Journal of Developmental and Physical Disabilities

, Volume 8, Issue 4, pp 347–365

Stimulant drugs in the developmental disabilities revisited

  • Michael G. Aman
Article

Abstract

In this paper, I attempt to update the evidence for a conceptual model published some years ago (Aman, 1982) that strived to account for variable responses to stimulant medication in children with normal IQ and in those with developmental disabilities. This model accounted for such variations in terms of differences in breadth of attention across clinical groups. Recent reports on the use of stimulant drugs in subjects with developmental disabilities were reviewed. The evidence shows that children with mental retardation and ADHD often benefit from such medication, although their response rate seems to be somewhat lower than that of ADHD children of normal IQ. There is a paucity of stimulant drug research with children having autism, but it is clear that some of them also benefit from stimulant medication. However, there are also reports of adverse behavioral reactions to the stimulants in some children with autism or PDD. Several studies examining predictor variables were reviewed. Breadth of attention, IQ, and mental age have been useful in predicting outcome in a number of studies, and I argue that this supports the model. There is a continuing need for stimulant drug research in children with developmental disabilities, especially in those with autism. There is also merit in assessing cognitive variables suggested by the model as well as demographic and clinical variables for their ability to predict clinical response in these children.

Key Words

Stimulants developmental disabilities medication treatment 

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References

  1. Aman, M. G. (1982). Stimulant drug effects in developmental disorders and hyperactivity: Toward a resolution of disparate findings.J. Aut. Devel. Dis. 12:385–398.CrossRefGoogle Scholar
  2. Aman, M. G. (1996). Recent studies in psychopharmacology in mental retardation. In N. N. Bray (Ed.),International review of research in mental retardation. New York: Academic Press. In press.Google Scholar
  3. Aman, M. G., Kern, R. A., McGhee, D. E., and Arnold, L. E. (1993a). Fenfluramine and methylphenidate in children with mental retardation and ADHD: Clinical and side effects.J. Am. Acad. Child Adol. Psychiatry 32:851–859.CrossRefGoogle Scholar
  4. Aman, M. G., Kern, R. A., McGhee, D. E., and Arnold, L. E. (1993b). Fenfluramine and methylphenidate in children with mental retardation and attention deficit hyperactivity disorder: Laboratory effects.J. Aut. Devel. Dis. 23:491–506.CrossRefGoogle Scholar
  5. Aman, M. G., Marks, R. E., Turbott, S. H., Wilsher, C. P., and Merry, S. N. (1991a). Clinical effects of methylphenidate and thioridazine in intellectually subaverage children.J. Am. Acad. Child. Adol. Psychiatry 30:246–256.CrossRefGoogle Scholar
  6. Aman, M. G., Marks, R. E., Turbott, S. H., Wilsher, C. P., and Merry, S. N. (1991b). Methylphenidate and thioridazine in the treatment of intellectually subaverage children: Effects on cognitive-motor performance.J. Am. Acad. Child Adol. Psychiatry 30:816–824.CrossRefGoogle Scholar
  7. Aman, M. G., and Singh, N. N. (1982). Methylphenidate in severely retarded residents and the clinical significance of stereotypic behavior.Appl. Res. Ment. Retard 3:1–14.CrossRefGoogle Scholar
  8. Aman, M. G., and Singh, N. N. (1986).Aberrant Behavior Checklist manual, Slosson Educational Publications, East Aurora, NY.Google Scholar
  9. Aman, M. G., Van Bourgondien, M. E., Wolford, P. C., and Sarphare, G. (1995). Psychotropic and anticonvulsant drugs in subjects with autism: Prevalence and patterns of use.J. Am. Acad. Child Adol. Psychiatry. 34: 1672–1681.CrossRefGoogle Scholar
