Table 5.

Outcomes at Endpoint by Secondary/adaptive Treatment Given Insufficient Response to Initial Behavioral Treatment

Outcome	B-then-B	B-then-M	Effect Size
Classroom rule violations per hour*	6.6 [5.1, 8.6]	9.4 [7.5, 11.7]	IRR = 1.41
Out-of-class disciplinary events per school year†	3.2 [1.2, 8.3]	1.0 [0.4, 2.7]	IRR = 0.30
Teacher DBD—ADHD	1.28 (.65)	1.00 (.65)	d = 0.44
Teacher DBD—ODD	0.63 (.60)	0.52 (.49)	d = 0.19
Teacher SSRS Social Skills Total Score	32.0 (9.6)	35.0 (9.1)	d = 0.31
Parent DBD—ADHD	1.60 (.66)	1.43 (.63)	d = 0.26
Parent DBD—ODD†	1.20 (.69)	0.90 (.59)	d = 0.45
Parent SSRS Social Skills Total Score	41.8 (9.1)	44.4 (11.2)	d = 0.26

Note. B-then-B=began with behavioral treatment and then received higher dose behavioral treatment, B-then-M=began with behavioral treatment then added medication treatment, IRR=incidence rate ratio, DBD=Disruptive Behavior Disorders Rating Scale (scores are average scale scores, range 0–3), ADHD=attention deficit hyperactivity disorder, ODD=Oppositional defiant disorder, SSRS=Social Skills Rating Scale. Values are means with standard deviations in parentheses (for continuous outcomes) or asymmetric 95% confidence intervals about the mean (for count outcomes). The IRR is the ratio of the event (e.g., rule violation) incidence rate in one group (here, B-then-M) to the incidence rate in another group (here, B-then-B). The other effect sizes are Cohen’s D with pooled standard deviation (equations 2.5.1 and 2.5.2, pp. 66–67, Cohen, 1988), and are listed such that a positive d reflects an advantage of B-then-M.

^†p<0.10,

^*p<0.05.