Comparing psychological and pharmacological treatments for hyperkinetic boys and their classmates

This study compares the short-term effects of methylphenidate and of teacher consultation on the on task behavior of diagnosed hyperkinetic outpatient boys and selected classmates. Statistically significant treatment effects were found for both drug treated and behaviorally treated hyperkinetic boys; the size of these effects did not differ between the two types of treatment. Within the behavioral group, the treatment effect spilled over, so that there was also a significant treatment effect on overactive classmates of the behaviorally treated hyperkinetic children and a trend toward a significant treatment effect on their average classmates. Some implications of the findings are discussed.This study was supported by grant number MH-22659 from the National Institute of Mental Health.     

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.     

Aggression in boys with attention deficit-hyperactivity disorder: Methylphenidate effects on naturalistically observed aggression,response to provocation,and social information processing

High and low-aggressive boys with attention deficit-hyperactivity disorder (ADHD) were compared and the effects of methylphenidate were examined on measures from three domains of aggression: (1) directly observed verbal and nonverbal aggressive behaviors exhibited in the context of a day treatment program, (2) aggressive responding when provoked during a laboratory task, and (3) social information processing patterns exhibited on tasks designed to tap the putative cognitive components of aggression. The high-aggressive (HA) and low-aggressive (LA) subgroups differed significantly on observational measures of aggression and on the laboratory provocation task, but the HA group showed more deviant cognitions on only one of the numerous measures of social information processing. Regarding medication effects on the direct observation measures, methylphenidate decreased aggression for both subgroups. On the laboratory provocation task, methylphenidate had only minimal effects. Significant drug effects were obtained on only two recall social information processing measures.     

Stimulus-governance and the hyperkinetic syndrome

The hypothesis that hyperkinetic children are stimulusgoverned was tested. In a sample of 39 nonmedicated hyperkinetic boys 26 were found to be stimulus-governed. In a control sample of 20 nonmedicated boys 6 were found to be stimulus-governed. An association was found between the hyperkinetic syndrome and stimulusgovernance. The hypothesis is raised that response to methylphenidate is related to stimulusgovernance. Several issues raised by the research are discussed.This research was supported in part by a grant from Bloemendaal Psychiatric Hospital, The Hague, The Netherlands. The authors wish to thank Mr. E. M. Ockhorst, for constructing the KFA-testing equipment, and Mr. R. Reyneart, for helping with the computer analysis. An earlier draft of the paper was presented at the European Conference of Neuropsychology, sponsored by the International Neuropsychology Society, at Oxford University, England.     

A comparison of objective measures of activity and distractibility in hyperactive and nonhyperactive children

In a 15-minute free-play and a 5-minute test session, 13 measures of activity, distractibility, and parental ratings of activity were obtained on three groups of children, consisting of 16 boys referred to a psychological services center for evaluation of possible hyperactivity, 16 referred to that same center for problems other than hyperactivity, and 20 obtained from the local community. Subjects were boys with average intelligence between the ages of 4 and 12 years. Results indicated that the multiple measures of activity and distractibility had significant but relatively low order correlations among themselves. These relationships varied as a function of the subject group. However, there was no sonsistent relationship between the measures of activity and distractibility. The pattern of relationships obtained suggested that both activity level and distractibility are not homogeneous, unidimensional constructs. Results also indicated that boys referred for hyperactivity displayed greater wrist activity in free play, tended to display greater ankle activity in free play, had significantly correlated wrist and ankle activity, and were rated by their parents as more active than other children. This pattern suggested a global restlessness in children referred for hyperactivity that distinguishes them from other children.     

Family coherence and ADHD

A lack of perseverance, poor attention, and poorly modulated behaviour are important criteria of Attention Deficit Hyperactivity Disorder (ADHD). Instructions often must be repeated, sometimes even by different family members, before a child with ADHD attends and complies. The hyperkinetic child might cause less disruption in families with high coherence. Families of 15 boys (aged 6 to 12 years) diagnosed with ADHD using the Mannheim Parent's Interview and the teacher's form of the Conners scale were compared with a matched healthy control group of 15 boys. Parents completed a form assessing the family's cooperation and childrearing practices. Intrafamilial coherence seems to have little positive association with the family's characteristics, especially for boys with Attention Deficit Hyperactivity Disorder. Low coherence among family members may reduce ADHD symptoms and may have protective effects on children with ADHD.     

