ALL |
META-ANALYSIS |
CITATIONS |
|
Benefit-Cost Summary Statistics Per Participant | ||||||
---|---|---|---|---|---|---|
Benefits to: | ||||||
Taxpayers | $3,006 | Benefits minus costs | $2,475 | |||
Participants | $5,095 | Benefit to cost ratio | $1.54 | |||
Others | $738 | Chance the program will produce | ||||
Indirect | ($1,818) | benefits greater than the costs | 57% | |||
Total benefits | $7,021 | |||||
Net program cost | ($4,546) | |||||
Benefits minus cost | $2,475 | |||||
Meta-Analysis of Program Effects | ||||||||||||
Outcomes measured | Treatment age | Primary or secondary participant | No. of effect sizes | Treatment N | Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis | Unadjusted effect size (random effects model) | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
First time ES is estimated | Second time ES is estimated | |||||||||||
ES | SE | Age | ES | SE | Age | ES | p-value | |||||
Grade point average^ Non-standardized measure of student performance calculated across subjects. |
9 | Primary | 1 | 67 | 0.161 | 0.193 | 9 | n/a | n/a | n/a | 0.315 | 0.104 |
Test scores Standardized, validated tests of academic achievement. |
9 | Primary | 6 | 353 | 0.038 | 0.085 | 9 | 0.023 | 0.094 | 17 | 0.038 | 0.659 |
Attention-deficit/hyperactivity disorder symptoms Clinical diagnosis of attention-deficit/hyperactivity disorder (ADHD) or symptoms measured on a validated scale. |
9 | Primary | 13 | 741 | -0.165 | 0.064 | 9 | 0.000 | 0.141 | 10 | -0.323 | 0.001 |
Anxiety disorder Clinical diagnosis of an anxiety disorder (e.g., general anxiety, panic, social anxiety, obsessive compulsive disorder) or symptoms measured on a validated scale. |
9 | Primary | 2 | 264 | -0.190 | 0.196 | 9 | -0.075 | 0.108 | 10 | -0.190 | 0.332 |
Disruptive behavior disorder symptoms Clinical diagnosis of a disruptive behavior disorder (e.g., conduct disorder, oppositional defiant disorder) or symptoms measured on a validated scale. |
9 | Primary | 9 | 489 | -0.247 | 0.089 | 9 | -0.136 | 0.079 | 12 | -0.387 | 0.001 |
Externalizing behavior symptoms Symptoms of externalizing behavior (e.g., aggressive, hostile, or disruptive behavior) measured on a validated scale. |
9 | Primary | 1 | 45 | -0.288 | 0.214 | 9 | -0.158 | 0.145 | 12 | -0.288 | 0.177 |
Global functioning^ How well individuals (typically those who are developmentally disabled or seriously mentally ill) have adapted to activities of daily living. |
9 | Primary | 2 | 103 | 0.414 | 0.171 | 9 | n/a | n/a | n/a | 0.613 | 0.114 |
Internalizing symptoms Symptoms of internalizing behavior (e.g., sadness, anxiety, or withdrawal) measured on a validated scale. |
9 | Primary | 2 | 93 | -0.133 | 0.155 | 9 | -0.133 | 0.155 | 11 | -0.219 | 0.157 |
Parental stress^ Stress reported by a parent, typically measured on a validated scale such as the Parental Stress Index. |
43 | Secondary | 1 | 67 | -0.293 | 0.194 | 43 | n/a | n/a | n/a | -0.574 | 0.003 |
Detailed Monetary Benefit Estimates Per Participant | ||||||
Affected outcome: | Resulting benefits:1 | Benefits accrue to: | ||||
---|---|---|---|---|---|---|
Taxpayers | Participants | Others2 | Indirect3 | Total |
||
Anxiety disorder | K-12 grade repetition | $9 | $0 | $0 | $4 | $13 |
Labor market earnings associated with anxiety disorder | $2,097 | $4,939 | $0 | $0 | $7,036 | |
Externalizing behavior symptoms | Criminal justice system | $72 | $0 | $169 | $36 | $278 |
K-12 special education | $278 | $0 | $0 | $139 | $417 | |
Health care associated with externalizing behavior symptoms | $551 | $156 | $568 | $275 | $1,550 | |
Program cost | Adjustment for deadweight cost of program | $0 | $0 | $0 | ($2,273) | ($2,273) |
Totals | $3,006 | $5,095 | $738 | ($1,818) | $7,021 | |
Detailed Annual Cost Estimates Per Participant | ||||
Annual cost | Year dollars | Summary | ||
---|---|---|---|---|
Program costs | $3,676 | 2000 | Present value of net program costs (in 2022 dollars) | ($4,546) |
Comparison costs | $956 | 2010 | Cost range (+ or -) | 40% |
Benefits Minus Costs |
Benefits by Perspective |
Taxpayer Benefits by Source of Value |
Benefits Minus Costs Over Time (Cumulative Discounted Dollars) |
The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in discounted dollars. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment. |
Abikoff, H., Hechtman, L., Klein, R.G., Weiss, G., Fleiss, K., Etcovitch, J., . . . Pollack, S. (2004). Symptomatic improvement in children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. Journal of the American Academy of Child & Adolescent Psychiatry, 43(7), 802-811.
