure legend, panel C
    C, Combined treatment and medication management were more effective than community care.
  • p. 8 Comment, para on comparisons with community care
    medi-cation management and behavioral treatment each fared better than community care in 1 non-ADHD domain only (teacher-rated social skills and parent-child relations)

Only the authors can say what is right here.

Judge's note: Table 5 spans p10-11. I matched the 15 rows on p11 to the 15 measure rows on p10. Row 12 (SSRS social skills, teacher) reads Comb>CC .001, Med Mgt ≈ CC .009, Behav ≈ CC .03§. The pairwise threshold for the social-skills domain is .003 (p10), and .009 lies above it. The table and the Abstract therefore say MM was not superior to CC on this measure. The Results text, the Comment and the Figure C legend say it was. Separately, the .009 entry has no § even though it is not significant, so the table's own notation is inconsistent too. The files do not show which statement is correct.

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Substance Table 5 vs text, community-care contrasts: (1) teacher SSRS social skills prints 'Med Mgt ≈ CC .009', but the Results, the Comment and the Figure C legend say medication management beat community care on teacher-rated social skills; the parent SSRS row, whose omnibus test was not significant, prints 'Med Mgt>CC'. (2) Teacher ODD prints 'Comb>CC .004' and 'Med Mgt>CC .004' without §, although .004 exceeds the domain pairwise threshold of .003 and the text says medication management beat CC in only one non-ADHD domain.
  • p. 11 Table 5, Social skills SSRS teacher/parent rows, CC comparisons
    Med Mgt ≈ CC
  • p. 6 Results
    teacher-reported social skills and 1 mea-sure of parent-child relations, respectively
  • p. 11 Table 5, ODD teacher row, Comb vs CC column
    Med Mgt>CC .004
  • p. 10 Table 5, Aggression-ODD domain thresholds
    P≤.02a, .003b

Only the authors can say what is right here.

Judge's note: Checked Table 5 on pages 10-11, using the layout text to align rows. The domain thresholds are P≤.02/.003 for both social skills and aggression-ODD. The Results (p6) say 'medication management and behavioral treatment were superior to community care on 1 domain only (teacher-reported social skills...)'. The Figure C legend (p12) says 'Combined treatment and medication management were more effective than community care.' The table symbols and § flags do not agree with this text or with the stated Bonferroni rule. The teacher-ODD sub-point is the same defect as C042.

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Substance "18 (3.1%) on no medication (combined treatment [14 subjects] and medication management [4 subjects]) (3.1%)": 18 of the stated 289 is 6.2%, and '(3.1%)' is printed twice.
  • p. 3 Medication Management, end-of-study medication status
    18 (3.1%) on no medication
  • p. 3 Medication Management section, end-of-study medication
    18 (3.1%) on no medication (combined treatment [14 subjects] and medication management [4 subjects]) (3.1%)

Judge's note: The page 3 image confirms the text. The sentence's denominator is 'the 289 subjects', and the other percentages fit it (212=73.4%, 30=10.4%). 3.1% matches 18/579 (whole sample), which is not the stated base.

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Substance Results text says medication management was superior to behavioral treatment on "parents' and teachers' ratings of inattention and teachers' ratings of hyperactivity-impulsivity". Table 5 shows teacher hyperactive-impulsive as "Med Mgt ≈ Behav .004§" and parent hyperactive-impulsive as "Med Mgt>Behav .001".
  • p. 5 Results, first study question
    ings of inattention and teachers' ratings of hyperactivity-
  • p. 10 Table 5, Hyperactive-impulsive rows
    Med Mgt ≈ Behav
  • p. 10 Table 5, hyperactive-impulsive rows
    Med Mgt ≈ Behav .004§
  • p. 6 Results, first question
    parents’ and teachers’ ratings of inattention and teachers’ ratings of hyperactivity-impulsivity

Judge's note: Read the text on pp. 5-6 and Table 5 on p. 10. Table 5 footnote §: "P values not significant after Bonferroni correction" (pairwise α .002 for ADHD symptoms). The significant Med Mgt>Behav entries are teacher inattention, parent inattention and parent hyperactive-impulsive. The text names the teacher rather than the parent hyperactivity-impulsivity rating. The text also calls these 'robust' differences and cites Table 5 directly.

