A prospective study of stimulant response in preschool children: insights from ROC analyses.
OBJECTIVE
The purpose of this study was to examine the efficacy of psychostimulant medication in a naturalistic sample of preschoolers. Benefits and side effects for methylphenidate and mixed amphetamine salts (Adderall) were examined.


METHODS
Twenty-eight preschoolers (ages 4.0 - 5.9) participated in the present investigation. They were obtained consecutively from a large sample of suburban children assessed for attention-deficit/hyperactivity disorder. After having received various dosing levels of a stimulant in a placebo-controlled crossover design, best dose was assigned based on the lowest Abbreviated Symptoms Questionnaire T score received in a given week. All analyses compared best dose ratings to placebo ratings.


RESULTS
Preschoolers' behavioral ratings by parents and teachers were improved as a function of stimulant medication. More than 82% of the medicated sample improved their behavioral rating by at least 1 SD as demonstrated by receiver operating characteristic (ROC) analyses, with more than 50% of medicated preschoolers improving by more than 2 SD. Side effects were infrequent at best dose of medication.


CONCLUSIONS
Clinically significant changes in behavioral ratings of preschoolers were noted in response to stimulant medication. Both stimulants were well tolerated. ROC curves were useful for clearly depicting on a case-by-case basis how much improvement was derived from psychopharmacological treatment.
Short
Elizabeth J
EJ
Department of Psychology, Case Western Reserve University, Cleveland, OH 44106, USA. EJS3@PO.CWRU.edu
Manos
Michael J
MJ
Findling
Robert L
RL
Schubel
Emily A
EA
D000662:Amphetamines / Q000008:administration & dosage / Q000494:pharmacology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000494:pharmacology*; D002675:Child, Preschool; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000494:pharmacology*; D012372:ROC Curve
C090411:Adderall; D000662:Amphetamines; D000697:Central Nervous System Stimulants; D008774:Methylphenidate