Response to Stimulant Medication across Six Measures of School-Related Performance in Children with ADHD and Disruptive Behavior

Abstract

Children with attention deficit hyperactivity disorder display disruptive behavioral disorders that tend to interfere with academic and social progress and that may respond only partially to classroom management and motivational approaches. Although stimulant medication is seen as a necessary adjunct to treatment in many cases, measurement of response to such treatment is often quite problematic. The present study provides findings on response to treatment with methylphenidate (Ritalin) across six measures of cognitive, academic, and social functioning in 71 boys, ages 7 to 11 years, with attention deficit hyperactivity disorder. Optimal response to this drug was determined in double-blind, placebo, crossover trials, and measurement of response focused on procedures similar to those in actual practice. Response ranged from approximately 18 to 71% across the six measures, suggesting that whether a child can be considered a responder to methylphenidate depends greatly on choice of outcome measure. A clinically therapeutic dosage level for each subject was also used to examine dose effects, and factor analytic results suggest that three of the six measures appeared to tap child behaviors quite different from those measured by traditional means.