Interventions for Students with Attention-Deficit/Hyperactivity Disorder: One Size Does Not Fit All

Brief Experimental Analysis of Reading Deficits for Children With Attention-Deficit/Hyperactivity Disorder

Reading difficulties are especially high among children with attention-deficit/hyperactivity disorder (ADHD). Although there are a number of empirically supported reading interventions for children with ADHD, there is little data to guide the selection of the most efficacious reading intervention for a specific child. Brief experimental analysis (BEA) is a procedure that directly compares the efficacy of various academic interventions with the goal of guiding the selection of the intervention that results in optimal efficacy. The current proof of concept study examined the efficacy of the BEA methodology for determining the relative effectiveness of seven reading interventions for children with ADHD. The seven interventions included empirically supported ADHD interventions as well as traditional interventions found in the BEA literature. Six children diagnosed with ADHD completed the proof of concept study. Results indicated that the BEA successfully determined an efficacious intervention for each participant. The efficacy of the interventions and the optimal intervention based on BEA procedures varied for each child, suggesting the importance of a BEA approach when comparing various interventions for reading in children with ADHD. Implications and future directions for selecting effective reading interventions for children with ADHD are discussed.

Unexpected effects of methylphenidate in attention-deficit/hyperactivity disorder reflect decreases in core/secondary symptoms and physical complaints common to all children

Abstract Hypotheses concerning unexpected, psychostimulant-related effects reported in previous studies were examined by separating behavioral/physical complaints highly specific to methylphenidate (MPH) from those that (a) may mimic core/secondary symptoms of the disorder, or (b) are commonly reported by unmedicated children in the general population. Sixty-five children with attention-deficit/hyperactivity disorder (ADHD) participated in a double-blind, placebo-controlled, within-subject (crossover) experimental design and received a placebo and four MPH doses in counterbalanced order following baseline assessment. Behavioral and physical complaints were significantly higher under baseline relative to placebo and the four immediate-release MPH conditions (5 mg, 10 mg, 15 mg, and 20 mg) across three symptom categories: ADHD core/secondary symptoms; symptoms commonly reported in the general population, including unmedicated children with ADHD; and symptoms highly specific to MPH. No significant differences were found among active drug conditions. Past unexpected findings of psychostimulant effects in ADHD may be due to the inclusion of scale items that reflect core/secondary features of ADHD and normally occurring behavioral/physical complaints in children.

Sequential evaluation of behavioral treatments and methylphenidate dosage for children with attention deficit hyperactivity disorder

We used a sequential approach to evaluate the relative and combined effects of different types of behavioral treatments, as well as dosage of methylphenidate (MPH), on the disruptive behavior of 3 students who had been diagnosed with attention deficit hyperactivity disorder. Results showed that individualized behavioral treatments produced decreases in disruptive behavior equivalent to MPH for all 3 participants and demonstrated the need to evaluate behavioral treatments and medication dosage on an individual basis.

ADHD and stuttering: a tutorial

The purpose of this tutorial is twofold. The first is to provide a brief description of some of the key diagnostic features of attention deficit hyperactivity disorder (ADHD) for speech-language pathologists who might not be knowledgeable about this disorder. The second purpose is to provide information and suggestions about treating children who stutter and who have been diagnosed with ADHD. Specific information is provided regarding medication used to treat ADHD symptoms as well as the minimal documented evidence of its impact on stuttering. Suggestions for educational, behavioral, and cognitive management of children who stutter and have ADHD also are discussed.

EDUCATIONAL OBJECTIVES

The reader will learn about and be able to: (1) identify diagnostic criteria for children with ADHD; (2) differentiate pharmacological, environmental, and behavioral interventions for children with ADHD; and (3) examine effective instructional techniques for children who stutter and have ADHD.