Swipe om te navigeren naar een ander artikel
This research was funded by a grant from the National Institute of Mental Health (MH62946). Dr. Pelham was also supported in part by grants from the National Institute of Mental Health (MH092466, MH53554, MH065899, MH62988), the Institute of Education Sciences (R37A120169 LO30000665A, R324B06045), the National Institute of Alcohol Abuse and Alcoholism (AA11873), the National Institute on Drug Abuse (DA12414, DA12986), and the National Institute of Child Health and Human Development (HD040935).
Placebo and three doses of methylphenidate (MPH) were crossed with 3 levels of behavioral modification (no behavioral modification, NBM; low-intensity behavioral modification, LBM; and high-intensity behavior modification, HBM) in the context of a summer treatment program (STP). Participants were 48 children with ADHD, aged 5–12. Behavior was examined in a variety of social settings (sports activities, art class, lunch) that are typical of elementary school, neighborhood, and after-school settings. Children received each behavioral condition for 3 weeks, order counterbalanced across groups. Children concurrently received in random order placebo, 0.15 mg/kg/dose, 0.3 mg/kg/dose, or 0.6 mg/kg/dose MPH, 3 times daily with dose manipulated on a daily basis in random order for each child. Both behavioral and medication treatments produced highly significant and positive effects on children’s behavior. The treatment modalities also interacted significantly. Whereas there was a linear dose–response curve for medication in NBM, the dose–response curves flattened considerably in LBM and HBM. Behavior modification produced effects as large as moderate doses, and on some measures, high doses of medication. These results replicate and extend to social-recreational settings previously reported results in a classroom setting from the same sample (Fabiano et al., School Psychology Review, 36, 195–216, 2007). Results illustrate the importance of taking dosage/intensity into account when evaluating combined treatments; there were no benefits of combined treatments when the dosage of either treatment was high but combination of the low-dose treatments produced substantial incremental improvement over unimodal treatment.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Abikoff, H., Hechtman, L., Klein, R. G., Weiss, G., Fleiss, K., Etcovitch, J., et al. (2004). Symptomatic improvement in children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 802–811. doi: 10.1097/01.chi.0000128791.10014.ac. PubMedCrossRef
Chronis, A. M., Pelham, W. E., Gnagy, E. M., Roberts, J. E., & Aronoff, H. R. (2003). The impact of late-afternoon stimulant dosing for children with ADHD on parent and parent–child domains. Journal of Clinical Child & Adolescent Psychology, 32, 118–126. doi: 10.1207/S15374424JCCP3201_11. CrossRef
Chronis, A. M., Fabiano, G. A., Gnagy, E. M., Onyango, A. N., Pelham, W. E., Williams, A., et al. (2004). An evaluation of the summer treatment program for children with attention-deficit/hyperactivity disorder using a treatment withdrawal design. Behavior Therapy, 35, 561–585. doi: 10.1016/S0005-7894(04)80032-7. CrossRef
DuPaul, G. J., & Eckert, T. L. (1997). The effects of school-based interventions for attention deficit hyperactivity disorder: a meta-analysis. School Psychology Review, 26, 5–27.
Fabiano, G. A., Pelham, W. E., Waschbusch, D., Gnagy, E. M., Lahey, B. B., Chronis, A. M., et al. (2006). A practical impairment measure: psychometric properties of the impairment rating scale in samples of children with attention-deficit/hyperactivity disorder and two school-based samples. Journal of Clinical Child and Adolescent Psychology, 35, 369–385. doi: 10.1207/s15374424jccp3503_3. PubMedCrossRef
Fabiano, G. A., Pelham, W. E., Gnagy, E. M., Burrows-MacLean, L., Coles, E. K., Chacko, A., et al. (2007). The single and combined effects of multiple intensities of behavior modification and multiple intensities of methylphenidate in a classroom setting. School Psychology Review, 36, 195–216.