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Substance Table 2, Telephone Screen, 'Distance from school and family' is printed as "600 (14)". 600/4541 is 13.2%.
  • p. 6 Table 2, Telephone Screen, Distance from school and family
    600 (14)

Judge's note: The footnote says the percentages are of subjects entering the phase (4541). The other cells in the column round correctly (891→20, 78→2, 411→9, 224→5, total 2204→49), and the counts sum to 2204. Only this percentage is off.

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Substance Table 5, teacher inattention: 'Comb>Behav' with P '.005' (no §), counted in the Results as significant ('according to parents' and teachers' ratings of inattention'), although the Methods' ADHD pairwise threshold is P<.0017 (Table 5: .002).
  • p. 11 Table 5, Inattention Teacher, Comb vs Behav P
    .005
  • p. 6 Results
    according to parents' and teachers' ratings of in-attention

Only the authors can say what is right here.

Judge's note: The page 11 crop shows .005 with no § beside Comb>Behav for teacher inattention. The Methods on p4 state '.01 ÷ 6 = .0017'. Elsewhere in the same domain, comparable values carry § (for example HI teacher Med Mgt≈Behav .004§). The Methods apply the same correction to 1-tailed contrasts, so nothing in the paper explains the discrepancy.

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Substance Table 3: Mania/hypomania is 13 (2.2%) overall with site range "0.0%-1.0%", while Other is 1 (0.2%) with site range "0.0%-5.2%". The ranges appear to be swapped.
  • p. 7 Table 3, Comorbidity, Mania/hypomania and Other rows
    0.0%-1.0%
  • p. 7 Table 3, Other (eg, bulimia, enuresis)
    0.0%-5.2%

Only the authors can say what is right here.

Judge's note: Seen in the Table 3 image. A pooled proportion cannot be larger than the largest site proportion, so 2.2% overall cannot sit with a site maximum of 1.0%. Likewise 1 case in total cannot give a 5.2% site rate at sites of about 96 children. Group counts 5+2+6+0 = 13 match the total. A swap is likely, but only the authors can confirm it.

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Substance Table 3: income $0-20 000 is "124 (21)" overall, and every group is 21%-23%, but the range across sites is printed as "7%-19%‡".
  • p. 7 Table 3, Income 0-20 000
    7%-19%‡

Only the authors can say what is right here.

Judge's note: Seen in the Table 3 image. The overall proportion is a weighted average of the site proportions, so it must fall inside the site range. 21.4% is above the stated maximum of 19%. The other income rows (41% within 28-55; 36% within 28-43) are consistent.

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Substance Table 3, Behavioral Treatment, income >$50 000 is printed as "53 (47)". 53/144 is 36.8%, and the column's income percentages sum to 23+40+47 = 110.
  • p. 7 Table 3, Income >50 000, Behavioral Treatment
    53 (47)

Judge's note: Seen in the Table 3 image. The other cells in the column use n = 144 (33→23, 58→40). The row counts 59+49+53+52 = 213 match the total, so the count looks right and the percentage wrong (probably 37).

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Substance Table 3, family composition 'Other' is printed as "4 (1) 1 (1) 0 (0) 1 (1) 3 (2)". The group counts sum to 5, not the total of 4, and the Community Care column then sums to 102+42+3 = 147, above its n = 146.
  • p. 7 Table 3, Family composition, Other
    3 (2)
  • p. 7 Table 3, Family composition, Other
    4 (1) 1 (1) 0 (0) 1 (1) 3 (2)

Only the authors can say what is right here.

Judge's note: Seen in the Table 3 image. The 2 Parents row (102+103+89+102 = 396) and the 1 Parent row (41+41+51+42 = 175) match their totals, and 396+175+4 = 575 matches the stated N for family composition. So one group cell (probably Community Care) is wrong, but only the authors can say which.

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Substance Table 5, power assertion (parent): prints 'Behav ≈ CC .005' (no §), yet the Results, the Comment ('teacher-rated social skills and parent-child relations') and the Figure D legend ('Combined and behavioral treatment were more effective than community care') say behavioral treatment beat community care; .005 also exceeds the domain pairwise threshold of .004.
  • p. 11 Table 5, Power assertion Parent row, CC comparisons
    Behav ≈ CC
  • p. 12 Figure legend, panel D
    D, Combined and behavioral treatment were more effective than community care.
  • p. 8 Comment
    (teacher-rated social skills and parent-child relations)
  • p. 11 Table 5 right half, Power assertion
    Behav ≈ CC .005

Only the authors can say what is right here.

