title: Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-only, ADHD and conduct problems, and controls.
abstract: OBJECTIVE
  This study compared the unique and combined effects of evidence-based treatments for ADHD-stimulant medication and behavior modification-on children's rates of reinforcement for deviant peer behavior (RDPB).
  
  
  METHODS
  Using a within-subjects design, 222 elementary school-age children attending a summer treatment program, including 151 children with ADHD (127 male), with and without comorbid conduct problems, and 71 control children (57 male), received varying combinations of behavior modification (no, low-intensity, and high-intensity) and methylphenidate (placebo, 0.15 mg/kg, 0.30 mg/kg, and 0.60 mg/kg). RDPB was measured through direct observation and compared across all behavior modification and medication conditions.
  
  
  RESULTS
  Children with ADHD reinforced the deviant behavior of their peers at a significantly higher rate than control children in the absence of either intervention. However, that difference largely disappeared in the presence of both behavior modification and medication. Both low and high-intensity behavior modification, as well as medium (0.30 mg/kg) and high (0.60 mg/kg) doses of methylphenidate, significantly reduced the rate of ADHD children's RDPB to levels similar to the control group.
  
  
  CONCLUSIONS
  Results indicate that although untreated children with ADHD do engage in RDPB at a greater rate than their non-ADHD peers, existing evidence-based interventions can substantially decrease the presence of RDPB, thereby limiting potential iatrogenic effects in group-based treatment settings.
authors.affiliation: Department of Psychology, Florida International University.
authors.forename: Sarah A
authors.identifier: 0000-0002-3497-2241
authors.initials: SA
authors.lastname: Helseth
authors.affiliation: Department of Psychology, Florida International University.
authors.forename: Daniel A
authors.identifier: 0000-0002-8115-1286
authors.initials: DA
authors.lastname: Waschbusch
authors.affiliation: Department of Psychology, Florida International University.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Gnagy
authors.affiliation: Department of Psychology, State University of New York.
authors.forename: Adia N
authors.initials: AN
authors.lastname: Onyango
authors.affiliation: Department of Psychology, State University of New York.
authors.forename: Lisa
authors.initials: L
authors.lastname: Burrows-MacLean
authors.affiliation: Department of Psychology, State University of New York.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Fabiano
authors.affiliation: Department of Psychology, Florida International University.
authors.forename: Erika K
authors.initials: EK
authors.lastname: Coles
authors.affiliation: Department of Applied Psychology, New York University.
authors.forename: Anil
authors.identifier: 0000-0002-3275-4726
authors.initials: A
authors.lastname: Chacko
authors.affiliation: Department of Psychology, Ohio University.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Wymbs
authors.affiliation: Department of Psychology, State University of New York.
authors.forename: Kathryn S
authors.initials: KS
authors.lastname: Walker
authors.affiliation: Department of Psychology, Ohio University.
authors.forename: Frances A
authors.initials: FA
authors.lastname: Wymbs
authors.affiliation: Department of Psychology, Kennesaw State University.
authors.forename: Allison
authors.initials: A
authors.lastname: Garefino
authors.affiliation: Department of Psychology, Florida International University.
authors.forename: Greta M
authors.identifier: 0000-0002-3813-9839
authors.initials: GM
authors.lastname: Massetti
authors.affiliation: Department of Psychology, Florida International University.
authors.forename: Jessica
authors.initials: J
authors.lastname: Robb Mazzant
authors.affiliation: Department of Psychology, State University of New York.
authors.forename: Martin T
authors.initials: MT
authors.lastname: Hoffman
authors.affiliation: Department of Psychology, Florida International University.
authors.forename: James G
authors.initials: JG
authors.lastname: Waxmonsky
authors.affiliation: Department of Psychology, Florida International University.
authors.forename: Kristin
authors.initials: K
authors.lastname: Nichols-Lopez
authors.affiliation: Department of Psychology, Florida International University.
authors.forename: William E
authors.initials: WE
authors.lastname: Pelham
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D019955:Conduct Disorder / Q000150:complications / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D010379:Peer Group; D012054:Reinforcement, Psychology; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate