Interventions for Children With Attention and Reading Disorders

The objective of this randomized clinical trial is to address unanswered questions about the
relative effectiveness of treatments for children with both Attention Deficit Hyperactivity
Disorder (ADHD) and significant reading difficulties (RD). The study evaluates attentional
and word reading outcomes for students with both conditions when provided with either (a)
disorder-specific ADHD treatment (carefully managed medication + parent training), (b)
disorder-specific RD treatment (intensive, individualized reading instruction), or (c) the
combination of ADHD and RD treatment. The study aims to address the relative benefits of
providing either disorder-specific ADHD or RD treatment alone and providing the combined
treatment. The investigators hypothesize that the combined treatment approach will result in
better outcomes in terms of both word reading/decoding and a reduction in ADHD symptoms than
either of the disorder-specific treatments alone. Treatment will last for 16 weeks, with
assessment prior to and following treatment and some measures collected regularly throughout
the intervention periods.

Inclusion Criteria:

1. Meet criteria for ADHD, Combined Type or ADHD, Predominantly Inattentive Type based
on the DISC-IV parent interview, Teacher baseline SNAP endorses additional
non-overlapping Inattentive symptoms with the parent DISC, which when combined with
the parent ratings result in endorsement of 6 or more symptoms required for diagnosis
by the Diagnostic and Statistical Manual.

2. Have at least 4 symptoms of inattention rated "Often" or "Very Often" on the teacher
version of the SNAP-IV.

3. Have a standard score of 90 or lower on either the Woodcock-Johnson III Tests of
Achievement Letter-Word Identification or Word Attack Subtests, or on the Basic
Reading Skills Cluster

4. Attend a participating school in Grades 2-5

5. Have at least one parent or guardian who understands English well enough to
participate in the behavioral parent training intervention.

6. Have a Full Scale OR Non-Verbal IQ estimate higher than 70 based on the IQ Composite
and Non-Verbal IQ estimate of the Kaufman Brief Intelligence Test (KBIT-2).

Exclusion Criteria:

1. Any documented or suspected bipolar disorder, severe psychosis, or other severe
emotional disturbance, developmental disability, or autism.

2. Receipt of primary school reading instruction in a language other than English.

3. A history or presence of cardiovascular problems that would contraindicate stimulant
treatment.

4. Chronic vocal tics.

5. Children will be excluded if they are taking a concomitant medication that has the
potential to significantly affect their ADHD symptoms, that would be contraindicated
to take along with the study medication, or if they have not been on a stable dose of
a psychotropic medication long enough to fully assess the clinical outcome or
tolerability.