Judge's note: In the page 11 table (rows aligned via the layout text) the power-assertion entries are Comb>CC .003; Med Mgt ≈ CC .006§; Behav ≈ CC .005. The domain threshold printed on page 10 is P≤.03/.004. The symbol and the threshold both conflict with the text and with the Figure D legend (crop C041-b).

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Reference or label "from the comprehensive assessment bat-tery,28" cites ref 28, "Biederman J, Newcorn J, Sprich S. Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders", a comorbidity review, not the MTA assessment paper (ref 18, Hinshaw et al, 'Comprehensive assessment of childhood attention-deficit hyperactivity disorder ...').
  • p. 2 Assessments
    from the comprehensive assessment bat-tery,28
  • p. 13 Reference 28
    Biederman J, Newcorn J, Sprich S. Comorbidity of attention deficit hyperactivity disorder
  • p. 2 Assessments, first sentence
    comprehensive assessment bat-tery,28 eliminating redundant measures
  • p. 13 Reference 28
    Biederman J, Newcorn J, Sprich S. Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders.

Judge's note: I read ref 28 on p13 and ref 18 in the text layer of the reference list. The text also cites ref 28 within the comorbidity range 26-30 on p2. Ref 18 is the assessment-battery paper and is cited for assessments elsewhere ('barriers18', '17,18'). The citation appears to be wrong, and ref 18 looks like the intended reference.

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Reference or label Reference 27 prints "Am J Psychiatry. 1993;151:1673-1685", but reference 28 in the same list dates volume 148 of the same journal to 1991 ("Am J Psychiatry. 1991;148:564-577"), which would put volume 151 in 1994.
  • p. 13 Reference 27
    Am J Psychiatry. 1993;151:1673-1685.
  • p. 13 Reference 28
    Am J Psychia-try. 1991;148:564-577.
  • p. 13 Reference 27
    Am J Psychiatry. 1993; 151:1673-1685

Only the authors can say what is right here.

Judge's note: Rests on outside knowledge: that Am J Psychiatry publishes one volume per year (vol 148 = 1991, so vol 151 = 1994). The page image (crop C046-a, p13) shows ref 27 as "1993; 151:1673-1685" and ref 28 as "1991;148:564-577". These are the only two Am J Psychiatry references in the paper. If the journal runs one volume per year, the year or the volume of ref 27 is wrong. Only the authors can say which one.

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25 minor (typos and the like; most checked by the judge only)
Substance Table 3 comorbidity rows: the Combined (n = 145) percentages match a denominator of 144 (e.g. "50 (34.7)", "53 (36.8)"), and the Medication Management (n = 144) percentages match 145 (e.g. 52 (35.9), 55 (37.9)).
  • p. 7 Table 3, Comorbidity rows, Combined (n = 145) and Medication Management (n = 144) columns
    50 (34.7)
  • p. 7 Table 3, Oppositional-defiant disorder
    53 (36.8)

Only the authors can say what is right here.

Judge's note: Seen in the Table 3 image. The pattern holds across rows: Comb 20 (13.9), 19 (13.2), 5 (3.5); MM 23 (15.8), 5 (3.4). MM percentages cannot come from any denominator ≤144. Other Table 3 rows (Male 114/145 = 79, 118/144 = 82) use the correct n, so the swap is confined to the comorbidity block. The discrepancies are only 0.2-0.3 points.

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Reference or label The Table 4 column header reads 'Assessment and Referral', but the Design section says 'we have changed the terminology for all outcome articles to medication management, behavioral treatment, combined treatment, and community care.'
  • p. 9 Table 4 column header
    Assessment and Referral
  • p. 2 Design
    changed the terminology for all outcome articles to medi-cation management, behavioral treatment, combined treat-ment, and community care.
  • p. 2 Methods, Design
    we have changed the terminology for all outcome articles to medi-cation management, behavioral treatment, combined treat-ment, and community care.

Judge's note: The Design crop on page 2 shows the stated change of terminology. The Table 4 header on page 9 still uses the old label. It is the same group, so this is only a labelling inconsistency.

