A continuing concern in clinical child psychopharmacology is developing treatment evaluation procedures that are more scientifically rigorous and ecologically valid than the ones that are popularly used at the present time. One potential model for such a procedure is school-based medication evaluation. This article describes some of the practical considerations associated with its implementation based on experience with 35 consecutive cases over a 6-year period.
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References
1.
Abikoff, H., & Gittelman, R. (1985). Classroom Observation Code: A modification of the Stony Brook Code. Psychopharmacology Bulletin, 21, 901–909.
2.
Aman, M.G., Singh, N.N., Stewart, A.W., & Field, C.J. (1985a). The Aberrant Behavior Checklist: A behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency, 89, 485–491.
3.
Aman, M.G., Singh, N.N., Stewart, A.W., & Field, C.J. (1985b). Psychometric characteristics of the Aberrant Behavior Checklist. American Journal of Mental Deficiency, 89, 492–502.
4.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders-Revise. (3rd ed.). Washington, DC: Author.
5.
Atkins, M.S., Pelham, W.E., & Licht, M.H. (1989). The differential validity of teacher ratings of inattention/overactivity and aggression. Journal of Abnormal Child Psychology, 17, 423–435.
6.
Barkley, R.A. (1990). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford.
7.
Barkley, R.A., Fischer, M., Newby, R.F., & Breen, M.J. (1988). Development of a multi-method clinical protocol for assessing stimulant drug response in children with attention deficit disorder. Journal of Clinical Child Psychology, 17, 14–24.
8.
Bennett, F.C., & Sherman, R. (1983). Management of childhood “hyperactivity” by primary care physicians. Journal of Developmental and Behavioral Pediatrics, 4, 88–93.
9.
Biederman, J., Newcorn, J., & Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. American Journal of Psychiatry, 148, 564–577.
10.
Bosco, J.J., & Robin, S.S. (1976). Ritalin Usage: A challenge to teacher education. Peabody Journal of Education, 53, 187–193.
11.
Brulle, A.R., Barton, L.E., & Foskett, J.J. (1983). Educator/physician interchanges: A survey and suggestions. Education & Training of the Mentally Retarded, 18, 313–317.
12.
Conners, C.K. (1973). Rating scales for use in drug studies with children. Psychophar-macology Bulleti. (Special Issue, Pharmacotherapy of Children), pp. 24–84.
13.
Copeland, L., Wolraich, M., Lindgren, S., Milich, R., & Woolson, R. (1987). Pediatricians' reported practices in the assessment and treatment of attention deficit disorders. Journal of Developmental and Behavioral Pediatrics, 8, 191–197.
14.
Epstein, M.H., Cullinan, D., & Gadow, K.D. (1986). Teacher ratings of hyperactivity in learning disabled, emotionally disturbed, and mentally retarded children. The Journal of Special Education, 20, 219–229.
15.
Fine, S., & Jewesson, B. (1989). Active drug placebo trial of methylphenidate: A clinical service for children with an attention deficit disorder. Canadian Journal of Psychiatry, 34, 447–449.
16.
Gadow, K.D. (1976, April). Psychotropic and anticonvulsant drug usage in early childhood special eduction programs I. Phase One: A preliminary report: Prevalence, attitude, training and problems. Paper presented at the annual meeting of the Council for Exceptional Children, Chicago. (ERIC Document Reproduction Service No. ED 125 198)
17.
Gadow, K.D. (1982). School involvement in pharmacotherapy for behavior disorders. The Journal of Special Education, 16, 385–399.
Gadow, K.D. (1986a). Children on medication (Vol. 1): Hyperactivity, learning disabilities, and mental retardation. Austin, TX: PRO-ED.
20.
Gadow, K.D. (1986b). Peer conflict scale. State University of New York, Department of Psychiatry, Stony Brook. (Available from author)
21.
Gadow. K.D. (1986c). Stimulant side effects checklist. State University of New York, Department of Psychiatry, Stony Brook. (Available from author)
22.
Gadow, K.D. (1992). Pediatric psychophar-macotherapy: A review of recent research. Journal of Child Psychology and Psychiatry, 33, 153–195.
23.
