Prediction of clinical response in children taking methylphenidate.
Young age plus weak memory and slow lab play predict strong methylphenidate response in kids with ADHD.
01Research in Context
What this study did
Dunlap et al. (1991) looked for early clues that tell us which kids with ADHD will do well on methylphenidate.
They gave the drug to a group of children and watched age, memory, and two lab games.
Then they asked doctors how the kids were doing in real life.
What they found
Younger kids with weaker memory and slower game scores improved most on the medicine.
These three signs explained about half of the good results.
Oddly, better lab scores did not always mean better behavior at home or school.
How this fits with other research
Bart et al. (2010) later showed the same drug can also boost motor skills in kids who have both ADHD and coordination disorder.
Liang et al. (2018) used huge health records and found that staying on the drug for ninety days cuts suicide-attempt risk.
Dicesare et al. (2005) warn that the pill can flip the reason a child acts out, so you may need a new functional analysis after dose changes.
Together the four papers say: the drug helps, but the helpful part differs by age, skill set, and what you measure.
Why it matters
You can guess who will benefit before you start. Pick the youngest kids with the poorest memory and slowest game times first.
Keep checking real-life behavior, not just computer scores.
And redo your FA if the child starts or stops the pill.
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02At a glance
03Original abstract
Twenty-six children having Attention Deficit Hyperactivity Disorder were tested before and after treatment with methylphenidate. In addition to standardized parent and teacher rating scales, each child was assessed on a variety of psychomotor tests with an emphasis on attentional constructs. Relatively few of the performance tests, administered prior to medication, predicted clinical response to medication. However, chronological age and performance on a memory distraction task and on the Graduated Holes Task (Kløve, 1963) were moderately correlated with clinical outcome. Using stepwise multiple regression analyses to predict outcome, age and the psychomotor tasks predicted about 50% of outcome variance. There was virtually no relationship between clinical change and change on the performance tests. Findings are discussed with respect to results from previous prediction studies, theoretical models of drug response, and clinical management.
Journal of autism and developmental disorders, 1991 · doi:10.1007/BF02284761