Effects of methylphenidate on kinematic aspects of handwriting in hyperactive boys

Poor handwriting in hyperactive children often contributes to academic failure. Beneficial effects of methylphenidate on the quality of handwriting have been shown. Using a digitizing tablet, the handwriting of 21 hyperactive boys was examined both during methylphenidate treatment and following withdrawal of the drug. Half of the hyperactive boys were tested first on methylphenidate and then following withdrawal of the drug and the remaining hyperactive boys were examined in the reverse order. Twenty-one control boys underwent the same examination. Velocity and acceleration of handwriting movements were measured. Furthermore, every writing specimen was independently rated by four examiners regarding the quality of handwriting. Following withdrawal of the drug, the quality of handwriting specimens of hyperactive boys was poorer than during treatment with methylphenidate. Statistical comparison of writing movements of hyperactive boys on and off methylphenidate revealed that the medication resulted in a deterioration in handwriting fluency. The results showed that following withdrawal of medication, hyperactive children did not differ from control boys in handwriting movements. The improvement in hyperactive behavior through methylphenidate was associated with increased legibility and greater accuracy of handwriting. The intention to write neatly may interfere with the fluent writing process.     

Prosocial behavior in hyperactive boys: Effects of stimulant medication and comparison with normal boys

To clarify the effects of stimulant medication on hyperactive (ADHD) children's prosocial as well as aversive behaviors toward peers, 19 hyperactive boys, aged 7–12, were observed as they acted as leaders for groups of 2–4 unfamiliar younger children. In a doubleblind crossover design, subjects were observed twice, once on placebo and again on a moderate (0.6 mg/kg) dose of methylphenidate (Ritalin). Thirteen comparison boys, without problems in attention and behavior, were also observed in the same leader roles. Relative to comparison boys, hyperactive boys on placebo were more socially engaged, used more aversive leadership techniques, and were rated as less likable by the younger children in their groups. Aversive social behaviors were the strongest predictors of being disliked by the younger children. No differences were found between comparison and unmedicated hyperactive boys for any aspect of prosocial behavior. Stimulant medication had a general dampening effect on social behavior, significantly reducing social engagement and increasing (mild) dysphoria relative to the placebo condition. The implications of these findings for understanding and treating the peer relationship difficulties of hyperactive children are discussed.This study was conducted at the Fernald Child Study Center, UCLA, and we very much appreciate the contributions of the many staff members of the program, especially those of Alice Huber-Dressler and Tracy Heller. We also are very grateful to staff and children of Corinne A. Seeds University Elementary School for their participation in this study.     

Self-control in hyperactive boys in anger-inducing situations: Effects of cognitive-behavioral training and of methylphenidate

The effects of cognitive-behavioral intervention and methylphenidate on anger control in hyperactive boys were investigated in two studies. The anger-inducing stimuli in both studies involved verbal provocation from peers. Study 1 assessed a brief intervention using self-control strategies, while Study 2 employed a longer training period and a control intervention that focused on enhancement of empathy. Both studies included methylphenidate versus placebo comparisons. Methylphenidate reduced the intensity of the hyperactive boys' behavior but did not significantly increase either global or specific measures of self-control. Cognitive-behavioral treatment, when compared to control training, was more successful in enhancing both general self-control and the use of specific coping strategies. There was no advantage for the combination of methylphenidate plus cognitive-behavioral intervention. Implications for intervention to ameliorate the social and interpersonal difficulties of hyperactive children are discussed.Major support for this study was provided by NIDA grant 01070. This research was also facilitated by a grant from the Spencer Foundation. The many training staff and raters, too numerous to mention individually here, are deserving of our special thanks. We also appreciate the cooperation of Marion Jacobs and the staff of the UCLA Psychology Clinic, where the first study was held, and of Howard Adelman and the staff of Fernald School, where the second study was housed; the clinical and administrative skills of Stephen Alkus, who organized the intervention program for the first study; the talents and diligence of David Neswald, who coordinated much of the videotape scoring; and the ever-present contributions of Doris Finck, who also edited and dubbed the video segments. Medication and placebos were supplied by CIBA-Geigy.     

