The mother-child interactions of hyperactive boys and their normal siblings

The mother-child interactions of hyperactive boys and their normal siblings were compared during free play and tasks. Hyperactive boys were less compliant in both settings, and their mothers were less positive toward them during tasks and rated them as having more behavior problems at home than their normal siblings.     

Growth of hyperactive children treated with methylphenidate.

This is a study of the growth of 72 hyperactive boys treated continuously with methylphenidate hydrochloride. Major findings were that methylphenidate produces an adverse effect on growth in height and in weight in the first year of treatment, but not in the second year; the first year height deficit is offset in the second year by a greater-than-expected growth rate. No clinical predictors of growth deficits were found; growth in height deficits are not related to total dosage or summer drug holidays, but weight deficits may be related to these factors. Side effects did not correlate with dosage. The temporary growth deficits of the first year are of such minor magnitude as to have little clinical significance.     

State-dependent learning in hyperactive children receiving methylphenidate

State-dependent learning refers to a failure of learning mastered under one drug condition to be remembered when tested under another drug condition. Previous studies of state-dependent learning in hyperactive children receiving stimulants have yielded conflicting results. The authors systematically evaluated learning and transfer of learning in children who were or were not receiving methylphenidate and included several design features intended to optimize the likelihood of demonstrating state-dependent learning. They found no evidence of state-dependent learning. These results diminish concern regarding state-dependent effects in hyperactive children who are positive drug responders and who are clinically administered methylphenidate to control their hyperactivity.     

Side effects of dextroamphetamine and methylphenidate in hyperactive children--a brief review

Four of the most commonly reported side effects of dextroamphetamine ( Dexedrine ) and methylphenidate (Ritalin), viz., anorexia, insomnia, stomach pains, and weight loss, were reviewed, with special attention to growth suppression accompanying weight loss. The available evidence indicates that the effects of insomnia, anorexia, and stomach pains are transient and diminish as treatment continues and as medication is properly managed. There is evidence for growth suppression accomapnying weight loss, and possibly some suppression of stature, but these effects are not long-lasting and, from existing evidence, seem to have little effect on adult height or weight.     

The effects of behavioral parent training on families with young hyperactive children

We sought to assess, through two case-studies, the strengths and limitations of a time-limited, family-based behavioral intervention for preschool-aged children with attention-deficit-hyperactivity disorder (ADHD). The families completed a ten week child management training program and attended a number of follow-up sessions. Changes in parent and child functioning were assessed with a variety of rating scales, interviews, and data collected by parents at home on targeted behavior problems. Improvements were found in parents' confidence in their child management ability and knowledge of behavioral principles, in certain child behavior problems, in parental ratings of hyperactivity, and in the parent-child relationship. Implications of the findings for the treatment of young children with hyperactivity are discussed.     

Cognitive effects of psychostimulant medication in hyperactive children

Hyperactive and normal children were given a test of selective attention (Stroop test) and a neurocognitive test sensitive to a functional deficit of prefrontal cortex (Wisconsin Card Sorting Test). Hyperactive children showed significant deficits on both measures. After a year of psychostimulant medication, the hyperactive children all showed clinical and neurocognitive improvement, but continued to show a selective attention deficit compared with normal children. The results indicate a dissociation between the cognitive processes measured by the Wisconsin test and selective attention as measured by the Stroop, and that the selective attention deficit is more resistant to psychostimulant intervention.     

Changes in the electroencephalogram accompanying the use of stimulant drugs (methylphenidate and dextroamphetamine) in hyperactive children

Fifteen hyperactive boys aged 5.6-10.6 years had their electroencephalograms (EEG) recorded during performance of a simple reaction task while on stimulant medication (methylphenidate or d-amphetamine) and after being free of medication for at least 48 hr. Interval histograms were formed from measurements of the duration of 780 half waves taken from predetermined portions of the EEG'S recorded from the left parietal-occipital derivation for both treatment conditions, and the histograms were subjected to a central-moments analysis. Previous evidence showed that, in normal children, smaller-valued 2nd, 3rd, and 4th central moments were associated with greater maturity. The EEG histograms obtained while the hyperactive children were taking stimulant medication had significantly (p less than 0.005) smaller 2nd, 3rd, and 4th central moments than the histograms of the same children obtained when off medication. Age of the group predicted from the means of the 2nd, 3rd, and 4th central moments of the EEG interval histograms was 91 months when the children were off medication--9 months less than the group's actual mean age. Age predicted in the same way when the children were on medication was 97 months. Findings support the concept of a neurophysiological maturational lag in hyperactivity and suggest that this lag is overcome, in part, by the use of stimulant drugs.     

