Abstract
An attempt is made to integrate data from a variety of clinical populations and from the animal literature. Evidence is presented suggesting that mentally retarded and autistic children generally show a poor response to stimulant medication, whereas hyperactive and normal children respond beneficially. Cognitive research in mentally retarded and autistic children is reviewed, and it is suggested that both diagnostic groups suffer from attentional difficulties, the mechanisms of which may be very similar. The literature on stimulant-induced stereotypy in animals is discussed, with emphasis on the clinical implications for autism and mental retardation. An attentional model is proposed to account for type of therapeutic response to stimulant medication. This is followed by a possible method for testing the model and by specific predictions relating to subject characteristics and response.
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Alexandris, A., & Lundell, F. W. Effect of thioridazine, amphetamine, and placebo on the hyperkinetic syndrome and cognitive area in mentally deficient children.Canadian Medical Association Journal, 1968,98, 92–96.
Aman, M. G. Drugs, learning, and the psychotherapies. In J. S. Werry (Ed.),Pediatric psychopharmacology:The use of behavior modifying drugs in children. New York: Brunner/Mazel, 1978.
Aman, M. G. Psychotropic drugs and learning problems — A selective review.Journal of Learning Disabilities, 1980,13, 87–96.
Aman, M. G. Psychoactive drugs in mental retardation. In J. L. Matson & F. Andrasik (Eds.),Treatment issues and innovations in mental retardation. New York: Plenum Press, 1982.
American Psychiatric Association.Diagnostic and statistical manual of mental disorders (DSM III) (3rd ed.). Washington, D.C.: American Psychiatric Association, 1980.
Anton, A. H., & Greer, M. Dextroamphetamine, catecholamines, and behavior.Archives of Neurology, 1969,21, 248–252.
Barkley, R. A., & Jackson, T. L. Hyperkinesis, autonomic nervous system activity and stimulant drug effects.Journal of Child Psychology and Psychiatry, 1977,18, 347–357.
Baumeister, A. A., & Forehand, R. Stereotyped acts. In N. R. Ellis (Ed.),International review of research in mental retardation (Vol. 6). New York: Academic Press, 1973.
Bell, A., & Zubek, J. P. Effects of deanol on the intellectual performance of mental defectives.Canadian Journal of Psychology, 1961,15, 172–175.
Blacklidge, V. Y., & Ekblad, R. L. The effectiveness of methylphenidate hydrochloride (Ritalin) on learning and behavior in public school educable mentally retarded children.Pediatrics, 1971,47, 923–926.
Bradley, C. The behavior of children receiving Benzedrine.American Journal of Psychiatry, 1937,94, 577–585.
Campbell, M. Pharmacotherapy in early infantile autism.Biological Psychiatry, 1975,10, 399–423.
Campbell, M. Pharmacotherapy. In M. Rutter & E. Schopler (Eds.),Autism: A reappraisal of concepts and treatment. New York: Plenum Press, 1978.
Campbell, M., Anderson, L. T., Meier, M., Cohen, I. L., Small, A. M., Samit, C., & Sachar, E. J. A comparison of haloperidol and behavior therapy and their interaction in autistic children.American Academy of Child Psychiatry, 1978,17, 640–655.
Campbell, M., Anderson, L. T., Small, A. M., Perry, R., Green, W. H., & Caplan, R. The effects of haloperidol on learning and behavior in autistic children.Journal of Autism and Developmental Disorders, 1982,12, 167–175.
Campbell, M., Cohen, I. L., & Anderson, L. T. Pharmacotherapy for autistic children: A summary of research.Canadian Journal of Psychiatry, 1981,26, 265–273.
Campbell, M., Fish, B., David, R., Shapiro, T., Collins, P., & Koh, C. Response to triiodothyronine and dextroamphetamine: A study of preschool schizophrenic children.Journal of Autism and Childhood Schizophrenia, 1972,2, 343–358.
Campbell, M., Small, A. M., Collins, P. J., Friedman, E., David, R., & Genieser, N. Levodopa and levoamphetamine: A crossover study in young schizophrenic children.Current Therapeutic Research, 1976,19, 70–86.
Cantwell, D. P., & Carlson, G. A. Stimulants. In J. S. Werry (Ed.),Pediatric psychopharmacology: The use of behavior modifying drugs in children. New York: Brunner/Mazel, 1978.
Christensen, D. E. Effects of combining methylphenidate and classroom token system in modifying hyperactive behavior.American Journal of Mental Deficiency, 1975,80, 266–276.
Clausen, J., Fineman, M., Henry, C. E., & Wohl, N. The effect of Deaner (2-dimethylaminoethanol) on mentally retarded subjects.Training School Bulletin, 1960,57, 3–12.
Cohen, D. J., & Young, J. G. Neurochemistry and child psychiatry.Journal of the American Academy of Child Psychiatry, 1977,16, 353–411.
Cohen, I. L. Campbell, M., Posner, D., Small, A. M., Triebel, D., & Anderson, L. T. Behavioral effects of haloperidol in young autistic children.Journal of the American Academy of Child Psychiatry, 1980,19, 665–677.
Conners, C. K., & Werry, J. S. Pharmacotherapy of psychopathology in children. In H. C. Quay & J. S. Werry (Eds.),Psychopathological disorders of childhood. New York: Wiley, 1979.
Cutler, M., Little, J. W., & Strauss, A. A. The effect of Benzedrine on mentally deficient children.American Journal of Mental Deficiency, 1940–41,45, 59–65.
Davis, K. V. The effect of drugs on stereotyped and nonstereotyped operant behaviors in retardates.Psychopharmacologia (Berlin), 1971,22, 195–213.
Davis, K. V., Sprague, R. L., & Werry, J. S. Stereotyped behavior and activity level in severe retardates: The effect of drugs.American Journal of Mental Deficiency, 1969,73, 721–727.
Douglas, V. I. Differences between normal and hyperkinetic children. In C. Conners (Ed.),Clinical use of stimulant drugs in children. Amsterdam: American Elsevier, 1974.
FitzGerald, F. Effects of d-amphetamine upon behavior of young chimpanzees reared under different conditions. In H. Brill & J. Cole (Eds.),Neuropsychopharmacology (Vol. 5). Amsterdam: Elsevier, 1967.
Freeman, R. D. Psychopharmacology and the retarded child. In F. J. Menolascino (Ed.),Psychiatric approaches to mental retardation. New York: Basic Books, 1970.
Freeman, B. F., Ritvo, E. R., Schroth, P. C., Tonick, I., Guthrie, D., & Wake, L. Behavioral characteristics of high- and low-IQ autistic children.American Journal of Psychiatry, 1981,138, 25–29.
Groves, P. M. Possible mechanisms involved in the stereotyped behavior elicited by amphetamine.Biological Psychiatry, 1977,12, 381–388.
Hagen, J. W. The effect of distraction on selective attention.Child Development, 1967,38, 685–694.
Hampton, W. H. Observed psychiatric reactions following use of amphetamine and amphetamine-like substances.Bulletin of the New York Academy of Medicine, 1961,37, 167–175.
Heistad, G. T., & Zimmerman, R. L. Double-blind assessment of Mellaril in a mentally retarded population using detailed evaluations.Psychopharmacology Bulletin, 1979,15, 86–88.
Hollis, J. H. Chlorpromazine: Direct measurement of differential behavioral effect.Science, 1968,159, 1487–1489.
Hutt, C., & Hutt, S. J. Stereotypies and their relation to arousal: A study of autistic children. In S. J. Hutt & C. Hutt (Eds.),Behavior studies in psychiatry. Oxford: Pergamon Press, 1970.
Knights, R. M., & Hinton, G. G. The effects of methylphenidate (Ritalin) on the motor skills and behavior of children with learning problems.Journal of Nervous and Mental Disease, 1969,148, 643–653.
Koegel, R. L., & Wilhelm, H. Selective responding to the components of multiple visual cues by autistic children.Journal of Experimental Child Psychology, 1973,15, 442–453.
Kolko, D. J., Anderson, L., & Campbell, M. Sensory preference and overselective responding in autistic children.Journal of Autism and Developmental Disorders, 1980,10, 259–271.
Lobb, H. Trace GSR conditioning with Benzedrine in mentally defective and normal adults.American Journal of Mental Deficiency, 1968,73, 239–246.
Lovaas, O. I., Koegel, R. L., & Schreibman, L. Stimulus overselectivity in autism: A review of research.Psychological Bulletin, 1979,86, 1236–1254.