Effects of positive and negative feedback on behavior control in hyperactive and normal boys

The hypothesis that hyperactive boys have relatively less response to negative feedback than to positive feedback was studied. Sixteen hyperactive boys and 16 controls were compared on two tasks under different feedback conditions. Feedback conditions were no feedback, positive feedback, and negative feedback. Tasks were symbol encoding and correcting spelling words. Hyperactives and controls were compared in amount of time on-task and amount of work correctly completed. Hyperactives were on-task significantly more under conditions of negative feedback than under positive feedback, but negative feedback significantly increased errors on the spelling correction task. Controls were equally responsive to positive, negative, or no feedback. Hyperactives accomplished significantly less than controls on the coding task, but performed as well as controls on the spelling correction task, which was administered to each boy at his own level of spelling ability. The results imply that while consistent negative feedback can reduce off-task behavior for hyperactives, it can also decrease the accuracy of the work they are doing.This research was supported in part by U.S. Public Health Service Training Grant (in Biological Science) No. MH07081. This article is based on a dissertation presented to the Graduate School of Arts and Sciences of Washington University in partial fulfillment of the requirements for the Ph. D. degree. The assistance of Dr. John A. Stern in helping with the preparation of the dissertation is gratefully acknowledged. The generous assistance of Dr. Cynthia Janes in helping prepare this paper is appreciated. The dissertation is available from University Micro-films (Order No. 74-13, 799). The assistance of Ms. B. Talent and Ms. S. Weiner in making reliability checks is gratefully acknowledged.     

Overall nutrient intake of preschool hyperactive and normal boys

Studies examining the relationship between sugar intake of hyperactive children and behavior problems have reported inconsistent results. We hypothesized that if the problem behaviors of attention deficit-disordered children with hyperactivity (ADDH) are exacerbated by food, then this might be due to differences in their background nutrition relative to non-ADDH children. Parents and day care workers of 24 ADDH and 27 non-ADDH preschoolaged boys were trained to keep food diaries for 21 days. Analysis of the last 14 days for each child revealed no differences in overall nutrient intake between the two groups. On the other hand, for 5 ADDH and 3 non-ADDH children the within-subject correlations between daily behavior and sugar intake were significant. We concluded that nutrition-behavior interactions are more likely a function of idiosyncratic sensitivities, rather than a general tendency for ADDH children to eat differently from non-ADDH children.This research was funded by the Alberta Mental Health Research Advisory Council, and by the National Health Research and Development Program of Health and Welfare Canada. We think Jeannine Fraser for help with data analyses.     

The interactions of hyperactive and normal boys with their fathers and mothers

This study examined the interactions of fathers and mothers with their hyperactive and normal children during both free-play and task periods. Eighteen hyperactive and 18 normal boys were observed interacting separately with their mothers and fathers in a playroom setting. Behavioral observations indicated, with minor exceptions, that fathers and mothers did not differ in their interactions with their sons. Substantial differences were found between hyperactive and normal boys in their parent-child interactions, particularly during the task setting. Hyperactive boys were generally less compliant and their parents more directive than normal parent-child dyads. Methodological problems are discussed that may have precluded the emergence of differences between mothers and fathers in their interactions with their sons.     

Motor timing deficits in community and clinical boys with hyperactive behavior: the effect of methylphenidate on motor timing

In a previous paper we showed that community children with hyperactive behavior were more inconsistent than controls in the temporal organization of their motor output. In this study we investigated: (1) various aspects of motor timing processes in 13 clinically diagnosed boys with attention deficit hyperactivity disorder (ADHD) who were compared to 11 community boys with hyperactive behavior and to a control group and (2) the effect of methylphenidate on the motor timing processes in the clinical group with ADHD in a double blind, cross-over, medication-placebo design, including 4 weeks of medication. The clinical group with ADHD, like the community group with hyperactivity, showed greater variability in sensorimotor synchronization and in sensorimotor anticipation relative to controls. The clinical group was also impaired in time perception, which was spared in the community group with hyperactivity. The persistent, but not the acute dose, of methylphenidate reduced the variability of sensorimotor synchronization and anticipation, but had no effect on time perception. This study shows that motor timing functions are impaired in both clinical and community children with hyperactivity. It is the first study to show the effectiveness of persistent administration of methylphenidate on deficits in motor timing in ADHD children and extends the use of methylphenidate from the domain of attentional and inhibitory functions to the domain of executive motor timing.     

