Attention deficit disorder with hyperactivity and methylphenidate: The effects of dose and mastery level on children's learning performance

This investigation examined the relationship between methylphenidate (MPH) and the learning and recall of paired associations by children with attention deficit disorder with hyperactivity (ADDH). Forty-five children with ADDH were randomly assigned to one of three groups (novel, partial mastery, and mastery learning) that varied in the amount of previous learning of paired associations and participated in a double-blind, placebo-control, repeated-measures-across-dose (crossover) design. Each child received four doses of MPH (5 mg, 10 mg, 15 mg, and 20 mg) and a placebo in a random, counterbalanced sequence. The results indicated that both the rate of acquisition and accuracy in learning paired associations were significantly, but differentially, affected by MPH dose and the degree of learning mastery. The implications of these results for psychopharmacological research and the monitoring of psychostimulant effects on children's learning performance in academic settings are discussed.The authors wish to acknowledge and express their sincere appreciation to the graduate and undergraduate student members of the Children's Learning Clinic.     

Adolescent suicide attempters presenting to a pediatric facility

This study profiles the characteristics of adolescent suicide attempters and the treatment they received in a pediatric emergency room (ER). A retrospective chart review of 4,072 adolescents seen in the ER at a children's hospital (CH) from July 1984 to June 1985 was undertaken. Twenty-seven adolescents who had deliberately injured themselves were identified. The average age was 14 years 7 months (range 11-19 years). Fifty-two percent of the patients were white and 78% were female. Ingestion was the most common method (78%), followed by attempted hanging (11%), and wrist laceration (7%). After evaluation by a pediatrician in the ER, 30% of the patients were treated and released, 11% were transferred directly to a psychiatric hospital, and 59% were admitted to the CH, with an average hospital stay of 1.88 days. Once hospitalized, consultations from psychiatry (81%), social service (50%), psychology (19%), and neurology (6%) were obtained. At the time of discharge from either the ER or CH, the patients had a variety of plans for ongoing care, with 52% being referred to outpatient counseling, 37% being transferred to a psychiatric hospital, and 11% having no documented plan for ongoing care. These results demonstrate that the evaluation of suicidal adolescents cared for in a pediatric facility may be episodic and suggest the need for a comprehensive program to approach the problem.     

Preventive group psychotherapy for at-risk infants and their mothers

There is increased evidence that infants who receive poor quality social stimulation from their primary caregiver are at risk for later developmental difficulties. This paper describes a preventive intervention for mother-infant dyads exhibiting impaired patterns of social interaction. An impaired relationship with the primary caregiver has been found to be associated with social and emotional deficits in early childhood as well as with significant psychopathology in adulthood. The intervention consisted of group treatment of mothers and their infants. Each group session has 4 subsections which, together, were directed towards improving the mothers' ability to relate in a stimulating and nurturant manner to their children. Types of intervention included didactic instruction, modeling, and interpretation of the infant's behavior. Qualitative data suggested that the group intervention has positive effects on the mother-infant dyads.     

The relations between sex-typed play and preschoolers' social behavior

For decades toy choice has been a very popular measure of children's sex-role adoption. In the present study, the relations between choice of masculine, neutral, or feminine toys and other social behaviors (sex typed and non-sex typed) were examined. The social behaviors (socializing, requesting assistance, prosocial behaviors, aggressive/defensive behaviors) and toy choices of 33 preschool children were observed in their classrooms. Only two behaviors were found to be sex typed (socializing with peers and spontaneous prosocial behavior), and both of these behaviors were related to toy choice. Toy choice was also related to helping. Among boys, masculine toy choice was associated with requesting assistance from teachers. When toy choice was classified as masculine, androgynous, and feminine, only sociability toward peers was related to toy choice. The results are discussed in terms of their implications for the continued use of toy choice as a measure of sex-role adoption.The authors wish to express their gratitude to Rene Dodez for her assistance in data analysis and to the children and teachers at the Child Study Laboratory. We also appreciate the contributions of Drs. Laurie Chassin, Jerry Harris, Susan Somerville, Sharlene Wolchik, and Antonette Zeiss. This research was completed by the first author in partial fulfillment of the masters of arts degree at Arizona State University.     