Lovaas, O. I., & Schreibman, L. Stimulus overselectivity of autistic children in a two stimulus situation.Behaviour Research and Therapy, 1971,9, 305–310.
Lovaas, O. I., Schreibman, L., Koegel, R. L., & Rehm, R. Selective responding by autistic children to multiple sensory input.Journal of Abnormal Psychology, 1971,77, 211–222.
Lyon, M., & Randrup, A. The dose-response effect of amphetamine upon avoidance behavior in the rat seen as a function of increasing stereotypy.Psychopharmacologia, 1972,23, 334–347.
Lyon, M., & Robbins, T. The action of central nervous system stimulant drugs: A general theory concerning amphetamine effects. In W. B. Essman & L. Valzelli (Eds.),Current developments in psychopharmacology (Vol. 2). New York: Spectrum, 1975.
Mackworth, N. H.Researches on the measurement of human performance. London: His Majesty's Stationery Office, 1950.
McConnell, T. R., Cromwell, R. L., Bialer, I., & Son, C. D. Studies in activity level: VII. Effects of amphetamine drug administration on the activity level of retarded children.American Journal of Mental Deficiency, 1964,68, 647–651.
Morris, J. V., MacGillivray, R. C., & Mathieson, C. M. The results of the experimental administration of amphetamine sulfate, in oligophrenia.Journal of Mental Science/British Journal of Psychiatry, 1955,101, 131–140.
Munkvad, I., & Randrup, A. The persistence of amphetamine stereotypies of rats in spite of strong sedation.Acta Psychiatrica Scandinavica, 1966,42(Suppl. 191), 178–187.
Radosh, A., & Gittelman, R. The effect of appealing distractors on the performance of hyperactive children.Journal of Abnormal Child Psychology, 1981,9, 179–189.
Randrup, A., & Munkvad, I. On the relation of tryptaminic and serotonergic mechanisms to amphetamine induced abnormal behavior.Acta Pharmacologica et Toxicologica, 1964,21, 272–282.
Randrup, A., & Munkvad, I. Special antagonism of amphetamine-induced abnormal behaviour. Inhibition of stereotyped activity with increase of some normal activities.Psychopharmacologia, 1965,7, 416–422.
Randrup, A., & Munkvad, I. Dopa and other naturally occurring substances as causes of stereotypy and rage in rats.Acta Psychiatrica Scandinavica, 1966,42(Suppl. 191), 193–199.
Randrup, A., & Munkvad, I. Stereotyped activities produced by amphetamine in several animal species and man.Psychopharmacologia, 1967,11, 300–310.
Randrup, A., & Munkvad, I. Biochemical, anatomical and psychological investigations of stereotyped behavior induced by amphetamines. In E. Costa & S. Garattini (Eds.),Amphetamines and related compounds. New York: Raven Press, 1970.
Randrup, A., & Munkvad, I. Pharmacology and physiology of stereotyped behavior.Journal of Psychiatric Research, 1974,11, 1–10.
Randrup, A., Munkvad, I., & Udsen, P. Adrenergic mechanisms and amphetamine induced abnormal behaviour.Acta Pharmacologica et Toxicologica, 1963,20, 145–157.
Rapoport, J. L., Buchsbaum, M. S., Weingartner, H., Zahn, T. P., Ludlow, C., & Mikkelsen, E. J. Dextroamphetamine-Its cognitive and behavioral effects in normal and hyperactive boys and normal men.Archives of General Psychiatry, 1980,37, 933–943.
Rapoport, J. L., Buchsbaum, M. S., Zahn, T. P., Weingartner, H., Ludlow, C., & Mikkelsen, E. J. Dextroamphetamine: Cognitive and behavioral effects in normal prepubertal boys.Science, 1978,199, 560–563.
Reynolds, B. S., Newsom, C. D., & Lovaas, O. I. Auditory overselectivity in autistic children.Journal of Abnormal Child Psychology, 1974,2, 253–263.
Robbins, T. W., & Sahakian, B. J. “Paradoxical” effects of psychomotor stimulant drugs in hyperactive children from the standpoint of behavioural pharmacology.Neuropharmacology, 1979,18, 931–950.
Rosenthal, R. H., & Allen, T. W. Intratask distractibility in hyperkinetic and nonhyperkinetic children.Journal of Abnormal Child Psychology, 1980,8, 175–187.