Problem solving in hyperactive,normal, and reading-disabled boys

Diagnostic problem solving was examined in groups of hyperactive, normal, and nonhyperactive reading disabled boys matched on age and verbal IQ. On the matrix solution task employed (a version of the game of 20 Questions) hyperactives used less efficient questions and strategies than the other two groups, in spite of the task being designed to maximize the performance of the hyperactives. Readingdisabled children were not significantly worse than normal children on the task. The results were interpreted as suggesting that the attentional difficulties of hyperactives retard the development of strategies for solving complex problems. Nonhyperactive reading disabled children may be less affected in this area because of the absence of significant attentional difficulties.This article is based on a doctoral dissertation submitted to the Faculty of Graduate Studies and Research of McGill University by the first author. We are grateful to the students, teachers, and principals of the following schools in the Montreal area: Allancroft, Beacon Hill, Briarwood, Cedar Park, Greendale, Hillcrest, Lakeside Heights, Martinvale, Sunny Dale, Thomas H. Bowes, and Vivian Graham. Special thanks are due Rhonda Amsel, John MacNamara, and Chet Olsen for their help and advice.     

Effects of methylphenidate on inhibitory control in hyperactive children

This study investigated the effects of methylphenidate (MPH) on inhibitory control in hyperactive children. A double-blind, placebo-control, within-subject (crossover) design was used in which 12 children, between 6 and 11 years of age, were each tested four times in each drug condition: 0.3 mg/kg and 1.0 mg/kg of methylphenidate, and placebo. Dependent measures included (a) the probability of inhibiting responses to a primary choice reaction time task given a stop signal, on the Stopping Task, and (b) response latency and errors on the Matching Familiar Figures Test (MFFT). MPH improved the efficiency of the central inhibitory mechanism by speeding the inhibitory process, thereby affording the children greater control over their actions and enabling them to increase the probability with which they inhibited responses given a stop signal. MPH increased response latency but did not reduce errors on the MFFT, and observation of the children's task performance highlighted the interpretive problems associated with this task. Performance on both tasks was better at a dosage of 1.0 mg/kg than at 0.3 mg/kg.     

Social perspective-taking and teacher ratings of peer interaction in hyperactive boys

Hyperactive and matched control boys at two age levels were compared on teacher ratings of peer interaction and three measures of social perspective-taking. The teachers' ratings of peer interaction discriminated between the hyperactive children and their controls. In addition, a significant interaction effect indicated that teachers rated the older hyperactive group as more deviant with peers than both their younger hyperactive counterparts and their age-matched controls. In a structured laboratory setting, the hyperactive children did not differ from control children on the three measures of social perspective-taking. The perspective-taking measures did, however, show differences across age groups. Implications for treatment are examined.The research reported in this paper is based on master's thesis submitted to the Graduate Faculty of Arts and Sciences of the University of Pittsburgh by the first author. The authors are indebted to Dr. C. Keith Conners for his assistance in recruiting hyperactive subjects and to Drs. Alex Siegel and Carl Barenboim for their critical evaluations regarding this investigation. Appreciation is expressed to the staff, teachers, parents, and students of the Forest Grove Elementary School for their cooperation.     

Attention styles and peer relationships of hyperactive and normal boys and girls

Attention skills of hyperactive and normal boys and girls and behavioral ratings by teachers were investigated. Peer perceptions were obtained using a sociometric measure. Results supported previous research that found attentional deficits in hyperactive children. Results also suggested that hyperactive girls, as well as hyperactive boys, have difficulty with peer relationships. Hyperactive boys and girls displayed different patterns of problem behavior, although both groups displayed more problems than normal boys and girls. Specifically, the hyperactive girls displayed more conduct problem behavior than normal girls, but less than hyperactive boys. Because of the disruptive behavior problems they present, hyperactive boys may be identified earlier than are hyperactive girls.Portions of this paper were presented at the 56th annual meeting of the Midwestern Psychological Association, Chicago, 1984. Thanks are expressed to the students and teachers of the Eastwood Local Schools who took part in the study.The author wishes to thank the Department of Psychology and the Faculty Research Committee at Bowling Green State University, Bowling Green, Ohio, for their support of this study.     

