title: Randomized, placebo-controlled, crossover study of methylphenidate for attention-deficit/hyperactivity disorder symptoms in preschoolers with developmental disorders.
abstract: OBJECTIVE
  The aim of this study was to investigate the short-term efficacy and safety of methylphenidate (MPH) to treat attention-deficit/hyperactivity disorder (ADHD) symptoms in an understudied population of preschoolers with pervasive developmental disorder (PDD) or intellectual disability (ID).
  
  
  METHODS
  Fourteen preschoolers with developmental disorders (DD, n = 14; PDD, n = 12; ID, n = 2) underwent MPH titration in a single-blind manner followed by a 4-week double-blind crossover phase. Each child was administered placebo for 2 weeks and "optimal dose" for 2 weeks. The primary outcome measure was the Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition (DSM-IV) ADHD subscale of the Conners' Parent Rating Scale-Revised (CPRS-R-DSM-IV-ADHD).
  
  
  RESULTS
  MPH improved parent-rated ADHD symptoms of the preschoolers; 50% were rated as responders. The CPRS-R-DSM-IV-ADHD subscale was significant for the PDD subgroup (p = 0.005, Cohen d = 0.97) and marginally significant for the entire DD sample (p = 0.08, Cohen d = 0.50). Half of the preschoolers experienced side effects with MPH, including reports of increased stereotypic behavior, upset stomach, sleep-related difficulties, and emotional lability. One child discontinued during titration due to side effects.
  
  
  CONCLUSIONS
  The predominant direction of response in these preschoolers with both ADHD and PDD/ID favored MPH, even though the response was more subtle and variable than in older and typically developing children. Due to high rates of adverse effects, preschoolers should be monitored closely.
authors.affiliation: University of Arizona , Child and Adolescent Psychiatry, Tucson, Arizona 85724-5002, USA. jkghuman@email.arizona.edu
authors.forename: Jaswinder K
authors.initials: JK
authors.lastname: Ghuman
authors.forename: Michael G
authors.initials: MG
authors.lastname: Aman
authors.forename: Luc
authors.initials: L
authors.lastname: Lecavalier
authors.forename: Mark A
authors.initials: MA
authors.lastname: Riddle
authors.forename: Alan
authors.initials: A
authors.lastname: Gelenberg
authors.forename: Ron
authors.initials: R
authors.lastname: Wright
authors.forename: Sydney
authors.initials: S
authors.lastname: Rice
authors.forename: Harinder S
authors.initials: HS
authors.lastname: Ghuman
authors.forename: Carolyn
authors.initials: C
authors.lastname: Fort
mesh_terms: D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D002659:Child Development Disorders, Pervasive / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D002675:Child, Preschool; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D016037:Single-Blind Method
chemical_list: D008774:Methylphenidate
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