Rylander, G. Stereotype behaviour in man following amphetamine abuse. In S. B. deC. Baker (Ed.),The correlation of adverse effects in man with observations in animals. Amsterdam: Excerpta Medica, 1971.
Safer, D. J., & Allen, R. P.Hyperactive children: Diagnosis and management. Baltimore: University Park Press, 1976.
Satterfield, J. H., Atoian, G. E., Brashears, G. C., Burleigh, A. C., & Dawson, M. E. Electrodermal studies in minimal brain dysfunction in children. In C. K. Conners (Ed.),Symposium on the clinical use of stimulant drugs in children. Amsterdam: Excerpta Medica, 1974.
Satterfield, J. H., & Dawson, M. E. Electrodermal correlates of hyperactivity in children.Psychophysiology, 1971,8, 191–197.
Schover, L. R., & Newsom, C. D. Overselectivity, developmental level, and overtraining in autistic and normal children.Journal of Abnormal Child Psychology, 1976,4, 289–298.
Singh, N. N., & Aman, M. G. Effects of thioridazine dosage on the behavior of severely mentally retarded persons.American Journal of Mental Deficiency, 1981,85, 580–587.
Sostek, A. J., Buchsbaum, M. S., & Rapoport, J. L. Effects of amphetamine on vigilance performance in normal and hyperactive children.Journal of Abnormal Child Psychology, 1980,8, 491–500.
Spencer, D. A. Ronyl (pemoline) in overactive mentally subnormal children.British Journal of Psychiatry, 1970,11, 239–240.
Sprague, R. L., & Sleator, E. K. Methylphenidate in hyperkinetic children: Differences in dose effects on learning and social behavior.Science, 1977,198, 1274–1276.
Sprague, R. L., & Werry, J. S. Methodology of psychopharmacological studies with the retarded. In N. R. Ellis (Ed.),International review of research in mental retardation (Vol. 5). New York: Academic Press, 1971.
Sroufe, L. Drug treatment of children with behavior problems. In F. Horowitz (Ed.),Review of child development research (Vol. 4). Chicago: University of Chicago Press, 1975.
Ullman, D. G. Breadth of attention and retention in mentally retarded and intellectually average children.American Journal of Mental Deficiency, 1974,78, 640–648.
Weiss, B., & Laties, V. G. Enhancement of human performance by caffeine and the amphetamines.Psychological Review, 1962,14, 1–36.
Werry, J. S., & Aman, M. G. Methylphenidate in hyperactive and enuretic children. In B. Shopsin & L. Greenhill (Eds.),The psychobiology of childhood: Profile of current issues. Jamaica, New York: Spectrum Publications, in press.
Wilhelm, H., & Lovaas, O. I. Stimulus overselectivity: A common feature in autism and mental retardation.American Journal of Mental Deficiency, 1976,81, 227–241.
Zahn, T. P., Rapoport, J. L., & Thompson, C. L. Autonomic and behavioral effects of dextroamphetamine and placebo in normal and hyperactive prepubertal boys.Journal of Abnormal Child Psychology, 1980,8, 145–160.
Zeaman, D. Learning processes of the mentally retarded. In S. Osler & R. E. Cooke (Eds.).The biosocial basis of mental retardation. Baltimore: Johns Hopkins Press, 1965.
Zeaman, D., & House, B. J. The role of attention in retardate discrimination learning. In N. R. Ellis (Ed.),Handbook of mental deficiency. New York: McGraw-Hill, 1963.
Zimmermann, R. L., & Heistad, G. T. Studies of the efficacy of antipsychotic drugs in institutionalized mentally retarded patients.Journal of the American Academy of Child Psychiatry (Special issue on psychopharmacology), 1982,21, 136–143.
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This research was supported by a grant from the Medical Research Council of New Zealand to Professor J. S. Werry. The author would like to thank the following for their helpful comments on this paper: Professor J. S. Werry, Dr. R. Kydd, S. Eastgate, M. A., Department of Psychiatry, and Dr. K. Wilton, Department of Education (all from the University of Auckland), and Dr. N. Singh, Department of Psychology, University of Canterbury.
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Aman, M.G. Stimulant drug effects in developmental disorders and hyperactivity — Toward a resolution of disparate findings. J Autism Dev Disord 12, 385–398 (1982). https://doi.org/10.1007/BF01538326
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DOI: https://doi.org/10.1007/BF01538326