The normalizing effects of methylphenidate on the classroom behavior of ADDH children

This study examined whether methylphenidate normalizes the behavior of hyperactive children (ADDH). Twenty-eight ADDH children were treated for 8 weeks with a mean dose of 41.5 mg/d of methylphenidate. Their classroom behavior and that of normal children was recorded by observers who were blind to diagnosis and treatment. Before treatment, all measures significantly differentiated the ADDH and normal children. After treatment, the two groups were indistinguishable on measures of gross and minor motor movement, noncompliance, interference, and overall hyperactivity. ADDH children were significantly improved on measures of attention but continued to be significantly less attentive. In many ways, the ADDH children were not only improved but indistinguishable from their normal peers.This paper was supported by NIMH grants 30822 and 18579. We gratefully acknowledge the assistance of Beth Landa, Ph.D., who performed the statistical analyses.     

The influence of an audience upon the reactions to filmed violence

In order to examine audience effects when viewing firmed violence, 5 to 6 year old pre-school boys who had been rated as submissive by their teachers watched an aggressive or a neutral movie either alone, accompanied by another submissive classmate, or a dominant one. Subsequent aggression against a frustrating, unknown and unseen boy was delivered via a modified Buss machine, especially adapted for children. Subjects accompanied by a dominant peer were more aggressive than the others but did not react differentially to the movies. Subjects tested alone were more aggressive after the violent film than after the neutral one and the opposite pattern occurred for the boys accompanied by a submissive classmate. These findings stress the importance of the social context when viewing filmed violence. It is suggested that the quality of the audience can have different directional (e.g. fear and aggression) as well as energizing properties. Links with the literature on social facilitation and audience effects are underlined.     

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.     

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.     

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.     

Effects of methylphenidate on working memory in pigeons

To assess the effects of methylphenidate on working memory, pigeons were trained in a delayed matching-to-sample task. Delay interval duration (0.2, 1, 3, 6, or 12 sec) was varied within sessions in order to separate delay-dependent from delay-independent effects of the drug on performance. A reduction in the sample response requirement from five responses to one response effectively reduced attention to the stimulus and impaired overall accuracy. Methylphenidate was administered in doses of 0.0 (saline control), 0.25, 2.5, and 10 mg/kg. Relative to performance with saline, accuracy was significantly reduced with 10 mg/kg methylphenidate to the same extent in both fixed ratio (FR) 1 and FR 5 conditions. The smaller doses had no effect, and there was no evidence that accuracy improved with drug administration. Intercepts and slopes of exponential functions fitted to measures of discriminability plotted as a function of delay showed that methylphenidate affected delay-independent aspects of performance (initial discriminability), but not delay-dependent aspects (rate of forgetting).     

Music and Video as Distractors for Boys with ADHD in the Classroom: Comparison with Controls,Individual Differences,and Medication Effects

This study examined the effects of music and video on the classroom behavior and performance of boys with and without attention deficit hyperactivity disorder (ADHD) and examined the effects of 0.3 mg/kg methylphenidate (MPH). In one study, 41 boys with ADHD and 26 controls worked in the presence of no distractor, music, or video. Video produced significant distraction, particularly for the boys with ADHD, and MPH improved the performance of boys with ADHD across distractor conditions.There were individual differences in response to the music such that some boys were adversely affected and others benefited relative to no-distractor.In a second study, music and MPH were assessed in an additional 86 boys with ADHD to examine further the music results. In the presence or absence of music, MPH improved performance relative to placebo. Similar individual differences were found as in Experiment 1.     

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.     