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Wording Eligibility says children were "in grades 1 through 4", yet Table 3 lists Grade 5: "1 (0.7)" (medication management arm; 1 (0.2) overall).
  • p. 2 Recruitment
    in grades 1 through 4
  • p. 7 Table 3, Grade 5
    1 (0.7)

Only the authors can say what is right here.

Judge's note: Both entries are visible in the images (p2 recruitment; p7 Table 3). A search for 'grade' finds no explanation, such as a child promoted between screening and baseline. It is a small unexplained inconsistency.

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Wording Dose analysis prints "treatment group: F = 14.6, P = .01; site: F = 3.2, P = .002". The two F/P pairs do not correspond under the declared F test with the ~200 denominator df given for the interaction (F11,200).
  • p. 4 Combined Treatment, dose paragraph
    treatment group:F = 14.6,P = .01;site:F = 3.2,P = .002

Only the authors can say what is right here.

Judge's note: On the p004 crop, the printed numbers are as quoted. Only the interaction has printed df (F11,200). With any numerator df from 1 to 11 and about 200 denominator df, F = 14.6 gives P well below .001, so it cannot reach P = .01. A smaller F (3.2) is also shown with a smaller P. P = .01 could only be reached with very few denominator df (about 5-6). We cannot settle this without the df, so it is raised as a query about which test and df each value comes from.

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Wording Comment: 'More than three fourths of subjects given behavioral treatment were successfully maintained without medication throughout the study' conflicts with 'behavioral treatment, where 38 crossovers to medication occurred' in an arm of n = 144 (106/144 = 73.6%).
  • p. 11 Comment
    More than three fourths of subjects given behavioral treatment were suc-cessfully maintained without medication
  • p. 6 Results
    where 38 crossovers to medication occurred
  • p. 11 Comment, limitations paragraph
    More than three fourths of subjects given behavioral treatment were suc-cessfully maintained without medication throughout the study.
  • p. 11 Discussion, limitations
    More than three fourths of subjects given behavioral treatment were suc-

Only the authors can say what is right here.

Judge's note: Table 3 gives behavioral treatment n = 144, and the Results (p6 crop) report 38 crossovers to medication. That leaves at most 106/144, or 73.6%, unmedicated, which is below three fourths. The paper gives no other count, so only the authors can say whether the crossovers were counted differently.

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Wording The Discussion lists 'peer interactions' among the domains where MTA treatments beat community care, but the significant result was teacher-rated social skills (SSRS); the peer sociometric measure was not significant (Table 4 footnote §: F = 2.3, P<.08).
  • p. 8 Comment, right column
    ternalizing symptoms, peer interactions, parent-child relations, and reading achievement
  • p. 8 Table 4 footnote §
    treatment group, F = 2.3, P<.08 (not significant after Bonferroni correction)

Judge's note: Checked page 8. The preceding paragraph lists the 5 non-ADHD domains as '...teacher-reported social skills, parent-child relations, and reading achievement'. The next paragraph swaps in 'peer interactions'. The paper measures peer relations separately with sociometrics (Methods, p2), and the Table 4 footnote § reports that measure as not significant. The authors may mean social skills loosely, but the wording misdescribes the result.

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Wording Table 4 footnote ||: 'treatment group, F = 3.75, P<.001' (ANCOVA with 'an overall df of 23,529') — the F and the P do not correspond under the declared test for a 4-group treatment term.
  • p. 8 Table 4 footnote ||
    treatment group, F = 3.75, P<.001

Only the authors can say what is right here.

Judge's note: Read the footnote on the page 8 image. With 4 arms, the treatment-group term has 3 numerator df. F(3,529)=3.75 gives an upper-tail P of about .011. Reaching P<.001 at F=3.75 would take about 6 or more numerator df. The footnote does not state the df for this term, so this is raised as a query.

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Wording Table 5, parent-rated social skills: the omnibus 'F3,887 = 2.2; P = .09' is above the domain omnibus α of .02, yet pairwise results are printed (Comb vs Behav .03§; 'Comb>CC .02§'; 'Med Mgt>CC'), contrary to footnote ‡ 'Done only when omnibus analysis for treatment × time effect was significant.'
  • p. 10 Table 5, Social skills Parent row
    Treatment × time: F3,887 = 2.2; P = .09
  • p. 10 Table 5 footnote ‡
    Done only when omnibus analysis for treatment × time effect was significant.
  • p. 11 Table 5, Social skills Parent, CC comparisons
    Comb>CC

Only the authors can say what is right here.

