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ERIC Number: EJ1013219
Record Type: Journal
Publication Date: 2013-Jun
Pages: 3
Abstractor: ERIC
Reference Count: 8
ISSN: ISSN-0021-9630
Commentary: Filling Out the Evidence Base for Treatment of Attention-Deficit Hyperactivity Disorder Symptoms in Children with Intellectual and Developmental Disability: Conclusions for Clinicians--A Response to Simonoff et al. (2013)
Arnold, L. Eugene
Journal of Child Psychology and Psychiatry, v54 n6 p701-703 Jun 2013
This randomized clinical trial of methylphenidate in children with intellectual disability (ID) by Simonoff et al. (2013) advances the field in several ways useful to clinicians. The large ("N" = 122) widely representative sample more definitively confirms findings previously reported from smaller studies and studies with a differently selected sample. The medium placebo-controlled effect size found is in line with previous more tentative suggestions for ID, such as those summarized by Aman, Buican, and Arnold (2003). This sample, selected for ID but coincidentally including some children with autism (a third of the sample), nicely complements the Research Units on Pediatric Psychopharmacology (RUPP) Autism Network (2005) study of 72 children with autism, most of whom also had ID (mean IQ 62.6, range 16-35). Similar effect was found in both studies, suggesting that one might expect a medium effect widely in the intellectual and developmental disability (IDD) population, with a 40-50% response rate. However, the rate of intolerable side effects was considerably lower in this trial (5/61, 8%) than in the RUPP Autism trial (13/72, 18%). The author suggests that this could be due to children with autism being more sensitive to the side effects than other children with ID, but could also be a difference in design. The author also notes that another interesting contrast is pattern similar to that of typically developing children (albeit at a lower level), whereas in the RUPP Autism study, the effect by parent ratings ("d" = 0.89) was larger than by teacher rating ("d" = 0.48). This could be due to the differences in school placement or situation-specific responses by children with autism. A possible explanation of some of the outcome differences might be the diagnostic inclusion screen. Putting the Simonoff et al. findings together with other relevant literature, the author presents several clinical implications.
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Publication Type: Journal Articles; Reports - Evaluative; Opinion Papers
Education Level: N/A
Audience: N/A
Language: English
Sponsor: N/A
Authoring Institution: N/A