Abstract
Attention deficit/hyperactivity disorder (ADHD) symptoms are common in youth with autism spectrum disorders (ASD) and are frequently treated with stimulant medications. Twenty-seven children were randomized to different dose titration schedules, and ADHD symptoms, tolerability, and aberrant behaviors were assessed weekly during a 6-week trial with long-acting liquid methylphenidate (MPH). MPH at low to moderate doses was effective in reducing ADHD symptoms and was well tolerated in young children with ASD and ADHD. Future studies are needed to assess generalization and maintenance of efficacy.



Similar content being viewed by others
References
Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. J. (1985). The aberrant behavior checklist: A behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency, 89, 485–491.
APA. (2000). Diagnostic and statistical manual of mental disorders, text revision (DSM-IV-TR), (4th ed.). Washington, DC: American Psychiatric Publishing.
APA. (2013). Diagnostic and statistical manual of mental disorders, Fifth Edition (DSM-5). Washington, DC: American Psychiatric Publishing.
Barkley, R. A., McMurray, M. B., Edelbrock, C. S., & Robbins, K. (1990). Side effects of methylphenidate in children with attention deficit hyperactivity disorder: A systemic, placebo-controlled evaluation. Pediatrics, 86, 184–192.
Campbell, M., Fish, B., David, R., Shapiro, T., Collins, P., & Koh, C. (1972). Response to triiodothyronine and dextroamphetamine: A study of preschool schizophrenic children. Journal of Autism and Developmental Disorders, 2(4), 343–358.
Frazier, T. W., Shattuck, P. T., Narendorf, S. C., Cooper, B. P., Wagner, M., & Spitznagel, E. L. (2011). Prevalence and correlates of psychotropic medication use in adolescents with an autism spectrum disorder with and without caregiver-reported attention-deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 21, 571–579.
Gadow, K. D., DeVincent, C. J., & Pomeroy, J. (2006). ADHD symptom subtypes in children with pervasive developmental disorder. Journal of Autism and Developmental Disorders, 36, 271–283.
Goldstein, S., & Schwebach, A. J. (2004). The comorbidity of pervasive developmental disorder and attention deficit hyperactivity disorder: Results of a retrospective chart review. Journal of Autism and Developmental Disorders, 34, 329–339.
Greenhill, L., Kollins, S., Abikoff, H., McCracken, J., Riddle, M., Swanson, J., et al. (2006). Efficacy and safety of immediate-release methylphenidate treatment for preschoolers with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1284–1293.
Handen, B. L., Johnson, C. R., & Lubetsky, M. (2000). Efficacy of methylphenidate among children with autism and symptoms of attention-deficit hyperactivity disorder. Journal of Autism and Developmental Disorders, 30, 245–255. doi:10.1023/A:1005548619694.
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988.
Lee, D. O., & Ousley, O. Y. (2006). Attention-deficit hyperactivity disorder symptoms in a clinic sample of children and adolescents with pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 16, 737–746.
Pearson, D. A., Santos, C. W., Aman, M. G., Arnold, L. E., Casat, C. D., Mansour, R., … Cleveland, L. A. (2013). Effects of extended release methylphenidate treatment on ratings of attention-deficit/hyperactivity disorder (ADHD) and associated behavior in children with autism spectrum disorders and ADHD symptoms. Journal of Child and Adolescent Psychopharmacology, 23(5), 337–351. doi:10.1089/cap.2012.0096.
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. Journal of Autism and Developmental Disorders, 25(3), 283–294.
Rao, P. A., Landa, R. J. (2013). Association between severity of behavioral phenotype and comorbid attention deficit hyperactivity disorder symptoms in children with autism spectrum disorders. Autism, 18, 272–280.
Robb, A. S., Findling, R .L., Childress, A. C., Berry, S. A., Belden, H. W., Wigal, S. B. (2014). Efficacy, safety, and tolerability of a novel methylphenidate extended-release oral suspension (MEROS) in ADHD. Journal of Attention Disorders. doi:10.1177/1087054714533191.
Santosh, P. J., Baird, G., Pityaratstian, N., Tavare, E., Gringas, P. (2006). Impact of comorbid autism spectrum disorders on stimulant response in children with attention deficit hyperactivity disorder: A retrospective and prospective effectiveness study. Child: Care, Health, and Development, 32, 575–583. doi:10.1111/j.1365-2214.2006.00631.x.
Stein, M. A., Mendelsohn, J., Obermeyer, W. H., Amromin, J., & Benca, R. (2001). Sleep and behavior problems in school-aged children. Pediatrics, 107, E60.
Stein, M. A., Sarampote, C. S., Waldman, I. D., Robb, A. S., Conlon, C., Pearl, P. L., et al. (2003). A dose-response study of OROS methylphenidate in children with attention-deficit/hyperactivity disorder. Pediatrics, 112, e404.
Schmidt, K. (1982). The effect of stimulant medication in childhood-onset pervasive developmental disorder—a case report. Journal of Developmental & Behavioral Pediatrics, 3(4), 244–246.
Stigler, K. A., Desmond, L. A., Posey, D. J., Wiegand, R. E., & McDougle, C. J. (2004). A naturalistic retrospective analysis of psychostimulants in pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 14, 49–56.
Volkmar, F. R., Hoder, E. L., Cohen, D. J. (1985). Inappropriate uses of stimulant medications. Clinical Pediatrics, 24, 127–130.
Author Contributions
All authors were involved in study conduct and contributed to the manuscript.
Funding
This study was an investigator initiated study funded by Pfizer Inc© (WI185890). Preliminary results of this study were presented at the American Professional Society of ADHD and Related Disorders’ annual meeting at Washington D.C. in January 2016 and the Pediatric Academic Societies’ annual meeting at Baltimore, Maryland in May 2016.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Mark A. Stein, PhD, receives research support from Akili Interactive Labs, National Institute of Mental Health, Pfizer Inc, and Shire. Mark A. Stein, PhD, is also a consultant for Akili Interactive Labs, Alcobra Pharma, Arbor Pharmaceuticals, Ironshore Pharmaceuticals and Development, Lundbeck, Shire, and Sunovion Pharmaceuticals Inc. Drs. Kim, French, Strickland, and Ms. Miller and Shonka do not have any conflicts of interest.
Rights and permissions
About this article
Cite this article
Kim, SJ., Shonka, S., French, W.P. et al. Dose-Response Effects of Long-Acting Liquid Methylphenidate in Children with Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD): A Pilot Study. J Autism Dev Disord 47, 2307–2313 (2017). https://doi.org/10.1007/s10803-017-3125-1
Published:
Issue date:
DOI: https://doi.org/10.1007/s10803-017-3125-1