Foreseeability and self-interest as moral judgment factors with normal and acting-out adolescent boys

Thirty-two male adolescents participated in a study of moral judgment and its relationship to social functioning. Half of the subjects were selected for frequent acting-out, aggressive behavior, and half were selected from regular eighth-grade classes and matched for intelligence. The moral stories featured good intentions with bad outcomes and varied as to whether or not the outcome was foreseeable and in the actor's self-interest. Subjects judged the actor, attributed judgments to adults, and casually explained the outcome. The difference in judgments between foreseeable and nonforeseeable actions was greater for “normal” subjects. Furthermore, although normal subjects judged foreseeable actions more harshly than acting-out subjects, the reverse was true for nonforeseeable actions. Judgments attributed to adults were harsher than subjects' own judgments, and this difference was greater for acting-out subjects. Causal attributions (personal vs. situational) and other reasoning related strongly to the foreseeability and self-interest factors but not to subject group.     

Autonomic and behavioral effects of dextroamphetamine and placebo in normal and hyperactive prepubertal boys

The hypothesis is tested that the response to dextroamphetamine in terms of activity, attention, impulsivity, and autonomic activity is similar in normal (N) and hyperactive (H) children. Fourteen N and 15 H boys had skin conductance (SC), heart rate (HR), and finger temperature (ST) recorded during rest, presentation of eight 75- dB tones, and a reaction time (RT) procedure on three occasions: off drug (Day 1) and after ingestion (double-blind) of placebo and of .5 mg/kg dextroamphetamine. Both N and H groups showed drug effects, compared to placebo, of reduced motor activity and impulsivity, improved attention (RT), increased HR and HR slowing during RT foreperiods, and decreased ST. Both groups also had decreases in SC responsivity but in different parts of the test. Placebo compared to Day 1 produced increased activity and autonomic arousal but no change in RT. Stimulant drugs thus have similar behavioral and autonomic effects in both N and H boys, but the beneficial effects on behavior do not depend critically on increases in arousal.     

Effects of methylphenidate (Ritalin) on information processing in hyperactive children

The effect of methylphenidate on information-processing efficiency was studied in 12 hyperactive, nonretarded children. Performance on six efficiency tasks (Posner Letter Matching, Reaction Time, Memory Search, Category Verification, Item Identification, and Word-Span) and a general measure of on-task behavior were compared for children receiving methylphenidate or a placebo. The median drug dosage was .38 mg/kg, and it was ingested 1 1/2 hours prior to testing. Children blind to the drug-placebo condition were tested on 4 days. In general, methylphenidate-related improvements in attention to on-task behaviors were found. An overall analysis of processing speed suggested that methylphenidate improved efficiency. Methylphenidate significantly decreased reaction times to simple and complex stimulus arrays; differences due to the drug remained even when on-task attentive behaviors were statistically removed. Significantly fewer identification errors occurred on the Posner task in the methylphenidate condition. Results indicated that methylphenidate improved general attentional behaviors and positively influenced processes that define perceptual efficiency.The first author was supported by NIH Training Grant No. HD 07184. We appreciate the assistance of Dr. Robert Sweeney in carrying out this research and the useful comments of Ellen B. Ryan and Jeanne D. Day.     

Span of apprehension in hyperactive boys

The spans of apprehension of hyperactive and normal boys were compared with a forced-choice letter-recognition task developed by Estes (1965). This task provides an estimate of the span which is relatively insensitive to either memory or motivational influences. The span size was the same for both groups when visual noise was absent. In the presence of noise, span size for the hyperactive boys decreased. Moreover, as the number of noise letters increased, the reduction in span size observed for the hyperactive boys increased. It is argued that this increasing reduction in span size represents a true deficit in attention.     

