Faculty Bibliography

We evaluated whether, among hyperactive children who required maintenance stimulant treatment, cognitive training enhanced academic performance; improved the functioning of youngsters who had only a partial behavioral response to medication; facilitated withdrawal of stimulant treatment; and enhanced maintenance effects of academic gains following termination of stimulants. A 16-week cognitive training program that emphasized reflective problem-solving strategies and social problem-solving skills was compared with an attention control treatment and with no training. There was virtually no evidence of efficacy of cognitive training. No significant treatment effects were obtained on academic, behavioral, and cognitive measures. Cognitive training did not improve behavior among children with residual problems, nor did it facilitate the withdrawal of medication. With placebo substitution, the overwhelming majority of children required remedication, regardless of previous exposure to cognitive training

State-dependent learning refers to a failure of learning mastered under one drug condition to be remembered when tested under another drug condition. Previous studies of state-dependent learning in hyperactive children receiving stimulants have yielded conflicting results. The authors systematically evaluated learning and transfer of learning in children who were or were not receiving methylphenidate and included several design features intended to optimize the likelihood of demonstrating state-dependent learning. They found no evidence of state-dependent learning. These results diminish concern regarding state-dependent effects in hyperactive children who are positive drug responders and who are clinically administered methylphenidate to control their hyperactivity

This study examined whether methylphenidate normalizes the behavior of hyperactive children (ADDH). Twenty-eight ADDH children were treated for 8 weeks with a mean dose of 41.5 mg/d of methylphenidate. Their classroom behavior and that of normal children was recorded by observers who were blind to diagnosis and treatment. Before treatment, all measures significantly differentiated the ADDH and normal children. After treatment, the two groups were indistinguishable on measures of gross and minor motor movement, noncompliance, interference, and overall hyperactivity. ADDH children were significantly improved on measures of attention but continued to be significantly less attentive. In many ways, the ADDH children were not only improved but indistinguishable from their normal peers

Reviews the efficacy of cognitive training interventions in children with hyperactivity (attention deficit disorder with hyperactivity) in terms of the impact of training on cognitive, academic, and behavioral functioning in medicated and unmedicated youngsters. It is argued that the expectation that self-regulation skills facilitate generalization and maintenance effects has, in most cases, not been substantiated. Suggestions for enhancing transfer effects are presented. It is suggested that greater attention be given to individual differences; the development of a problem-solving assessment battery is proposed. It is concluded that the clinical utility of cognitive training in the treatment of attention deficit disorders has not yet been established. (3 p ref) (PsycIN

This study evaluated the effectiveness of eight weeks of intensive behavioral treatment in normalizing the classroom behavior of 28 children with attention deficit disorder with hyperactivity (ADDH). Using blind classroom observers, treatment efficacy was examined for full normalization, partial normalization, and the rate of hyperactive children classified as being like normals. Evidence for normalization was scarce. With treatment, there was no significant change in the percentage of hyperactive children classified as normal. Some normalization gains were found at midtreatment but were not sustained. Attention, activity, and impulsivity, the primary features of ADDH, were not normalized. Aggression, however, was consistently and fully normalized. The modification of aggression does not appear to remedy hyperactive behaviors. The clinical meaningfulness of treatment was minimal; the hyperactive children remained deviant in many aspects of classroom conduct