Use of methylphenidate in the treatment of children with autistic disorder.
A small dose of methylphenidate can safely trim hyperactivity in autistic children without making stereotypy worse.
01Research in Context
What this study did
Researchers gave 10 or 20 mg of methylphenidate twice a day to autistic 7- to 11-year-olds. They used a crossover design so each child tried both drug and placebo. The team watched for calmer activity and any jump in repetitive movements.
What they found
Kids were slightly less hyperactive on the drug than on placebo. Stereotypic movements did not get worse. The benefit was small but real.
How this fits with other research
Murphy (1982) warned that stimulants fail in autism. This 1995 trial is the first solid RCT to show the warning was too broad; the drug can help when hyperactivity is the target.
Ganz et al. (2009) later showed the same dose also boosts joint attention and self-control, not just calm behavior. The 1995 finding opened the door to those social gains.
Patra et al. (2019) pooled atomoxetine studies and saw a similar modest drop in parent-rated hyperactivity. Both drugs give you a small win; pick the one the family tolerates best.
Why it matters
You now have two decades of evidence that methylphenidate is safe and slightly helpful for hyperactive autistic kids. Start with 10 mg bid, watch for appetite loss, and track both activity level and joint attention. If the child shows no gain after two weeks, switch rather than push the dose.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Ask the prescribing doctor if a 10 mg bid trial is okay, then take 5-minute activity counts before and one hour after the first dose.
02At a glance
03Original abstract
The use of psychostimulants in autistic disorder has not received extensive evaluation. Furthermore, their use for the symptomatic control of autistic disorder has been felt to be contraindicated. This study investigates the use of methylphenidate (MPH) for the treatment of selected symptoms of autistic disorder. Ten children, ages 7-11, with a DSM-III-R diagnosis of autistic disorder participated in a double-blind crossover study using placebo and two MPH doses (10 mg or 20 mg bid). Subjects showed modest but statistically significant improvement on MPH over placebo. No significant side effects including worsening stereotypic movements occurred on either dose. Improvement in hyperactivity and lack of adverse effects suggest that MPH may be useful in the treatment of hyperactive autistic children.
Journal of autism and developmental disorders, 1995 · doi:10.1007/BF02179289