STIMULANT-DRUGS IN THE DEVELOPMENTAL-DISABILITIES REVISITED

In this paper, I attempt to update the evidence for a conceptual model published some years ago (Aman, 1982) that strived to account for var iable responses to stimulant medication in children with normal IQ and in those with developmental disabilities. This model accounted for su ch variations in terms of differences in breadth of attention across c linical groups. Recent reports on the use of stimulant drugs in subjec ts with developmental disabilities were reviewed. The evidence shows t hat children with mental retardation and ADHD often benefit from such medication, although their response rate seems to be somewhat lower th an that of ADHD children of normal IQ. There is a paucity of stimulant drug research with children having autism, but it is clear that some of them also benefit from stimulant medication. However, there are als o reports of adverse behavioral reactions to the stimulants in some ch ildren with autism or PDD. Several studies examining predictor variabl es were reviewed. Breadth of attention, IQ, and mental age have been u seful in predicting outcome in a number of studies, and I argue that t his supports the model. There is a continuing need for stimulant drug research in children with developmental disabilities, especially in th ose with autism. There is also merit in assessing cognitive variables suggested by the model as well as demographic and clinical variables f or their ability to predict clinical response in these children.