ATTENTION-DEFICIT DISORDER AND METHYLPHENIDATE - NORMALIZATION RATES,CLINICAL EFFECTIVENESS, AND RESPONSE PREDICTION IN 76 CHILDREN

Objective: To evaluate the magnitude and clinical significance of meth ylphenidate (MPH) effects on the classroom behavior and academic perfo rmance of 76 children with attention deficit disorder/hyperactivity (A DDH). Method: A double-blind, placebo controlled, within-subject(cross over) experimental design was used to evaluate acute MPH effects at fo ur dose levels (5 mg, 10 mg, 15 mg, and 20 mg) on children's attention , academic functioning, and behavior in regular classroom settings. Re sults were contrasted with a normal control sample. Results: Standard statistical analysis revealed MPH effects on classroom functioning tha t were primarily linear. Analysis of the clinical significance of effe cts indicated that large proportions of treated children exhibited sig nificantly improved or normalized classroom functioning; however, a la rge subset of them failed to show improved academic functioning. Overa ll, children failing to respond at lower dose levels have a high proba bility of improving or becoming normalized as a function of increasing dose. Conclusions: For a majority of children with ADDH, MPH results in significantly improved or normalized attention and classroom behavi or. A significant subset, however, fail to realize gains in their acad emic functioning and will require supplemental interventions.