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Efficacy of methylphenidate among mentally retarded children with attention deficit hyperactivity disorder
B L Handen1, A M Breaux, A Gosling
1University of Pittsburgh School of Medicine, Pennsylvania.
Insights
Methylphenidate effectively improved hyperactivity and attention in children with intellectual disabilities and attention deficit hyperactivity disorder (ADHD). However, it did not enhance learning or social interaction skills.
Area of Science:
- Pediatric Psychiatry
- Neurodevelopmental Disorders
- Child Psychology
Background:
- Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder.
- Intellectual disability (ID) is characterized by deficits in intellectual and adaptive functioning.
- Comorbidity of ADHD and ID presents unique treatment challenges.
Purpose of the Study:
- To evaluate the efficacy of methylphenidate in children with both ID and ADHD.
- To assess methylphenidate's impact on behavioral, academic, and social domains.
- To compare treatment response in this population to non-retarded individuals.
Main Methods:
- Double-blind, placebo-controlled crossover study design.
- Inclusion of 12 children meeting diagnostic criteria for ADHD and IQ scores between 50-74.
- Assessment using behavioral ratings, academic output, laboratory attention/learning tasks, and social behavior observations.
Main Results:
- 75% of subjects showed improvement on the Conners Hyperactivity Index with methylphenidate.
- Significant increases in work output, on-task behavior, and attentional skills were observed.
- No significant improvements in learning or social interactions were associated with methylphenidate treatment.
Conclusions:
- Methylphenidate is effective in managing hyperactivity and attention deficits in children with ID and ADHD.
- Treatment gains in attention did not translate to improved learning outcomes.
- Children with ID and ADHD respond to methylphenidate similarly to the non-retarded population regarding specific domains.
Abstract:
Twelve children with IQ scores of 50 to 74 (educable mental retardation) who met rigorous diagnostic criteria for attention deficit hyperactivity disorder participated in a double-blind crossover study of the efficacy of two doses of methylphenidate compared with placebo. Dependent measures included behavioral ratings, classroom work output, laboratory measures of attention and learning, and direct observations of social behavior. Improvement with medication on the Conners Hyperactivity Index was observed in 75% of subjects. Significant increases in work output, on-task behavior, and attentional skills were associated with methylphenidate. However, gains in measures of attention were not associated with improvement in learning, as measured by a paired associate learning task. Additionally, no significant increases in appropriate social interactions during free play were associated with methylphenidate. The results suggest that mentally retarded children with attention deficit hyperactivity disorder respond to methylphenidate at similar rates and in similar domains to that of the nonretarded population.