Horn, W.F., Ialongo, N.S., Pascoe, J.M., Greenberg, G., Packard, T., Lopez, M., . . . Puttler, L. (1991). Additive effects of psychostimulants, parent training, and self-control therapy with ADHD children. Journal of the American Academy of Child & Adolescent Psychiatry, 30(2), 233-240.
Huang, Y.H., Chung, C.Y., Ou, H.Y., Tzang, R.F., Huang, K.Y., Liu, H.C., . . . Liu, S.I. (2015). Treatment effects of combining social skill training and parent training in Taiwanese children with attention deficit hyperactivity disorder. Journal of the Formosan Medical Association, 114(3), 260-267.
Klein, R.G., & Abikoff, H. (1997). Behavior therapy and methylphenidate in the treatment of children with ADHD. Journal of Attention Disorders, 2(2), 89-114.
MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit hyperactivity disorder. Archives of General Psychiatry, 56(12), 1073-1086.
Pfiffner, L.J., Yee Mikami, A., Huang-Pollock, C., Easterlin, B., Zalecki, C., & McBurnett, K. (2007). A randomized, controlled trial of integrated home-school behavioral treatment for ADHD, predominantly inattentive type. Journal of the American Academy of Child & Adolescent Psychiatry, 46(8), 1041-1050.
Pfiffner, L.J., Zalecki, C., Kaiser, N.M., Villodas, M., McBurnett, K., Hinshaw, S.P., . . . Zalecki, C. (2014). A two-site randomized clinical trial of integrated psychosocial treatment for ADHD-inattentive type. Journal of Consulting and Clinical Psychology, 82(6), 1115-1127.
Power, T.J., Mautone, J.A., Soffer, S.L., Clarke, A.T., Marshall, S.A., Sharman, J., . . . Jawad, A.F. (2012). A family-school intervention for children with ADHD: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 80(4), 611-623.
Sibley, M.H., Graziano, P.A., Kuriyan, A.B., Coxe, S., Pelham, W.E., Rodriguez, L., . . . Ward, A. (2016). Parent–teen behavior therapy + motivational interviewing for adolescents with ADHD. Journal of Consulting and Clinical Psychology, 84(8), 699-712.
Sibley, M.H., Pelham, W.E., Derefinko, K.J., Kuriyan, A.B., Sanchez, F., & Graziano, P.A. (2013). A pilot trial of Supporting Teens’ Academic Needs Daily (STAND): A parent-adolescent collaborative intervention for ADHD. Journal of Psychopathology and Behavioral Assessment, 35(4), 436-449.
van der Oord, S., Prins, P.J.M., Oosterlaan, J., & Emmelkamp, P.M.G. (2007). Does brief, clinically based, intensive multimodal behavior therapy enhance the effects of methylphenidate in children with ADHD? European Child & Adolescent Psychiatry, 16(1), 48-57.
Webster-Stratton, C., Reid, M.J., & Beauchaine, T.P. (2011). Combining parent and child training for young children with ADHD. Journal of Clinical Child and Adolescent Psychology, 40(2), 191-203.