Articles
Treatment Effects of Methylphenidate on Behavioral Adjustment in Children With Mental Retardation and ADHD

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ABSTRACT

Objective

The effects of stimulant medication treatment were investigated in children with mental retardation (MR) and attention-deficit/hyperactivity disorder (ADHD).

Method

Parent and teacher behavioral ratings and reports of side effects were obtained for children (N = 24, mean age = 10.9 years, SD = 2.4) during a placebo-controlled, double-blind, crossover treatment trial with 0.15 mg/kg, 0.30 mg/kg, and 0.60 mg/kg b.i.d. dosages of methylphenidate.

Results

The most significant improvements occurred at the 0.60 mg/kg methylphenidate dose for teacher ratings of inattention (p = .024), hyperactivity (p < .001), aggression (p < .001), and asocial behavior (p = .009). No significant improvements, relative to placebo, occurred at the 0.15 mg/kg dosage. Of interest, nearly all significant medication-related behavioral improvements were detected by teachers. However, parents were sensitive raters of side effects, noting more sleeping problems and loss of appetite at the 0.60 mg/kg dose compared with placebo.

Conclusions

These results suggest that symptoms of ADHD can be treated successfully in children with ADHD/MR, and consistent with MTA study results, higher doses were most effective. Furthermore, these improvements were not accompanied by increases in symptoms such as staring, social withdrawal, or anxiety.

Section snippets

PARTICIPANTS

Twenty-four children with ADHD/MR (18 boys and 6 girls) participated in this study. The mean chronological age of these children was 10.9 years (SD = 2.4), the mean IQ (Stanford-Binet, 4th edition) (Thorndike et al., 1986) was 56.5 (SD = 10.24), and the mean mental age (estimated using the Stanford-Binet) was 5.7 years (SD = 1.2). Seventeen children had mild (50+) MR; seven had moderate MR. The ethnic breakdown of these children was as follows: 9 white, 14 African American, and 1 Hispanic. The

RESULTS

The data were analyzed using SPSS-PC (version 10.0) repeated-measures one-way analysis of variance (ANOVA) procedures, with MPH dosage as the within-subjects variable. Because preliminary analyses revealed no significant effects of gender or dose order, these factors were dropped from subsequent analyses. For significant effects, post hoc Student-Newman-Keuls analyses were performed to determine which doses of medication were significantly different from one another (p ≤ .05). Because the

DISCUSSION

Our findings of decreases in ADHD symptomatology with MPH treatment in children with ADHD/MR are consistent with those of previous investigations (e.g., Hagerman et al., 1988;Handen et al. (1991), our participants did not experience significant increases in serious side effects such as staring, social withdrawal, and anxiety at the 0.6 mg/kg dose. In fact, the 0.6 mg/kg b.i.d. MPH dose produced the maximum treatment benefit, but it was also associated with the typical MPH side effects of

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  • Cited by (0)

    This research was supported by NIMH grant R29 MH48212 . The authors thank the parents, teachers, and children who participated in this study. The authors are indebted to John E. Overall, Ph.D., who provided additional statistical consultation.

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