Gadow, K.D. (in press). A school-based medication evaluation program. In J.L. Matson (Ed.), Handbook of hyperactivity in children. Elmsford, NY: Pergamon.
24.
Gadow, K.D., Nolan, E.E., & Sverd, J. (1992). Methylphenidate in hyperactive boys with comorbid tic disorder: II. Shortterm behavioral effects in school settings. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 462–471.
25.
Gadow, K.D., Nolan, E.E., Paolicelli, L.M., & Sprafkin, J. (1991). A procedure for assessing the effects of methylphenidate on hyperative children in public school settings. Journal of Clinical Child Psychology, 20, 268–276.
26.
Gadow, K.D., Nolan, E.E., Sverd, J., Sprafkin, J., & Paolicelli, L. (1990). Methylphenidate in aggressive-hyperactive boys: I. Effects on peer aggression in public school settings. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 710–718.
27.
Gadow, K.D., & Paolicelli, L.M. (1986). Global tick rating scale. State University of New York, Department of Psychiatry, Stoney Brook. (Available from author)
28.
Gadow, K.D., Paolicelli, L.M., Nolan, E.E., Schwartz, J., Sprafkin, J., & Sverd, J. (1992). Methylphenidate in aggressive-hyperactive boys: II. Indirect effects of medication treatment on peer behavior. Journal of Child and Adolescent Psychophar-macology, 2, 49–61.
29.
Gadow, K.D., Pomeroy, J.C., & Nolan, E.E. (1992). A procedure for monitoring stimulant medication in hyperactive mentally retarded school children. Journal of Child and Adolescent Psychopharmacology, 2, 131–143.
30.
Gadow, K.D., & Sprafkin, J. (1987). Stony Brook child psychiatric checklist–3R. Department of Psychiatry, State University of New York, Stony Brook. (Available from author)
31.
Gittelman-Klein, R., Klein, D.F., Abikoff, H., Katz, S., Gloisten, A.C., & Kates, W. (1976). Relative efficacy of methylphenidate and behavior modification in hyperkinetic children: An interim report. Journal of Abnormal Child Psychology, 4, 361–379.
32.
Goyette, C.H., Conners, C.K., & Ulrich, R.F. (1978). Normative data on revised Conners Parent and Teacher Rating Scales. Journal of Abnormal Child Psychology, 6, 221–236.
33.
Grayson, P., & Carlson, G.A. (1991). The utility of a DSM-III-R-based checklist in screening child psychiatric patients. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 669–673.
34.
Halperin, J.M., O'Brien, J.D., Newcorn, J.H., Healey, J.M., Pascualvaca, D.M., Wolf, L.E., & Young, J.G. (1990). Validation of hyperactive, aggressive, and mixed hyperactive/aggressive childhood disorders: A research note. Journal of Child Psychology and Psychiatry, 31, 255–259.
35.
Howell, D.C. (1982) Statistical methods for psychology. Boston: PWS Publishers.
36.
Jensen, P.S., Xenakis, S.N., Shervette, R.E., Bain, M.W., & Davis, H. (1989). Diagnosis and treatment of attention deficit disorder in two general hospital clinics. Hospital and Community Psychiatry, 40, 708–712.
37.
Loney, J. (1984). A short parent scale for sub-grouping childhood hyperactivity and aggression. Poster presented at the annual meeting of the American Psychological Association, Toronto.
38.
Loney, J., & Milich, R. (1982). Hyperactivity inattention, and aggression in clinical practice. In M. Wolraich & D.K. Routh (Eds.), Advances in developmental and behavioral pediatric. (Vol. 3, pp. 113–147). Greenwich, CT: JAI Press.
39.
Loney, J., & Ordona, T.T. (1975). Using cerebral stimulants to treat minimal brain dysfunction. American Journal of Orthopsychiatry, 45, 564–572.
40.
McBride, M.C. (1988). An individual double-blind crossover trial for assessing methylphenidate response in children with attention deficit disorder. Journal of Pediatrics, 113, 137–145.
41.
Milich, R., & Fitzgerald, G. (1985). Validation of inattention/overactivity and aggression ratings with classroom observations. Journal of Consulting and Clinical Psychology, 53, 139–140.
42.
