Predicting methylphenidate response in children with ADHD: Theoretical, empirical, and conceptual models

Objective: To evaluate the theoretical merit and empirical validity of mode ls designed to predict response to methylphenidate (MPH) among children wit h attention-deficit/hyperactivity disorder (ADHD). Method: Seventy-six chil dren with ADHD received each of 4 counterbalanced doses of MPH (5, 10, 15, and 20 mg) in the context of a double-blind, placebo-controlled, within-sub ject (crossover) experimental design. Logical and conceptual foundations of 3 models of MPH response were subjected to critical scrutiny, and patterns of relationship anticipated on the basis of these models were subjected to empirical analysis. Results: The conceptual foundations of all reviewed mo dels were found to be substantially flawed, and none provided an adequate e mpirical basis for predicting response to MPH among children with ADHD. Con clusions: The observed pattern of relationships suggests that magnitudes of response to MPH in domains of classroom attention and behavioral disinhibi tion are correlated and differentially predictive of response on measures o f academic performance and teacher-rated behavior.