ADHD Children's Responses to Stimulant Medication and Two Intensities of a Behavioral Intervention

Abstract

Multimodal interventions involving pharmacotherapy and behavior therapy are increasingly viewed as the treatment of choice for Attention-Deficit Hyperactivity Disorder (ADHD). Virtually all investigations of combined treatments have involved powerful behaviortherapy packages including token economies. Such interventions are costly and labor intensive and not accessible to most youngsters with the disorder. This study examined the effects of a relatively simple behavioral intervention alone and in combination with stimulant medication. Subjects were three boys, ages 10 and 11, attending a summer day treatment program. Rates of off-task behavior in the classroom were examined in relation to all six possible conbinations of two doses of methylphenidate plus placebo and two "intensities" of teacher reprimands, immediate and delayed. Results suggest that for some children with ADHD, a simple behavioral intervention implemented in its most intense form can achieve results comparable to those achieved with medication. Additionally, for some children medication can obviate the need forthe most intense form of a behavioral intervention. A case-by-case assessment is necessary and feasible.