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ADHD in Children Health Center

Ritalin, Behavior Modification Make the Grade for ADHD

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The students received either placebo or Ritalin three times per day during the eight weeks of the study. Each student received a different dose of the drug or a placebo each day of the study, allowing the researchers to compare how the students behaved and performed academically at each dose.

The students also received behavior modification therapy aimed at helping them to control their behavior and function better in settings such as school. Instruction included tips on better note-taking, social skills, and problem-solving.

The researchers looked at the quality of the students' notes, performance on daily quizzes, writing assignments, in-class worksheets, and how often they completed assigned homework. The students were also monitored for signs of ADHD-related behavior in the classroom.

About 80% of the students showed some degree of academic improvement while taking Ritalin. The biggest improvement occurred at the smallest drug dose (10 mg), with lesser improvements seen when the dose was doubled or tripled.

Pelham tells WebMD the study focused only on daily productivity in the classroom, and not long-term effects on academic performance. In fact, says an education specialist who was not involved in the study, it's not clear whether taking Ritalin now will help with a student's chance of getting into a good college later.

Judith Wiener, PhD, professor of human development and applied psychology at the University of Toronto, tells WebMD studies have shown Ritalin to have inconsistent effects on academic performance.

"What seems to be the case is that if you look at long-term outcomes of kids with ADHD who have or have not been on Ritalin, that you get no differences," she says. "On the other hand, if you look at things like task engagement -- short-term gains on specific tasks while they're taking the drugs vs. not -- then you tend to get better results from the Ritalin group."

Wiener suspects Ritalin has no effect on long-term academic performance because over time, other factors interfere with academic achievement.

Still, Pelham tells WebMD, behavior modification -- working with children in the classroom to provide positive incentives for appropriate behavior and penalties for inappropriate behavior -- may be all that some children or teens with ADHD need to work well in school.

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