Behavioral assessment of methylphenidate in a child with frontal lobe damage

The assessment and management of inattentive, hyperactive, and impulsive behavior in a 6-year-old girl who experienced frontal lobe damage are described. A multimodel approach combining medical, educational, and behavioral techniques to assess hyperactive behavior, optimal medication level, and medication and psychotherapeutic effectiveness is described. The results of the study suggest that in similar cases, children and adolescents manifesting these behaviors should be given a trial of stimulant medication in a controlled environment to assess if such therapy is indicated. Additional support is given for the increasing need for detanté and cooperation with health-care professionals.     

Book reviews

Current Psychology -     

Effective functioning in dual-career families: an investigation

This study is concerned with the commonalities inherent in diverse psychotherapeutic strategies, despite seemingly discontinuous theoretical stances. Two approaches were evaluated with respect to effective family functioning, viz. Analytical Psychology and Systems Theory. Analytical Psychology posits the growth of conscious awareness in the individual as the source of therapeutic change. Problem centred systems therapy of the family emphasizes the importance of teaching clinically presenting families to negotiate collectively family rules and expectations and thus to allocate and monitor roles via clear and direct verbal communication. Both positions thus stress the reflective mode as a pivotal factor in effective problem solving. Analytical psychology maintains that conscious awareness expands to the extent that the individual integrates the contrasexual aspect of the personality, that is, the affective, expressive mode or 'feminine principle' in the male, or the instrumental, assertive 'masculine principle' in the female. Such individuals are said to be 'androgenous'. It was therefore hypothesized that such individuals would more readily be able to negotiate family rules and expectations in a manner consistent with a major therapeutic thrust of family therapy. These clinically derived hypotheses were subjected to an empirical test by assessing twenty, non-clinical, dual-career families where both parents pursued careers and were therefore presumably both required to share instrumental and affective roles on the basis of mutual agreement. Results indicated that negotiation contributed significantly to successful role fulfilment and effective family functioning, thus substantiating the focus of family therapy strategies upon clear and direct communication and role allocation.     

On the basis of early transitivity judgments

This research had two aims. The first was to test three explanations of performance on N-term series tasks by young children: the labeling model of B.DeBoysson-Bardies and K. O'Regan (1973), Nature (London), 246, 531–534, the sequential-contiguity model of L. Breslow (1981, Psychological Bulletin, 89, 325–351), and the ordered array or image model of C. A. Riley and T. Trabasso (1974, Journal of Experimental Child Psychology, 17, 187–202). In the first experiment, 5-year-old children were taught additional premises which would interfere with labeling and sequential-contiguity processes, but not with forming an ordered array. Reasoning performance was essentially comparable to previous results with the paradigm, thus supporting the ordered array model. The second aim was to reexamine children's ability to learn sets of premises which can be assembled into an ordered array, since there was reason to believe that previous studies had created false positives. In the second experiment, 3- to 7-year-old children were taught either overlapping (a > b, b > c, …) or nonoverlapping (a > b, c > d, …) premises. Overlapping premises can be integrated into an ordered array (a, b, c, d, e), but nonoverlapping premises cannot. However, the overlapping condition proved more difficult, and the success rate for preschoolers ($\text{3}\text{1}\text{2}\text{-}\text{to 4}\text{1}\text{2}\text{-year-olds}$) was of zero order. This raises doubts about their ability to learn a set of premises of the kind required for transitive inference. These doubts were strengthened by the third experiment which showed that when premises were not presented in serial order, preschool ($\text{3}\text{1}\text{2}\text{-}\text{to 4}\text{1}\text{2}\text{-year-old}$) children could not learn the premises of an N-term series task.