Using permuted blocks of four, we randomly assigned households to receive ivermectin or malathion . The randomization plan was generated by the Merck Research Laboratories statistical group and was sent to the contractor who offered the treatment packages. Eligible households were designated another available treatment package. The schedule was not uncovered to investigators until following the database was finalized. Statistical Evaluation The primary objective of establishing noninferiority required data to be analyzed according to both the intention-to-treat and per-protocol principles.Counseling, called psychotherapy also, can play a significant part in treatment by helping to develop increased awareness of ineffective habits. Therapy may also be a way to develop actions to build organizational and setting up skills. However, no current research has demonstrated that counseling alone will eliminate the actual symptoms of ADHD; rather, counseling can become more effective once an effective medication is available. Medication will ‘start the engine’ but not necessarily provide a way to ‘steer.’ Basically, counseling may help with issues of marital instability or poor interpersonal abilities but by itself will not end inattention, impulsivity, or emotions of restlessness.