The specificity of the effects of stimulant medication on classroom learning-related measures of cognitive processing for Attention Deficit Disorder children

There appear to be beneficial effects of stimulant medication on daily classroom measures of cognitive functioning for Attention Deficit Disorder (ADD) children, but the specificity and origin of such effects is unclear. Consistent with previous results, 0.3 mg/kg methylphenidate improved ADD children's performance on a classroom reading comprehension measure. Using the Posner letting-matching task and four additional measures of phonological processing, we attempted to isolate the effects of methylphenidate to parameter estimates of (a) selective attention, (b) the basic cognitive process of retrieving name codes from permanent memory, and (c) a constant term that represented nonspecific aspects of information processing. Responses to the letter-matching stimuli were faster and more accurate with medication compared to placebo. The improvement in performance was isolated to the parameter estimate that reflected nonspecific aspects of information processing. A lack of medication effect on the other measures of phonological processing supported the Posner task findings in indicating that methylphenidate appears to exert beneficial effects on academic processing through general rather than specific aspects of information processing.     

The Nature of Teacher Talk in Early Childhood Classrooms and Its Relationship to Children's Play With Objects and Peers

The nature of teacher talk in early childhood classrooms as well as how such talk is related to children's level of play with objects and peers during free play was examined. The purpose of the study was to determine what levels of teacher talk were related to child functioning. Eighty-nine children (42 girls, 47 boys; age range = 31 through 63 months) enrolled in three early childhood programs participated in the study. Results demonstrated that when teachers are within 3 ft of a child, they do not talk to that child 81% of the time and they talk at high levels 18% of the time. Although previous research suggests that high-level teacher talk should be related to high-level play with objects, the results indicated that high-level teacher talk was related to lower levels of play with objects and unrelated to play with peers on the part of the children.     

Mitigating aggression and promoting prosocial behavior in aggressive elementary schoolboys

The effects of four school-based interventions designed to decrease children's aggression and promote prosocial behavior were assessed. One hundred and four aggressive boys, ages 8–13, from ‘Behavior Disorder’ classrooms, were assigned to one of four training conditions: cognitive (self-control) training, behavioral (prosocial skills) training, combined cognitive-behavioral training, or attention/play training. School psychologists trained the boys in small groups for 10 1-h sessions. It was hypothesized that training in both cognitive and behavioral competencies would lead to the most behavioral improvement. Results indicated that, according to teacher report, those children receiving the cognitive-behavioral and attention/play interventions improved significantly more than those exposed to cognitive and behavioral training by decreasing their aggression and increasing their prosocial behavior immediately following the intervention. At 6-month follow-up, only those children exposed to the attention/play intervention remained significantly improved.     

It’s a Bird! It’s a Plane! It’s a Gender Stereotype!: Longitudinal Associations Between Superhero Viewing and Gender Stereotyped Play

Although content analyses have found that superhero programs in the media portray strong gender stereotypes of masculinity, little research has examined the effects of viewing such programs. In the current study, 134 mothers of preschool children (from the Western and Northwestern United States) reported their child’s superhero exposure in the media, male-stereotyped play, weapon play, and parental active mediation of the media at two time points (1 year apart). Results revealed that boys viewed superhero programs more frequently than girls, with nearly a quarter of boys viewing superhero programs at least weekly. Analyses revealed that superhero exposure was related to higher levels of male-stereotyped play for boys and higher levels of weapon play for both boys and girls from Time 1 to Time 2, even after controlling for initial levels. Parental active mediation did not negate these effects, and even served to strengthen one finding for girls. Specifically, among girls with high superhero exposure, weapon play was highest for girls who received frequent active mediation. Implications of the results are discussed with a focus on whether such programs are developmentally appropriate for preschool children.     

Priming aggressive thoughts: The effect of the anticipation of a violent movie upon the aggressive behaviour of the spectators

In order to examine the effects of filmed violence expectancy, male subjects were induced to think that they would watch an aggressive or neutral movie. The behavioural measures of aggression of the potential viewers were collected via an interaction aggressometer that allowed subjects to manipulate the level of aversiveness of electric shocks supposedly delivered to others. Main results indicated that the mere anticipation of viewing an aggressive movie was already effective in producing the usual instigation effect of filmed violence. Evidence was also provided indicating that degree of physical provocation influenced subjects' aggressive responses. The results are discussed in terms of Berkowitz' (1984) cognitive-neoassociation analysis; anticipating a violent movie may prime aggressive behaviour.