Judge's note: Pages 10 and 11 show the omnibus P = .09 against the threshold P≤.02. The Statistical Analyses section (p4) also restricts pairwise tests to significant omnibus results. The row nevertheless carries pairwise entries, including 'Med Mgt>CC' with an ellipsis P, whereas other non-significant rows show ellipses. The Results say 10 of 19 omnibus tests were significant, which is consistent with this row being non-significant. Only the authors can say whether these entries should be removed.

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Wording Table 5, personal closeness (parent): 'Treatment × time: F3,908 = 2.0; P = .0008' — the F and the P do not correspond under the declared F test.
  • p. 10 Table 5, Personal closeness Parent
    Treatment × time: F3,908 = 2.0; P = .0008
  • p. 10 Table 5, Parent-child relations, Personal closeness
    F3,908 = 2.0; P = .0008

Only the authors can say what is right here.

Judge's note: Confirmed on the page 10 crop. F(3,908)=2.0 gives an upper-tail P of about .11. The same P, .0008, appears in the power-assertion row directly above it, where F = 5.6. Everything else in the row points to a non-significant omnibus test: the pairwise columns are all ellipses, and the Results' count of '10 of 19' significant omnibus tests matches only if this row is non-significant. The printed P looks copied from the row above, but only the authors can confirm.

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Wording Table 5, parent hyperactive-impulsive: 'F3,609 = 21.5' has the same F as parent inattention ('F3,669 = 21.5') but a denominator df 60 lower than the other ADHD rating rows (666-669).
  • p. 10 Table 5, Hyperactive-impulsive, Parent
    F3,609 = 21.5

Only the authors can say what is right here.

Judge's note: Read the page 10 crop. Parent inattention and parent hyperactivity come from the same parent ratings, and Table 4 shows the same Ns for both. An identical F combined with df of 609 rather than about 669 looks like a typesetting error. Denominator df do differ slightly between rows (666 vs 669), so the authors would need to confirm.

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Wording Table 5, social skills: the parent row prints 'Site: F = 3.8; P = .02' and the teacher row 'Site: F = 3.9; P = .002'; F and P do not correspond under the declared test for the parent row.
  • p. 10 Table 5, Social skills, Parent
    Site: F = 3.8; P = .02
  • p. 10 Table 5, Social skills, Teacher
    Site: F = 3.9; P = .002

Only the authors can say what is right here.

Judge's note: Read on the page 10 image. With 6 sites the site term has 5 numerator df. F(5, about 900)=3.8 gives P of about .002, matching the teacher row (F=3.9, P=.002), not .02. The other site rows (for example F=2.8, P=.02 and F=4.4, P=.0006) agree roughly with 5 numerator df. The site df are not printed, so this is a query.

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Typo Misspelling "implemenation for any behavioral components" (implementation).
  • p. 3 Behavioral Treatment
    implemenation for any behavioral components

Judge's note: The misspelling is visible in the page 3 image.

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Typo Drug name misspelled "buproprion" (bupropion) on p3 and twice on p4.
  • p. 3 Medication Management
    1 (0.3%) on buproprion
  • p. 4 Community Care
    and/or buproprion (n = 1)

Judge's note: The misspelling is visible in the p3 and p4 images.

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Typo Missing full stop: "having a case-load of 12 families" ends the paragraph without a period.
  • p. 3 Behavioral Treatment, first paragraph
    load of 12 families
  • p. 3 Behavioral Treatment, first paragraph
    caseload of 12 families

Judge's note: The page 3 crop shows no period after 'families'.

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Typo "Bonferonni corrections" misspelled (Bonferroni) on p4 and p11, inconsistent with "Bonferroni" in the Table 5 footnotes.
  • p. 4 Statistical Analyses
    Bonferonni corrections were applied
  • p. 11 Comment
    Bonferonni corrections
  • p. 4 Statistical Analyses
    Bonferonni corrections were applied to all omnibus tests

Judge's note: The p11 image clearly shows 'Bonferonni'. The text layer of p4 also reads 'Bonferonni'. The Table 5 footnotes use the correct spelling.

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Typo "despite refusing part of all of their assigned treatments" should read "part or all".
  • p. 4 Fidelity and Compliance
    despite refusing part of all of their assigned treatments

Judge's note: The p4 image (Fidelity and Compliance, right column) shows 'part of all'.

