Methylphenidate and cognitive therapy with add children: A methodological reconsideration

The present doubleblind study examined the effects of methylphenidate, cognitive therapy, and their combination in attention deficitdisordered (ADD) children. Four treatment groups were compared on measures of attentional deployment and cognitive style, tests of academic achievement, and behavioral rating scales. In contrast to a previous study conducted in this laboratory, children in this study were not receiving medication during posttesting. Results were interpreted to suggest that measurable effects of stimulant medication dissipate rapidly upon discontinuation of pharmacotherapy. The combination of methylphenidate and cognitive therapy was not found to be any more efficacious than either of the treatments studied alone. Discussion suggests that medication status at follow-up is an essential feature of research design.This research was supported in full by U.S. Public Health Service Grant No. MH 37-628 from the National Institute of Mental Health, Psychopharmacology Branch, and by Biomedical Research Award No. RR 0715807 from the National Institutes of Health, each awarded to R. T. Brown. Placebo and methylphenidate were supplied by CIBA-GEIGY, Summit, New Jersey. The authors are grateful to Dr. Rute Medenis and the entire staff at the University of Illinois Pediatrics Clinic for their valuable assistance and kind support throughout the project. The authors would also like to thank Avery L. Spunt, R.Ph., College of Pharmacy, University of Illinois, for his assistance in packaging the medication and monitoring compliance; Arthur I. Neyhus, Ph.D., Coordinator of Child Study Facility, University of Illinois at Chicago, for his assistance in evaluation; and J. Scott Allen, Jimmy Bruce, Robert Miller, Michael Mazius, and Steven Orenczuk, for their assistance in training of the children.The contributions of these authors are equal.