Response to commentary on the multimodal treatment study of ADHD (MTA): mining the meaning of the MTA

In the December 2000 issue of the Journal of Abnormal Child Psychology, we published a set of papers presenting secondary analyses of the Multimodal Treatment Study of ADHD (MTA), and R. A. Barkley (2000) provided a commentary. A critique of the design of the study (MTA Cooperative Group, 1999) was presented based on a theoretical perspective of a behavioral inhibition deficit that has been hypothesized as the core deficit of ADHD (R. A. Barkley, 1997). The commentary questioned the design and analysis of the MTA in terms of (1) the empirical criteria for selection of components of behavioral (Beh) intervention, (2) the effectiveness of the Beh intervention, (3) the methods for analyses at the group and individual level, (4) implications of the MTA findings for clinical practice, (5) the role of genetics in response to treatment, and (6) the lack of a nontreatment control group. In this response, we relate the content of the papers to the commentary, (1) by reviewing the selection criteria for the Beh treatment, as outlined by K. C. Wells, W. E. Pelham, et al. (2000), (2) by addressing the myth that the MTA Beh treatment was ineffective (Pelham, 1999), (3) by describing the use of analyses at the level of the individual participant, as presented by J. S. March et al. (2000) and W. E. Pelham et al. (2000) as well as elsewhere by J. M. Swanson et al. (2001) and C. K. Conners et al. (2001), (4) by relating some of the suggestions from the secondary analyses about clinically relevant factors such as comorbidity (as presented by J. S. March et al., 2000) and family and parental characteristics (as presented by B. Hoza et al., 2000, S. P. Hinshaw et al., 2000, and K. C. Wells, J. N. Epstein, et al., 2000), (5) by discussing the statistical concept of heritability and the lack of a significant difference in the presence of ADHD symptoms in parents of the MTA families compared to parents in the classmate-control families (as presented by J. N. Epstein, et al., 2000), and (6) by acknowledging that an ethically necessary weakness of the MTA design is that it did not include a no-treatment control group. We discuss the use of secondary analyses to suggest how, when, and for what subgroups effectiveness of the Beh treatment may have been manifested. Finally, we invite others to use the large and rich data set that will soon be available in the public domain, to perform secondary analyses to mine the meaning of the MTA and to evaluate theories of ADHD and response to treatments.     

Can test list context manipulations improve recognition accuracy in the DRM paradigm?

Only test-based manipulations can be used to help people distinguish accurate from false memories once events have been encoded. In two experiments we examined how the type of studied words (weak vs strong associates, or less vs more memorable associates) and nonstudied lure words (related vs unrelated lures) on the test list affect recognition accuracy in the Deese-Roediger-McDermott paradigm. False recognition of critical lures decreased substantially in the related-lure context, but so did correct recognition of studied words. False recognition was little affected by the studied-word manipulations. In general, participants claimed to recognise critical lures as often as weak associates or less memorable studied words but less often than either strong associates or more memorable studied words. The test-list context affected how participants classified their recognition experiences but it did not systematically change their overall memory accuracy.     

Masked priming of number judgments depends on prime validity and task

The influence of brief masked primes (42 or 50 msec) on number target judgments is shown to be highly sensitive to the list-wide validity of the primes for performing a particular target task. Odd/even judgments were facilitated on parity-valid trials (e.g., 1-7) relative to parity-invalid trials (e.g., 6-7), especially when .8 rather than .2 of the trials were parity valid. The opposite pattern was observed with magnitude judgments relative to 5: Responses were facilitated on magnitude- valid trials (e.g., 6-7) relative to magnitude-invalid trials (e.g., 1-7), especially when .8 of the trials were magnitude valid. These results are consistent with Bodner and Masson's (2001) claim that a processing episode constructed during a masked prime event is more likely to be recruited when there is a high probability that it will facilitate responding to the target.     