Milich, R., & Landau, S. (1988). Teacher ratings of inattention/overactivity and aggression: Cross validation with classroom observations. Journal of Clinical Child Psychology, 17, 92–97.
43.
Neisworth, J.T., Kurtz, P.D., Ross, A., & Madle, R.A. (1976). Naturalistic assessment of neurological diagnoses and pharmacological intervention. Journal of Learning Disabilitie., 9149–152.
44.
Newton, J. (1982). Psychoactive medication in a large urban school district. Journal of School Health, 52, 495–497.
45.
Nolan, E.E., & Gadow, K.D. (1992). Relationship between ratings and observations of stimulant drug response in hyperactive children. Manuscript submitted for publication.
46.
Nolan, E.E., Gadow, K.D., & Sverd, J. (1992). Assessing tic disorders in naturalistic settings. Unpublished manuscript.
47.
Ottinger, D.R., Halpin, B., Miller, M., Demian, L., & Hannemann, R. (1985). Evaluating drug effectiveness in an office setting for children with attention deficit disorders. Clinical Pediatrics, 24, 245–251.
48.
Pelham, W.E., & Hoza, J. (1987). Behavioral assessment of psychostimulant effects on ADD children in a summer day treatment program. In R. Prinz (Ed.), Advances in behavioral assessment of children and familie. (Vol. 3, pp. 3–34). Greenwich, CT: JAI Press.
49.
Robin, S.S., & Bosco, J.J. (1973). Ritalin for school children: The teacher's perspective. Journal of School Health, 43, 624–628.
50.
Safer, D.J., & Allen, R.P. (1976). Hyperactive children: Diagnosis and medical management. Baltimore: University Park Press.
51.
Safer, D.J., & Krager, J.M. (1988). A survey of medication treatment for hyperactive/inattentive students. Journal of the American Medical Association, 260, 2256–2258.
52.
Sandoval, J., Lambert, N.M., & Yandell, W. (1976). Current medical practice and hyperactive children. American Journal of Orthopsychiatry, 46, 323–334.
53.
Sindelar, P.T., & Meisel, C.J. (1982). Teacher–physician interaction in the treatment of children with behavioral disorders. International Journal of Partial Hospitalization, 1, 271–277.
54.
Singh, N.N., Epstein, M.H., Luebke, J., & Singh, Y.N. (1990). Psychopharmacological interventions I: Teacher perceptions of psychotropic medication for seriously emotionally disturbed students. The Journal of Special Education, 24, 283–295.
55.
Sleator, E.K., & von Neumann, A. (1974). Methylphenidate in the treatment of hyperkinetic children. Clinical Pediatrics, 13, 19–24.
56.
Slimmer, L.W., & Brown, R.T. (1985). Parents' decision-making process in medication administration for control of hyperactivity. Journal of School Health, 55, 221–225.
57.
Solomons, G. (1973). Drug therapy: Initiation and follow-up. Annals of the New York Academy of Sciences, 205, 335–344.
58.
Sprafkin, J., & Gadow, K.D. (1987). An observational study of emotionally disturbed and learning-disabled children in school settings. Journal of Abnormal Child Psychology, 15, 393–408.
59.
Sprafkin, J., Grayson, P., Gadow, K.D., Nolan, E.E., & Paolicelli, L.M. (1986). Code for observing social activity (COSA). State University of New York, Department of Psychiatry and Behavioral Science, Stony Brook. (Available from author)
60.
Sprague, R.L., & Sleator, E.K. (1975). What is the proper dose of stimulant medication in hyperactive children?International Journal of Mental Healt., 4, 75–104.
61.
Swanson, J.M., & Kinsbourne, M. (1978). Should you use stimulants to treat the hyperkinetic child?Modern Medicin., 46, 71–80.
62.
Ullmann, R., & Sleator, E.K. (1986). Responders, nonresponders, and placebo responders among children with attention deficit disorder. Clinical Pediatrics, 25, 594–599.
63.
Varley, C.K., & Trupin, E.W. (1983). Double-blind assessment of stimulant medication for attention deficit disorder: A model for clinical application. American Journal of Orthopsychiatry, 53, 542–547.
64.
Weithorn, C.J., & Ross, R. (1975). Who monitors medication?Journal of Learning Disabilitie., 8, 458–461.