Jadad, A. R., Boyle, M., Cunningham, C., Kim, M., & Schachar, R. (1999). Treatment of attention-deficit hyperactivity disorder. Evidence Report/Technology Assessment No. 11. Rockville: Agency for Healthcare Research and Quality.
Kolko, D. J., Bukstein, O. G., & Barron, J. (1999). Methylphenidate and behavior modification in children with ADHD and comorbid ODD or CD: main and incremental effects across settings. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 578–586. doi: 10.1097/00004583-199905000-00020. PubMedCrossRef
Loney, J., & Milich, R. (1982). Hyperactivity, inattention, and aggression in clinical practice. In M. Wolraich & D. K. Routh (Eds.), Advances in developmental and behavioral pediatrics (Vol. 3, pp. 113–147). Greenwich: JAI Press.
Northup, J., Fusilier, I., Swanson, V., Huerte, J., Bruce, T., Freeland, J., et al. (1999). Further analysis of the separate and interactive effects of methylphenidate and common classroom contingencies. Journal of Applied Behavior Analysis, 32, 35–50. doi: 10.1901/jaba.1999.32-35. PubMedCentralPubMedCrossRef
O’Connor, B., Fabiano, G. A., Waschbusch, D. A., Belin, P. J., Gnagy, E. M., Pelham, W. E., et al. (2013). Effects of a summer treatment program on functional sports outcomes in young children with ADHD. Manuscript submitted for publication.
Page, T., Fabiano, G., Greiner, A., Waxmonsky, J., Pelham W.E. III, Gnagy, E., et al. (2013). Comparative cost analysis of sequential, adaptive, behavioral, pharmacological, and combined treatments for ADHD. Manuscript submitted for publication.
Pelham, W. E. (1993). Pharmacotherapy for children with attention-deficit hyperactivity disorder. School Psychology Review, 22, 199–227.
Pelham, W. E. Jr., Burrows-MacLean, L., Massetti, G., Coles, E. K., Wymbs, B. T., Chacko, A., et al. (2013). Behavioral and pharmacological treatment for children with ADHD in the home setting. Manuscript submitted for publication.
Pelham, W. E. Jr., Fabiano, G., Waxmonsky, J., Greiner, A., Gnagy, E., & Murphy, S. (2013). Treatment sequencing for ADHD: An adaptive, multiple-randomization study of medication and behavioral interventions. Manuscript submitted for publication.
Pelham, W. E., & Waschbusch, D. A. (1999). Behavioral intervention in ADHD. In H. C. Quay & A. Hogan (Eds.), Handbook of disruptive behavior disorders (pp. 255–278). New York: Plenum. CrossRef
Pelham, W. E., Bender, M. E., Caddell, J., Booth, S., & Moorer, S. H. (1985). Methylphenidate and children with attention deficit disorder: dose effects on classroom academic and social behavior. Archives of General Psychiatry, 42, 948–952. doi: 10.1001/archpsyc.1985.01790330028003. PubMedCrossRef
Pelham, W. E., Greenslade, K. E., Vodde-Hamilton, M. A., Murphy, D. A., Greenstein, J. J., Gnagy, E. M., et al. (1990a). Relative efficacy of long-acting stimulants on children with attention deficit-hyperactivity disorder: a comparison of standard methylphenidate, sustained-release methylphenidate, sustained-release dextroamphetamine, and Pemoline. Pediatrics, 86, 226–237. PubMed
Pelham, W. E., Carlson, C., Sams, S. E., Vallano, G., Dixon, M. J., & Hoza, B. (1993). Separate and combined effects of methylphenidate and behavior modification on boys with ADHD in the classroom. Journal of Consulting and Clinical Psychology, 61, 506–515. doi: 10.1037/0022-006X.61.3.506. PubMedCrossRef
Pelham, W. E., Greiner, A. R., & Gnagy, E. M. (1997). Summer treatment program manual. Buffalo: Comprehensive Treatment for Attention Deficit Disorders, Inc.
Pelham, W. E., Aronoff, H. R., Midlam, J. K., Shapiro, C. J., Gnagy, E. M., Chronis, A. M., et al. (1999). A comparison of Ritalin and Adderall: efficacy and time-course in children with attention-deficit/hyperactivity disorder. Pediatrics, 103. Retrieved from: http://www.pediatrics.org/cgi/content/full/103/4/e43.
Pelham, W. E., Gnagy, E. M., Greiner, A. R., Hoza, B., Hinshaw, S. P., Swanson, J. M., et al. (2000). Behavioral vs. behavioral and pharmacological treatment in ADHD children attending a summer treatment program. Journal of Abnormal Child Psychology, 28, 507–526. doi: 10.1023/A:1005127030251. PubMedCrossRef
Pelham, W. E., Gnagy, E. M., Burrows-MacLean, L., Williams, A., Fabiano, G. A., Morrisey, S. M., et al. (2001). Once-a-day Concerta™ methylphenidate versus t.i.d. methylphenidate in laboratory and natural settings. Pediatrics, 107. Retrieved from: http://www.pediatrics.org/cgi/content/full/107/6/e105. doi: 10.1542/peds.107.6.e105.
Pelham, W. E., Burrows-MacLean, L., Gnagy, E. M., Fabiano, G. A., Coles, E. K., Tresco, K. E., et al. (2005). Transdermal methylphenidate, behavioral, and combined treatment for children with ADHD. Experimental and Clinical Psychopharmacology, 13, 111–126. doi: 10.1037/1064-1218.104.22.168. PubMedCrossRef
Pelham, W. E., Gnagy, E. M., Greiner, A. R., Waschbusch, D. A., Fabiano, G. A., & Burrows-MacLean, L. (2010). Summer treatment programs for attention deficit/hyperactivity disorder. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (2nd ed., pp. 277–292). New York: The Guilford Press.
Stage, S. A., & Quiroz, D. R. (1997). A meta-analysis of interventions to decrease disruptive classroom behavior in public education settings. School Psychology Review, 26, 333–368.
Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management. (2011). ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of Attention-Deficit/Hyperactivity Disorder in children and adolescents. Pediatrics, 128, 2011–2654. doi: 10.1542/peds.2011-2654. CrossRef
Swanson, J. M., Elliott, G. R., Greenhill, L. L., Wigal, T., Arnold, L. E., Vitiello, B., et al. (2007). Effects of stimulant medication on growth rates across 3 years in the MTA follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1014–1026. doi: 10.1097/chi.0b013e3180686d7e.
Van der Oord, S., Prins, P. J. M., Oosterlan, J., & Emmelkamp, P. M. G. (2008). Efficacy of methylphenidate, psychosocial treatments and their combination in school-aged children with ADHD: a meta-analysis. Clinical Psychology Review, 28, 783–800. doi: 10.1016/j.cpr.2007.10.007. PubMedCrossRef
Waschbusch, D. A., Cunningham, C. E., Pelham, W. E., Rimas, H. L., Greiner, A. R., Gnagy, E. M., et al. (2011). A discrete choice conjoint experiment to evaluate parent preferences for treatment of young, medication naïve children with ADHD. Journal of Clinical Child and Adolescent Psychology, 40(4), 546–561. doi: 10.1080/15374416.2011.581617. PubMedCentralPubMedCrossRef
Wechsler, D. (1991). Wechsler intelligence scale for children (3rd ed.). San Antonio: The Psychological Corporation.
- A Dose-Ranging Study of Behavioral and Pharmacological Treatment in Social Settings for Children with ADHD
William E. Pelham
Elizabeth M. Gnagy
Gregory A. Fabiano
Erika K. Coles
Brian T. Wymbs
Kathryn S. Walker
Martin T. Hoffman
James G. Waxmonsky
Daniel A. Waschbusch
- Springer US