The authors limited their outcome measures to differences between pre- and posttreatment ratings of ADHD symptoms, using ADHD-specific scales, ADHD questionnaires, or direct observations. This may have been particularly relevant to interpretation of the outcomes of the behavioral treatments because behavioral therapies such as parent behavioral training may improve other aspects of a child’s behavior, such as parent-child interactions or oppositional behavior, neither of which was assessed in this meta-analysis. Similarly, for the behavioral treatments, teacher ratings were considered more “blind” than parent ratings. It is also possible that the behavioral interventions, many of which relied on parent training, were effective in the home but did not generalize to school. The elimination of efficacy in the most proximal assessment to the probably blinded assessment also raises the question of what qualifies as a positive outcome. Family conflict is a known consequence of ADHD. We also know a great deal about the power of the placebo effect. Thus, if the “unblinded” parent distinguishes an improvement that is not detected by the teacher or observer, perhaps it is still a valid measure of improvement.