title: Ameliorating attention problems in children with sickle cell disease:  a pilot study of methylphenidate.
abstract: OBJECTIVE
  This pilot study examined whether methylphenidate (MPH) was effective in enhancing cognitive performance and attention for children with sickle cell disease (SCD) with cerebrovascular complications who evidence attention problems.
  
  
  METHODS
  In this multisite, pilot study, we evaluated 2 separate double-blind controlled clinical trials, including a laboratory trial of the short-term efficacy of MPH, with the second study a 3-week home/school crossover trial evaluating the efficacy of MPH. The laboratory trial included 14 participants between the age of 7 and 16 years. Assessments included measures of sustained attention, reaction time, executive functions, and verbal memory. The home/school trial included 20 participants. The outcome measures were parent and teacher ratings of attention. The first study compared MPH with placebo, while the second trial compared placebo, low-dose (LD) MPH, and moderate-dose MPH.
  
  
  RESULTS
  In the laboratory trial, significant effects were revealed for measures of memory and inhibitory control. Parent and teacher reports from the home/school trial indicate that moderate-dose MPH produced superior improvement in attention relative to the placebo and LD MPH.
  
  
  CONCLUSIONS
  Stimulant medication positively impacted select measures of memory and inhibitory control in some children with SCD. Attention, as rated by parent and teachers, was improved for a greater number of children and adolescents on higher doses of MPH relative to LD MPH and placebo. Stimulant medication may provide an effective intervention for some children with SCD and cerebrovascular complications who demonstrate attention problems.
authors.affiliation: Department of Psychology, Drexel University, Philadelphia, PA 19104, USA. brian.daly@drexel.edu
authors.forename: Brian
authors.initials: B
authors.lastname: Daly
authors.forename: Mary C
authors.initials: MC
authors.lastname: Kral
authors.forename: Ronald T
authors.initials: RT
authors.lastname: Brown
authors.forename: David
authors.initials: D
authors.lastname: Elkin
authors.forename: Avi
authors.initials: A
authors.lastname: Madan-Swain
authors.forename: Monica
authors.initials: M
authors.lastname: Mitchell
authors.forename: Lori
authors.initials: L
authors.lastname: Crosby
authors.forename: David
authors.initials: D
authors.lastname: Dematteo
authors.forename: Angela
authors.initials: A
authors.lastname: Larosa
authors.forename: Sherron
authors.initials: S
authors.lastname: Jackson
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D001288:Attention / Q000187:drug effects*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D002648:Child; D003071:Cognition / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage*; D010865:Pilot Projects; D011930:Reaction Time / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate