A Dose-Ranging Study of Behavioral and Pharmacological Treatment in Social Settings for Children with ADHD

Placebo and three doses of methylphenidate (MPH) were crossed with 3 levels of behavioral modification (no behavioral modification, NBM; low-intensity behavioral modification, LBM; and high-intensity behavior modification, HBM) in the context of a summer treatment program (STP). Participants were 48 children with ADHD, aged 5–12. Behavior was examined in a variety of social settings (sports activities, art class, lunch) that are typical of elementary school, neighborhood, and after-school settings. Children received each behavioral condition for 3 weeks, order counterbalanced across groups. Children concurrently received in random order placebo, 0.15 mg/kg/dose, 0.3 mg/kg/dose, or 0.6 mg/kg/dose MPH, 3 times daily with dose manipulated on a daily basis in random order for each child. Both behavioral and medication treatments produced highly significant and positive effects on children’s behavior. The treatment modalities also interacted significantly. Whereas there was a linear dose–response curve for medication in NBM, the dose–response curves flattened considerably in LBM and HBM. Behavior modification produced effects as large as moderate doses, and on some measures, high doses of medication. These results replicate and extend to social-recreational settings previously reported results in a classroom setting from the same sample (Fabiano et al., School Psychology Review, 36, 195–216, 2007). Results illustrate the importance of taking dosage/intensity into account when evaluating combined treatments; there were no benefits of combined treatments when the dosage of either treatment was high but combination of the low-dose treatments produced substantial incremental improvement over unimodal treatment.     

Inferred and expressed self-image of pupils rated by teachers as high and low in anxiety: a comparison of self-other ratings.

The association was examined between 98 third-grade pupils' expressed self-image scores and inferred self-image ratings from teachers. Significant self-other agreements were found with sexes combined. With sexes separated, significant self-other agreements were found for the 52 girls, but not for the 46 boys.     

Expression recognition and behavioural problems in early adolescence

The processing of emotional expressions is fundamental for normal socialisation and social interaction. Fifty-five children (aged 11–14 years) in mainstream education participated in this study. They were presented with a standardised set of pictures of facial expressions and asked to name one of the six emotions illustrated (sadness, happiness, anger, disgust, fear, and surprise). Following experimental testing, their behaviour was rated by two independent teachers on the Psychopathy Screening Device (PSD). The PSD assesses two dimensions of behavioral problems: affective-interpersonal disturbance and impulsive behaviour/conduct problems. The results showed that the ability to recognise sad and fearful expressions (but not happy, angry, disgusted, or surprised expressions) was inversely related to both level of affective-interpersonal disturbance and impulsive/conduct problems. These results are interpreted with reference to current models of empathy and its disorders.