REDUCING RISK OF PRESSURE SORES: EFFECTS OF WATCH PROMPTS AND ALARM AVOIDANCE ON WHEELCHAIR PUSH-UPS

People who use wheelchairs are at risk for developing pressure sores. Regular pressure relief, in the form of a wheelchair push-up, is one way to reduce the likelihood of pressure sores. We examined the effects of antecedent (i.e., instructions, audible prompts) and consequent (i.e., alarm avoidance) events on wheelchair push-ups, using a multiple baseline analysis with 2 participants with spina bifida. Results suggest that the combined procedure was more effective than either antecedent or consequent events alone, and there is some evidence suggesting maintenance of effects over time.     

Continuities and Consequences of Interactional Styles Across the Life Course

Behavior patterns can be sustained across the life course by two kinds of person-environment interaction. Cumulative continuity arises when an individual's interactional style channels him or her into environments that themselves reinforce that style, thereby sustaining the behavior pattern across the life course through the progressive accumulation of its own consequences. Interactional continuity arises when an individual's style evokes reciprocal, sustaining responses from others in ongoing social interaction, thereby reinstating the behavior pattern across the individual's life course whenever the relevant interactive situation is replicated. Using archival data from the Berkeley Guidance Study (Macfarlane, Allen, & Honzik, 1954), we present evidence for the operation of these two continuity-promoting processes by identifying individuals who were ill-tempered, shy, or dependent in late childhood and then tracing the continuities and consequences of these interactional styles across the subsequent 30 years of their lives in the domains of work and family. The importance of the sociocultural context in mediating these continuities and consequences is stressed.     

Comparing subtest profiles of g loadings and correlations with RT measures

It is argued that if a response time (RT) measure correlates with psychometric test (PT) scores because it shares variance in common with general intelligence, g, then the profile of g loadings for a set of PTs would be predictable from the profile of correlations between the RT measure and the PT scores. On the other hand, if an RT correlates with PTs through variance not shared with g, the g loadings of the PTs should be unrelated to the correlations between RT and PTs. The profiles of g loadings and correlations with RT were compared for a set of 6 RT measures and 8 PT scores from Smith and Stanley (1983). To demonstrate statistical significance, standard errors of the statistics were generated by Efron's bootstrap technique (Efron, 1979). It was clearly shown that the profile of the PT's g loadings could be well predicted from the RT-PT correlations for four of the RT measures. It can be concluded that RT tasks do measure general intelligence. Analysis of the errors in prediction suggested that the RTs may correlate more with fluid than crystallized intelligence.     

IMPROVING THE PEER INTERACTIONS OF STUDENTS WITH EMOTIONAL AND BEHAVIORAL DISORDERS THROUGH SELF-EVALUATION PROCEDURES: A COMPONENT ANALYSIS AND GROUP APPLICATION

We conducted two experiments examining the effects of a self-evaluation package on the peer interactions of students described as emotionally or behaviorally disordered. Experiment 1 assessed the additive effects of various components of a self-evaluation package on the frequency of inappropriate and appropriate peer interactions. The components assessed were rewards alone, rewards plus discussion, and self-evaluation plus rewards. Results showed limited effectiveness when rewards alone and rewards plus discussion were implemented. However, substantial improvements in peer interactions were observed when the self-evaluation component was added. Experiment 2 examined the efficacy and feasibility of the procedures when implemented in a group setting. Students in three classrooms served as participants. Direct observation data collected for 8 of the participants showed the procedures to be effective in improving peer interactions when implemented in a group context.     

CHOICE MAKING TO PROMOTE ADAPTIVE BEHAVIOR FOR STUDENTS WITH EMOTIONAL AND BEHAVIORAL CHALLENGES

Two analyses investigated the effects of choice making on the responding of elementary school students with emotional and behavioral challenges. In the first analysis, 2 participants were given choices from menus of academic tasks, all of which were pertinent to their educational objectives in English and spelling, respectively. Reversal designs showed that the choice-making conditions increased task engagement and reduced disruptive behavior for both students. An additional analysis was performed with a 3rd student in an effort to further distinguish the effects of choice making from preference. In this study, one of the no-choice phases was yoked to a previous choice-making condition. This analysis demonstrated that the choice-making condition was superior to baseline and yoked control phases as determined by levels of task engagement and disruptive behavior. The findings of the two analyses contribute information relevant to students with emotional and behavioral disorders, and to a growing literature on the desirable effects of choice making for students with disabilities and challenging behaviors.