  10. Barkley, R. A., DuPaul, G. J., & Costello, A. (1993). Stimulants. In Werry, J. S., and Aman, M. G. (eds.),Practitioner's Guide to Psychoactive Drugs for Children and Adolescents, New York, Plenum Medical Book Co., pp. 205–237.Google Scholar
  11. Beale, I. L., and McDowell, J. P. (1994). Effects of methylphenidate on attention in children with moderate mental retardation.J. Devel. Phys. Dis. 6:137–148.Google Scholar
  12. Birmaher, B., Qintana, H., and Greenhill, L. L. (1987). Methylphenidate treatment of hyperactive autistic children.J. Am. Acad. Child Adol. Psychiatry 27:248–251.CrossRefGoogle Scholar
  13. Campbell, M., Fish, B., David, R., Shapiro, T., Collins, P., and Koh, C. (1972). Response to tri-iodothyronine and dextroamphetamine: A study of preschool schizophrenic children.J. Aut. Child. Schizophr. 2:343–358.CrossRefGoogle Scholar
  14. Campbell, M., Small, A. M., Collins, P.J., Friedman, E., David, R., and Genieser, N. (1976). Levodopa and levoamphetamine: A crossover study in young schizophrenic children.Curr. Ther. Res. 19:70–86.PubMedGoogle Scholar
  15. Cohen, N. J., Sullivan, J., Minde, K., Novak, C., and Helwig, C. (1981). Evaluation of the relative effectiveness of methylphenidate and cognitive behavior modification in the treatment of kindergarten-aged hyperactive children.J. Abnorm. Child Psychol. 91:43–54.CrossRefGoogle Scholar
  16. Conners, C. K. (1975). Controlled trial of methylphenidate in preschool children with minimal brain dysfunction. In Gittleman-Klein, R. (ed.),Recent Advances in Child Psychopharmacology, Human Science Press, New York, pp. 64–78.Google Scholar
  17. Conners, C. K. (1990).Conners' rating scales manual: Conners' Teacher Rating scales, Conners' Parent Rating Scales. Instruments for Use with Children and Adolescents, Multihealth Systems, North Tonawanda, NY.Google Scholar
  18. Gadow, K. D. (1985). Prevalence and efficacy of stimulant drug use with mentally retarded children and youth.Psychopharmacol. Bull. 21:291–303.PubMedGoogle Scholar
  19. Gadow, K. D., and Pomeroy, J. C. (1990). A controlled case study of methylphenidate and fenfluramine in a young mentally retarded, hyperactive child.Austr. New Zeal. J. Devel. Dis. 16:323–334.Google Scholar
  20. Geller, B., Guttmacher, L. B., and Bleeg, M. (1981). Coexistence of childhood onset pervasive developmental disorder and attention deficit disorder with hyperactivity.Am. J. Psychiatry 138:388–389.PubMedGoogle Scholar
  21. Hagerman, R. J., Murphy, M. A., and Wittenberger, M. D. (1988). A controlled trial of stimulant medication in children with the fragile X syndrome.Am. J. Med. Gen. 30:377–392.CrossRefGoogle Scholar
  22. Handen, B. L., Breaux, A. M., Gosling, A., Ploof, D. L., and Feldman, H. (1990). Efficacy of methylphenidate among mentally retarded children with attention deficit hyperactivity disorder.Pediatrics 86:922–930.PubMedGoogle Scholar
  23. Handen, B. L., Breaux, A. M., Janosky, J., McAuliffe, S., Feldman, H., and Gosling, S. (1992). Effects and non-effects of methylphenidate in children with mental retardation and ADHD.J. Am. Acad. Child Adol. Psychiatry 31:455–461.CrossRefGoogle Scholar
  24. Handen, B. L., Feldman, H., Gosling, A., Breaux, A. M., and McAuliffe, S. (1991). Adverse side effects of methylphenidate among mentally retarded children with ADHD.J. Am. Acad. Child Adol. Psychiatry 30:241–245.CrossRefGoogle Scholar
  25. Handen, B. L., Janosky, J., and McAuliffe, S. (In press). Long-term follow-up of children with mental retardation and ADHD.J. Abnorm. Child Psychol. Google Scholar
  26. Handen, B. L., Janosky, J., McAuliffe, S., Breaux, A. M., and Feldman, H. (1994). Prediction of response to methylphenidate among children with ADHD and mental retardation.J. Am. Acad. Child Adol. Psychiatry 33:1185–1193.CrossRefGoogle Scholar
