Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased     

Form-priming effects in nonword naming

Form-priming effects from sublexical (syllabic or segmental) primes in masked priming can be accounted for in two ways. One is the sublexical pre-activation view according to which segments are pre-activated by the prime, and at the time the form-related target is to be produced, retrieval/assembly of those pre-activated segments is faster compared to an unrelated situation. However, it has also been argued that form-priming effects from sublexical primes might be due to lexical pre-activation. When the sublexical prime is presented, it activates all form-related words (i.e., cohorts) in the lexicon, necessarily including the form-related target, which-as a consequence-is produced faster than in the unrelated case. Note, however, that this lexical pre-activation account makes previous pre-lexical activation of segments necessary. This study reports a nonword naming experiment to investigate whether or not sublexical pre-activation is involved in masked form priming with sublexical primes. The results demonstrated a priming effect suggesting a nonlexical effect. However, this does not exclude an additional lexical component in form priming.     

Semantic gender assignment regularities in German

Gender assignment relates to a native speaker's knowledge of the structure of the gender system of his/her language, allowing the speaker to select the appropriate gender for each noun. Whereas categorical assignment rules and exceptional gender assignment are well investigated, assignment regularities, i.e., tendencies in the gender distribution identified within the vocabulary of a language, are still controversial. The present study is an empirical contribution trying to shed light on the gender assignment system native German speakers have at their disposal. Participants presented with a category (e.g., predator) and a pair of gender-marked pseudo-words (e.g., der Trelle vs. die Stisse) preferentially selected the pseudo-word preceded by the gender-marked determiner "associated" with the category (e.g., masculine). This finding suggests that semantic regularities might be part of the gender assignment system of native speakers.     

The word frequency effect in picture naming: contrasting two hypotheses using homonym pictures

Models of speech production disagree on whether or not homonyms have a shared word-form representation. To investigate this issue, a picture-naming experiment was carried out using Dutch homonyms of which both meanings could be presented as a picture. Naming latencies for the low-frequency meanings of homonyms were slower than for those of the high-frequency meanings. However, no frequency effect was found for control words, which matched the frequency of the homonyms' meanings. Subsequent control experiments indicated that the difference in naming latencies for the homonyms could be attributed to processes earlier than word-form retrieval. Specifically, it appears that low name agreement slowed down the naming of the low-frequency homonym pictures.     

Stress priming in picture naming: an SOA study

This study investigates whether or not the representation of lexical stress information can be primed during speech production. In four experiments, we attempted to prime the stress position of bisyllabic target nouns (picture names) having initial and final stress with auditory prime words having either the same or different stress as the target (e.g., WORtel-MOtor vs. koSTUUM-MOtor; capital letters indicate stressed syllables in prime-target pairs). Furthermore, half of the prime words were semantically related, the other half unrelated. Overall, picture names were not produced faster when the prime word had the same stress as the target than when the prime had different stress, i.e., there was no stress-priming effect in any experiment. This result would not be expected if stress were stored in the lexicon. However, targets with initial stress were responded to faster than final-stress targets. The reason for this effect was neither the quality of the pictures nor frequency of occurrence or voice-key characteristics. We hypothesize here that this stress effect is a genuine encoding effect, i.e., words with stress on the second syllable take longer to be encoded because their stress pattern is irregular with respect to the lexical distribution of bisyllabic stress patterns, even though it can be regular with respect to metrical stress rules in Dutch. The results of the experiments are discussed in the framework of models of phonological encoding.     

A developmental grammar for syllable structure in the production of child language.

The order of acquisition of Dutch syllable types by first language learners is analyzed as following from an initial ranking and subsequent rerankings of constraints in an optimality theoretic grammar. Initially, structural constraints are all ranked above faithfulness constraints, leading to core syllable (CV) productions only. Subsequently, faithfulness gradually rises to the highest position in the ranking, allowing more and more marked syllable types to appear in production. Local conjunctions of Structural constraints allow for a more detailed analysis.     

Masked syllable priming of English nouns.

This study investigates the role of sublexical units in the phonological encoding of English single-word production in a word-naming task (Experiment 1) and a picture-naming task (Experiment 2). Targets corresponded to bisyllabic English nouns with word-initial stress which varied on the structure of their first syllable: CV (e.g., pi.lot), CVC (e.g., pic.nic), or CV[C] (e. g., pi[ll]ow).1 Targets were preceded by a visually masked prime that either matched their first syllable (e.g., pi%%% - pi.lot) or that was one segment longer (e.g., pil%% - pi.lot) or shorter (e.g., pi%%%% - pic.nic) than the first syllable. Response times were compared to a neutral control condition (e.g., %&$%% - pi.lot) to measure the priming effects (either facilitation or inhibition). Results showed significant facilitation for both the CV and the CVC conditions. However, contrary to previous findings, there was no interaction between the syllabic structure of the prime and the target.