Table 6.

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

Outcome	M-then-M	M-then-B	Effect Size
Classroom rule violations per hour	14.5 [9.5, 22.1]	17.1 [10.9, 26.9]	IRR = 1.18
Out-of-class disciplinary events per school year†	2.2 [0.8, 6.6]	8.2 [3.5, 19.6]	IRR = 3.66
Teacher DBD—ADHD	1.21 (.63)	1.43 (.71)	d = −0.34
Teacher DBD—ODD†	0.70 (.52)	1.15 (.91)	d = −0.61
Teacher SSRS Social Skills Total Score	32.2 (6.2)	28.8 (11.0)	d = −0.39
Parent DBD—ADHD	1.38 (.60)	1.62 (.63)	d = −0.38
Parent DBD—ODD†	1.02 (.65)	1.33 (.73)	d = −0.46
Parent SSRS Social Skill Total Score	44.5 (11.2)	44.0 (9.6)	d = −0.05

Note. M-then-M=began with medication treatment and then received higher dose medication treatment, M-then-B=began with medication treatment and then added behavioral 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, M-then-B) to the incidence rate in another group (here, M-then-M). 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 M-then-B.

^†p<0.10.