Growth hormone and prolactin secretion in adults and hyperactive children: Relation to methylphenidate serum levels

The effect of a single dose of oral methylphenidate (MPH) on blood levels of growth hormone (GH) and prolactin (PRL) was measured in 27 hyperactive children (HKC), eight ‘hyperactive’ adults and eight normal adults in two experimental paradigms: a double-blind crossover study of MPH in a single dose (0.3 mg/kg) and a double-blind crossover study of MPH at two dose levels (0.3 and 0.6 mg/kg). In all groups in both studies, a consistent and statistically significant increase in circulating GH concentrations was observed; in HKC, this increase was dose-related. Also, in all groups in both studies there was a consistent decrease in circulating PRL concentrations. This change was significant in the adults at the 0.3 mg/kg dose, but in the children only at the 0.6 mg/kg dose. The increase in GH correlated with MPH serum levels in both the HKC and the adults. The decrease in PRL correlated with MPH serum levels only in the adults.     

Identifying children at high somatic risk: long-term effects on mother-child interaction

The identification of alpha 1 antitrypsin deficiency (ATD) by neonatal screening was hypothesized to have had negative long-term effects on the mother-child relationship. This hypothesis was tested by studying selected aspects of mother-child interaction in a structured task situation in the home, and comparing 53 cases with clinically healthy 5-7-year-old children with ATD versus 52 control cases with children without ATD. The mothers in the two groups did not differ notably from each other. However, as compared with controls, ATD-children were found to evidence considerably more problematic behavior in interacting with their mothers (being e.g. inappropriately childish, silly, precocious, inhibited, tense, irritated). The findings were interpreted as supporting the hypothesis of a negative long-term effect of identifying the child's ATD.     

Influence of methylphenidate on motor performance and attention in children with developmental coordination disorder and attention deficit hyperactive disorder

Individuals with attention deficit hyperactive disorder (ADHD) often have coexisting developmental coordination disorder (DCD). The positive therapeutic effect of methylphenidate on ADHD symptoms is well documented, but its effects on motor coordination are less studied. We assessed the influence of methylphenidate on motor performance in children with comorbid DCD and ADHD. Participants were 30 children (24 boys) aged 5.10–12.7 years diagnosed with both DCD and ADHD. Conners’ Parent Rating Scale was used to reaffirm ADHD diagnosis and the Developmental Coordination Disorder Questionnaire was used to diagnose DCD. The Movement Assessment Battery for Children-2 and the online continuous performance test were administrated to all participants twice, with and without methylphenidate. The tests were administered on two separate days in a blind design. Motor performance and attention scores were significantly better with methylphenidate than without it (p < 0.001 for improvement in the Movement Assessment Battery for Children-2 and p < 0.006 for the online continuous performance test scores).The findings suggest that methylphenidate improves both attention and motor coordination in children with coexisting DCD and ADHD. More research is needed to disentangle the causality of the improvement effect and whether improvement in motor coordination is directly affected by methylphenidate or mediated by improvement in attention.     

Effects of birth of a sibling on mother-child interactions

The interactions of working-class mothers and their firstborn children were studied in a playroom situation shortly before, as well as shortly after, the mother delivered a new baby. Both mothers and children exhibited less warmth and increased neutral affect subsequent to the birth of the new baby. Thus, in the sample, the analytic view that birth of a sibling has a major effect on the mother-child relationship was confirmed.This research was sponsored by a grant from the University of Washington Graduate School Research Fund.     

Current medical practice and hyperactive children.

An extensive questionnaire was completed by 48 physicians, detailing the medical and behavioral information they collect in forming a diagnosis of conditions that have hyperactive behavior as a symptom. Results indicate that diagnoses are made primarily on the basis of behavioral indicators, and indicators and information from the child's personal medical history, rather than from other data collected during the physical exam.     

Effects of two doses of methylphenidate on cross-situational and borderline hyperactive children's evoked potentials

This study involved 27 children displaying cross-situational hyperactivity and 14 youngsters with borderline hyperactivity. For all patients, evoked potentials were recorded after receiving 0 (placebo), 0.3 and 0.6 mg/kg methylphenidate. Under each pharmacologic condition, subjects were administered: a photic stimulation procedure; two versions of the Continuous Performance Test (CPT), which varied in difficulty level; and a discrimination ('oddball') test. Under photic stimulation, methylphenidate reduced the impact of increasing brightness levels on the rates of amplitude increment and latency decrease in the P208 component of the visual evoked response. These results are similar to those obtained by Buchsbaum and Wender (1973) for hyperactive patients with a positive clinical response to amphetamine. In CPT and the discrimination test, the two active dosages of methylphenidate brought about a comparable reduction of placebo levels of errors and reaction time. Analogously, in both versions of CPT, the two active dosages resulted in comparable increases in the amplitude of two components of the late positive complex (LPC; P510 and P740). P510 was identified as a classical P300. In the discrimination test, the effect of the stimulant on the response evoked by the visual non-target was to increase the amplitude of a component (P463) previously identified as P300. These pharmacologic results were nearly identical for borderline and cross-situational patients. In general, the results confirmed previous observations that methylphenidate improves hyperactive children's performance and increases the amplitude of their LPC. Further, these findings support previous observations that hyperactive patients' cognitive processing is optimized by a dosage of 0.3 mg/kg methylphenidate. Finally, the similarity between findings for cross-situational and borderline hyperactive patients is consistent with other evidence that stimulant effects are not limited to classically hyperactive children.