Effects of methylphenidate (Ritalin) on selective attention in hyperactive children

This study investigated the effect of methylphenidate (Ritalin) on the selective attention of hyperactive children designated as favorable or adverse responders to stimulant medication. Using a type II incidental learning paradigm, it was found that children in the drug condition recalled more central and less incidental stimuli than those children in the placebo condition. While no differential effects on recall were found for responder type, methylphenidate did affect the spontaneous overt labeling of central stimuli by the favorable responder group. Results were interpreted in terms of the role of methylphenidate in narrowing the focus of attention. Implications for the classification of hyperactive children as favorable and adverse responders were also discussed.This paper is based on a master's thesis completed by the first author in the Department of Psychology, University of Guelph, under the supervision of the second author. The authors wish to thank J. Thomas Dalby for his assistance in the conducting of this experiment.     

Performance and activity of hyperactive and normal boys as a function of distraction and reward

Twenty-five hyperactive boys and 25 controls matched for age, social class, and race were compared on three performance tasks (coding, tone discrimination, and connecting dots) in two settings (nondistracting and highly distracting). Control Ss performed significantly better than did hyperactives in all conditions, except during tone discrimination and connecting dots in the nondistracting setting. Distraction decreased performance for both groups on the coding task and for hyperactives on the tone discrimination task, but significantly improved performance for controls on the connecting dots task. Distraction, where detrimental, was not significantly more so for hyperactives than for controls. The effect of reward on coding performance was studied in the distracting condition; reward produced the best performance for both groups, but significant differences between groups were not found.This research was supported in part by U.S. Public Health Service Training Grant (in Biological Sciences) No. MH07081.The participation of the following people in helping to design this research study and collect data is hereby acknowledged: David Bremer, Ted Goltz, Ruth Rosenthal, and Michael Stern.     

Attention and distractibility during reading in hyperactive boys

Nonhyperactive and clinically defined hyperactive boys were administered reading tasks under quiet and distracting conditions. Hyperactive boys were less attentive to task relevant stimuli and more attentive to task irrelevant stimuli than their controls. Our results demonstrate that the previous findings of inattentiveness among hyperactive boys on laboratory tasks can be generalized to more typical school activities such as reading.     

Methylphenidate and cognitive therapy: A comparison of treatment approaches with hyperactive boys

This study of hyperactive boys evaluated the effects of three modes of treatment in relation to an untreated group. The treatments were administered over a 3-month period and included cognitive training, stimulant drug therapy (methylphenidate), and the two treatments combined. A follow-up assessment was conducted approximately 3 months after contact between the training staff and the child had ceased. Analyses of attentional deployment and cognitive style measures, tests of academic achievement, and behavioral ratings showed that only those children in the two medication treatment conditions demonstrated improvement in attentional deployment and behavioral ratings. In the cognitive therapy condition, there were changes only on measures of attentional deployment. The data did not provide evidence indicating that the combined medication and cognitive therapy condition was any more effective than that condition involving medication alone. Discussion provides future guidelines for evaluation of the relative effectiveness of stimulant drug therapy and other psychological treatment modalities.     

A psychosocial study of hyperactive and learning-disabled boys

Adequately reading hyperactive boys, normally behaved learning-disabled (LD) boys, and normal controls were contrasted on tests measuring personality traits, cognitive role taking, and moral reasoning. Additionally, parents and teachers rated all children on a number of behaviors, and parents were interviewed in a process-oriented fashion to assess home stimulation potential. Hyperactive boys were rated more aggressive and anxious than LD boys and controls and had not been encouraged as much by parents to achieve. Hyperactives had been born to younger parents, on the average, and 25% lived with their mothers and stepfathers. None of the LD or control boys had stepfathers. The groups did not differ significantly in moral reasoning ability, cognitive role taking, or locus of control; on the Junior Personality Inventory hyperactives tended to have elevated scores on the neuroticism scale while LD boys had higher scores on the lie scale.This research was supported by Grant HDNS-09119 from the National Institute of Child Health and Human Development.