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Typo The grant acknowledgment on p13 reads "UO1 MH50461 (Drs Hinshaw and Elliot)", but the investigator list on p5 spells the name "Glen R. Elliott, MD, PhD" (references 15-17 also have "Elliott G").
  • p. 13 Acknowledgments
    (Drs Hinshaw and Elliot)
  • p. 5 Investigator list
    Glen R. Elliott, MD, PhD
  • p. 13 Funding note
    Drs Hinshaw and Elliot

Judge's note: The page images confirm both spellings. It is the same person: the same UC Berkeley/UCSF site is paired with Hinshaw in both places. This is a misspelling of the surname.

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Typo "Weschler Individual Achievement Test" (Results p. 6, twice; Comment p. 8, "We-schler") is misspelled. Elsewhere the paper prints "Wechsler" (Methods, Table 4 footnote ¶, ref 34).
  • p. 6 Results
    Weschler Individual Achievement
  • p. 8 Comment
    We-schler Individual Achievement Test
  • p. 8 Comment, left column
    We-schler Individual Achievement Test reading achieve-ment score
  • p. 6 Results
    Weschler Individual Achievement Test reading achievement score (Table 4)

Judge's note: Seen in the page 6 and page 8 images. The text layer also shows the correct spelling at line 193, in the Table 4 footnote and in ref 34.

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Typo Misspelling "teacher-reported social skillls" (Results, p. 6); should be "skills".
  • p. 6 Results
    teacher-reported social skillls
  • p. 6
    teacher-reported social skillls, par-

Judge's note: The triple 'l' is visible in the page 6 image.

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Typo Table 3, total income >$50 000 is printed as "213 (36)". 213/579 is 36.8%, while other total cells are rounded to the nearest percent.
  • p. 7 Table 3, Income >50 000, Totals
    213 (36)

Judge's note: Seen in the Table 3 image. Other cells round normally (351→61, 177→31, 239→41). The printed 36 matches truncation rather than rounding, a 1-point discrepancy. 213/576 (excluding unknowns) also gives 37.

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Typo Table 4 has two malformed cells. Medication Management ODD aggression Teacher baseline reads "1.39 (0.92) [0.92]", with the SD repeated in the N slot. Community care classroom observer hyperactivity 14 mo reads "0.18 (109) [0.15]", with SD and N transposed.
  • p. 8 Table 4, Medication Management, ODD aggression Teacher, Baseline
    1.39 (0.92) [0.92]
  • p. 9 Table 4, Classroom observer hyperactivity, Assessment and Referral 14 mo
    0.18 (109) [0.15]

Judge's note: Both cells checked in the crops of pp. 8-9. Every other bracket holds an integer N. The second cell should evidently read 0.18 (0.15) [109], consistent with the [109] in the row below. The true N for the first cell is not recoverable.

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Typo Missing word in the Comment: "According to least 1 informant" should read "According to at least 1 informant".
  • p. 8 Comment
    According to least 1 informant

Judge's note: Seen in the page 8 image, left column.

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Typo Table 4, Assessment and Referral, Hyperactive/impulsive classroom observer, 14 mo: '0.18 (109) [0.15]' has the SD and N swapped; it should read 0.18 (0.15) [109].
  • p. 9 Table 4, Assessment and Referral, Hyperactive/impulsive Classroom observer, 14 mo
    0.18 (109) [0.15]

Judge's note: The crop confirms the cell prints '0.18 (109) [0.15]', against the column format 'mean (SD) [No. of Subjects]'. The neighbouring cells (for example 0.006 (0.014) [109]) support N = 109.

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Typo Table 5, parent hyperactive-impulsive, community-care contrasts: 'Med MgtCC' is missing the comparison symbol (likely '>', P = .001).
  • p. 11 Table 5, Hyperactive-impulsive Parent, CC comparisons
    Med MgtCC

Judge's note: The crop of page 11 shows 'Med MgtCC' with no symbol between the two labels. The P of .001 and the parallel rows suggest '>'.

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Typo Reference 44 reads "a three-level heirarchical linear model"; this should be "hierarchical".
  • p. 14 Reference 44
    three-level heirarchical linear model

Judge's note: The p14 crop confirms the spelling "heirarchical" in the title of ref 44. It is a plain misspelling.

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