Journal of Abnormal Child Psychology

, Volume 20, Issue 2, pp 213-232

Single and combined effects of methylphenidate and behavior therapy on the classroom performance of children with attention-deficit hyperactivity disorder

  • Caryn L. CarlsonAffiliated withDepartment of Psychology, The University of Texas at Austin
  • , William E. PelhamJr.Affiliated withWestern Psychiatric Institute and Clinic
  • , Richard MilichAffiliated withThe University of Kentucky
  • , Joanne DixonAffiliated withWestern Psychiatric Institute and Clinic

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Twenty-four boys with attention deficit-hyperactivity disorder (ADHD) participating in an intensive summer treatment program each received b.i.d. placebo and two doses of methylphenidate (MPH, 0.3 mg/kg and 0.6 mg/kg) crossed with two classroom settings: a behavior modification classroom including a token economy system, time out and daily home report card, and a “regular” classroom setting not using these procedures. Dependent variables included classroom observations of on-task and disruptive behavior, academic work completion and accuracy, and daily self-ratings of performance. Both MPH and behavior modification alone significantly improved children's classroom behavior, but only MPH improved children's academic productivity and accuracy. Singly, behavior therapy and 0.3 mg/kg PMH produced roughly equivalent improvements in classroom behavior. Further, the combination of behavior therapy and 0.3 mg/kg MPH resulted in maximal behavioral improvements, which were nearly identical to those obtained with 0.6 mg/kg MPH alone.