  27. Handen, B. L., McAuliffe, S., Janosky, J., Feldman, H., and Breaux, A. M. (1995). Methylphenidate in children with mental retardation and ADHD: Effects on independent play and academic functioning.J. Devel. Phys. Dis. 7:91–103.Google Scholar
  28. Helsel, W. J., Hersen, M., Lubetsky, M. J., Fultz, S. A., Sisson, L., and Harlovic, C. H. (1989). Stimulant drug treatment of four multihandicapped children using a randomized single-case design.J. Multihand. Pers. 2:139–154.CrossRefGoogle Scholar
  29. Johnson, C. R., Handen, B. L., Lubetsky, M. J., and Sacco, K. A. (1994). Efficacy of methylphenidate and behavioral interventions on classroom behavior in children with ADHD and mental retardation.Behav. Mod. 18:470–487.CrossRefGoogle Scholar
  30. Lovaas, O. I., Koegel, R. L., and Schreibman, L. (1979). Stimulus overselectivity in autism: A review of research.Psychol. Bull. 86:1236–1254.PubMedCrossRefGoogle Scholar
  31. Playton, J. B., Burkhart, J. E., Hersen, M., and Helsel, W. J. (1989). Treatment of ADHD in mentally retarded children: A preliminary study.J. Am. Acad. Child Adol. Psychiatry 28:761–767.CrossRefGoogle Scholar
  32. Quintana, H., Birmaher, B., Stedge, D., Lennon, S., Freed, J., Bridge, J., & Greenhill, L. (1995). Use of methylphenidate in the treatment of children with autistic disorder.J. Aut. Devel. Dis. 25:283–294.CrossRefGoogle Scholar
  33. Realmuto, G. M., August, G. J., and Garfinkel, B. D. (1989). Clinical effect of buspirone in autistic children.J. Clin. Psychopharmacol. 9:122–125.PubMedCrossRefGoogle Scholar
  34. Schell, R. M., Pelham, W. E., Bender, M. E., Andree, J. A., Law, R., and Robbins, F. R. (1986). The concurrent assessment of behavioral and psychostimulant interventions: A controlled case study.Behav. Assess. 8:373–384.Google Scholar
  35. Schleifer, M., Weiss, G., Cohen, N., Elman, M., Cvejic, H., and Kruger, E. (1975). Hyperactivity in preschoolers and the effect of methylphenidate.Am. J. Orthopsychiatry 45:38–50.PubMedCrossRefGoogle Scholar
  36. Schmidt, K. (1982). The effect of stimulant medication in childhood-onset pervasive developmental disorder A case report.J. Devel. Behav. Pediatr. 3:244–246.Google Scholar
  37. Sokol, M. S., Campbell, M., Goldstein, M., and Kriechman, A. M. (1987). Attention deficit disorder with hyperactivity and the dopamine hypothesis: Case presentations with theoretical background.J. Am. Acad. Child Adol. Psychiatry 26:428–433.CrossRefGoogle Scholar
  38. Sporn, A., and Pinsker, H. (1981). Use of stimulant medication in treating pervasive developmental disorder.Am. J. Psychiatry 138:997.PubMedGoogle Scholar
  39. Strayhorn, J. M., Rapp, N., Donina, W., and Strain, P. S. (1988). Randomized trial of methylphenidate for an autistic child.J. Am. Acad. Child Adol. Psychiatry 27:244–247.CrossRefGoogle Scholar
  40. Ullman, D. G. (1974). Breadth of attention and retention in mentally retarded and intellectually average children.Am. J. Ment. Def. 78:640–648.Google Scholar
  41. Varley, C. K., and Trupin, E. W. (1982). Double-blind administration of methylphenidate to mentally retarded children with attention deficit disorder: A preliminary study.Am. J. Ment. Def. 86:560–566.Google Scholar
  42. Vitriol, C., and Farber, B. (1981). Stimulant medication in certain childhood disorders.Am. J. Psychiatry 138:1517–1518.PubMedGoogle Scholar
  43. Volkmar, F., Hoder, E. L., and Cohen, D. J. (1985). Inappropriate uses of stimulant medications.Clinical Pediatr. 24:127–130.Google Scholar
  44. Zeaman, D., and House, B. J. (1963). The role of attention in retardate discrimination learning. In: Ellis, N. R. (ed.),Handbook of Mental Deficiency, McGraw Hill, New York.Google Scholar

Copyright information

© Plenum Publishing Corporation 1996

Authors and Affiliations

  • Michael G. Aman
    • 1
  1. 1.The Nisonger CenterOhio State UniversityColumbus

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