Kratter 1983

Methods	Randomized controlled trial, but used a modified randomization method to ensure the medicated subjects were equally distributed between the 3 groups Dissertation submitted to the faculty of the Department of Psychology at St. John's University, New York in 1983
Participants	24 boys from the Five Towns area of Lang Island, New York, USA diagnosed with ADHD (DSM‐III) based on parent and child interviews Age range 93 to 142 months (mean = 120.63 months) Participants had a minimum score of 15 on the Abbreviated Parent‐Teacher Questionnaire and were free from neurological disease or psychosis. The participants who received stimulants were equally assigned into each group
Interventions	Three intervention groups: 1. Meditation training (MT): individual sessions twice weekly for 4 weeks. Meditation technique was modified from Benson 1975 and Carrington 1975: repeating the word "Ahnam" out loud and progressively more softly until the word was repeated silently. The actual meditation duration was gradually increased from 2 minutes to 8 minutes by the end of the 4‐week training period. Practice was at least 3 times per week at home. 2. Relaxation training (RT): individual sessions twice weekly for 4 weeks, using modified progressive muscle relaxation by reduction in the number of muscle groups when compare to the standard progressive muscle relaxation, deep and slowing breathing phase before and after the tension‐relaxation cycles and 5‐second tension periods. The actual relaxation training duration was gradually increased from 2 minutes to 8 minutes by the end of 4 weeks. Practice was at least 3 times per week at home. 3. Waiting list controls (WLC): received no experimental manipulation
Outcomes	1. Matching Familiar Figure Test (MFFT) Kagan 1966 which measures the dimension of reflection‐impulsivity by participants choosing identical pictures from an array of 6 variants. Errors reflect impulsivity. 2. Fruit Distraction Test (FDT) Santostefano 1978 which tests the selective deployment of attention between relevant and irrelevant stimuli by naming the color with and without distraction and contradictions 3. Nowicki‐Strickland Locus of Control Scale (LCS) which is used in the identification of hyperactive children and to evaluate treatment effectiveness (consists of 39‐items; 4‐point scale) 4. Abbreviated Parent ‐Teacher Questionnaire (PTQ)Conners 1973 consisted of 10 overlapping items from the Conners' Teacher Rating Scale and the Parent Symptoms Questionnaire 5. Werry‐Weiss‐Peters Activity Scale (WWPAS) Werry 1968: a rating scale which assesses activity level in specific situations
Notes	Parents were to be included in the training sessions Results table did not show number in each group. Data cannot be used in meta‐analysis.
Risk of bias
Bias	Authors' judgement	Support for judgement
Adequate sequence generation?	Unclear risk	Quote: "were randomly assigned to one of three conditions" Quote: "subjects who received stimulant medication... were assigned in a modified random fashion such that they were represented in approximately equal numbers" Comment: the randomization was not adequately done
Allocation concealment?	Unclear risk	Comment: No mention about allocation concealment.
Blinding? All outcomes	High risk	Comment: the intervention cannot be blinded. No description of blinding of the assessors.
Incomplete outcome data addressed? All outcomes	Unclear risk	Comment: no mention of attrition
Free of selective reporting?	Low risk	Comment: all outcomes were reported as mentioned in the method section
Free of other bias?	Low risk