8. How were children selected for this study? In all instances, the child's parents contacted the investigators to learn more about the study, after first hearing about it through local pediatricians, other health care providers, elementary school teachers, or radio/newspaper announcements. Children and parents were then carefully interviewed to learn more about the nature of the child's symptoms, and rule out the presence of other conditions or factors that may have given rise to the child's difficulties. In addition, extensive historical information was gathered and diagnostic interviews were conducted, in order to establish whether or not the child exhibited the long-standing pattern of symptoms characteristic of ADHD across home, school, and peer settings. If children met full criteria for ADHD and study entry (and many did not), informed parental consent with child assent and school permission were received, the children and families were eligible for study entry and randomization. Children who had behavior problems but not ADHD were not eligible for study participation.

9. Where is this study taking place? Research sites include the New York State Psychiatric Institute at Columbia University, New York, N.Y.; Mount Sinai Medical Center, New York, N.Y.; Duke University Medical Center, Durham, N.C.; University of Pittsburgh; Pittsburgh, PA.; Long Island Jewish Medical Center, New Hyde Park, N.Y.; Montreal Children's Hospital, Montreal, Canada; University of California at Berkeley; and University of California at Irvine, CA.

10. How much money has been spent on this study? The study was jointly funded by the NIMH and the Department of Education, with costs totaling just over $11 million dollars.

11. What is Attention Deficit Hyperactivity Disorder (ADHD)? ADHD refers to a family of related chronic neurobiological disorders that interfere with an individual's capacity to regulate activity level (hyperactivity), inhibit behavior (impulsivity), and attend to tasks (inattention) in developmentally appropriate ways. The core symptoms of ADHD include an inability to sustain attention and concentration, developmentally inappropriate levels of activity, distractibility, and impulsivity. Children with ADHD have functional impairment across multiple settings including home, school, and peer relationships. ADHD has also been shown to have long-term adverse effects on academic performance, vocational success, and social-emotional development. Children with ADHD experience an inability to sit still and pay attention in class and the negative consequences of such behavior. They experience peer rejection and engage in a broad array of disruptive behaviors. Their academic and social difficulties have far-reaching and long-term consequences. These children have higher injury rates. As they grow older, children with untreated ADHD, in combination with conduct disorders experience drug abuse, antisocial behavior, and injuries of all sorts. For many individuals, the impact of ADHD continues into adulthood.

12. What are the symptoms of ADHD? (a) Inattention. People who are inattentive have a hard time keeping their mind on one thing and may get bored with a task after only a few minutes. Focusing conscious, deliberate attention to organizing and completing routine tasks may be difficult. (b) Hyperactivity. People who are hyperactive always seem to be in motion. They can't sit still; they may dash around or talk incessantly. Sitting still through a lesson can be an impossible task. They may roam around the room, squirm in their seats, wiggle their feet, touch everything, or noisily tap a pencil. They may also feel intensely restless. (c) Impulsivity. People who are overly impulsive seem unable to curb their immediate reactions or think before they act. As a result, they may blurt out answers to questions or inappropriate comments, or run into the street without looking. Their impulsivity may make it hard for them to wait for things they want or to take their turn in games. They may grab a toy from another child or hit when they are upset.

13. How is ADHD related to ADD? In the early 1980s, DSM-III dubbed the syndrome Attention Deficit Disorder, or ADD, which could be diagnosed with or without hyperactivity. This definition was created to underline the importance of the inattentiveness or attention deficit that is often, but not always, accompanied by hyperactivity. The revised 3^rd edition of DSM-III-R, published in 1987, returned the emphasis back to the inclusion of hyperactivity within the diagnosis, with the official name of ADHD. With the publication of DSM-IV, the name ADHD still stands, but there are different subject types within this classification, to include symptoms of both inattention and hyperactivity-impulsivity, signifying that there are some individuals in whom one or another pattern is predominant (for at least the past 6 months). Thus, the term "ADD" (though no longer current) should be understood to be subsumed under the general family of conditions now called ADHD.

14. How is ADHD diagnosed? The diagnosis of ADHD can be made reliably using well-tested diagnostic interview methods. Diagnosis is based on history and observable behaviors in the child's usual settings. Ideally, a health care practitioner making a diagnosis should include input from parents and teachers. The key elements include a thorough history covering the presenting symptoms, differential diagnosis, possible comorbid conditions, as well as medical, developmental, school, psychosocial, and family histories. It is helpful to determine what precipitated the request for evaluation and what approaches had been used in the past. As of yet, there is no independent test for ADHD. This is not unique to ADHD, but applies as well to most psychiatric disorders, including other disabling disorders such as schizophrenia and autism.

15. How many children are diagnosed with ADHD? ADHD is the most commonly diagnosed disorder of childhood, estimated to affect 3 to 5 percent of school-age children, and occurring three times more often in boys than in girls. On average, about one child in every classroom in the United States needs help for this disorder.

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