Positive Effects of Methylphenidate on Social Communication and Self-Regulation in Children with Pervasive Developmental Disorders and Hyperactivity
ABSTRACT This report examined the effect of methylphenidate on social communication and self-regulation in children with pervasive developmental disorders and hyperactivity in a secondary analysis of RUPP Autism Network data. Participants were 33 children (29 boys) between the ages of 5 and 13 years who participated in a four-week crossover trial of placebo and increasing doses of methylphenidate given in random order each for one week. Observational measures of certain aspects of children's social communication, self-regulation, and affective behavior were obtained each week. A significant positive effect of methylphenidate was seen on children's use of joint attention initiations, response to bids for joint attention, self-regulation, and regulated affective state. The results go beyond the recent literature and suggest that methylphenidate may have positive effects on social behaviors in children with PDD and hyperactivity.
- SourceAvailable from: Yael Leitner
[Show abstract] [Hide abstract]
- "In the only controlled study of atomoxetine (Jahromi et al., 2009), results were significantly better than placebo, but the sample size was small and only 7 of 16 children (43%) were considered responders. Overall, both methylphenidate and atomoxetine appear to effectively treat ADHD-related symptoms in ASD (MTA Cooperative Group, 2004; Arnold et al., 2006, 2012; Posey et al., 2006; Santosh et al., 2006; Jahromi et al., 2009; Murray, 2010), but atomoxetine demonstrated better tolerability than stimulants in individuals with co-occurring ADHD and ASD. Response rates may, however, be lower in ASD plus ADHD, than in ADHD alone, and symptoms of inattention may be less likely to respond than symptoms of hyperactivity and impulsivity. "
ABSTRACT: Symptoms of attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD) often co-occur. The DSM-IV had specified that an ASD diagnosis is an exclusion criterion for ADHD, thereby limiting research of this common clinical co-occurrence. As neurodevelopmental disorders, both ASD and ADHD share some phenotypic similarities, but are characterized by distinct diagnostic criteria. The present review will examine the frequency and implications of this clinical co-occurrence in children, with an emphasis on the available data regarding pre-school age. The review will highlight possible etiologies explaining it, and suggest future research directions necessary to enhance our understanding of both etiology and therapeutic interventions, in light of the new DSM-V criteria, allowing for a dual diagnosis.Frontiers in Human Neuroscience 04/2014; 8(1):268. DOI:10.3389/fnhum.2014.00268 · 2.99 Impact Factor
[Show abstract] [Hide abstract]
- "Some of these medications have clear value in the management of interfering symptoms and behaviors associated with ASD. Improvements in social behaviors have been noted in some trials, though these findings often derive from secondary analyses [e.g., studies of risperidone (Scahill et al. 2012)], or are from open-label studies, (Aman et al. 2009) or are from populations with specific comorbidity [e.g., hyperactivity in trials of methylphenidate and guanfacine (Scahill et al. 2006; Jahromi et al. 2009)]. By contrast, few studies have prospectively aimed to demonstrate an impact on the core social and communicative symptoms of ASD. "
ABSTRACT: STX209 (arbaclofen), a selective GABA-B agonist, is hypothesized to modulate the balance of excitatory to inhibitory neurotransmission, and has shown preliminary evidence of benefit in fragile X syndrome. We evaluated its safety, tolerability, and efficacy in non-syndromic autism spectrum disorders, in an 8-week open-label trial enrolling 32 children and adolescents with either Autistic Disorder or Pervasive Developmental Disorder-Not Otherwise Specified, and a score ≥17 on the Aberrant Behavior Checklist (ABC)-Irritability subscale. STX209 was generally well-tolerated. The most common adverse events were agitation and irritability, which typically resolved without dose changes, and were often felt to represent spontaneous variation in underlying symptoms. Improvements were observed on several outcome measures in this exploratory trial, including the ABC-Irritability (the primary endpoint) and the Lethargy/Social Withdrawal subscales, the Social Responsiveness Scale, the CY-BOCS-PDD, and clinical global impression scales. Placebo-controlled study of STX209 is warranted.Journal of Autism and Developmental Disorders 11/2013; 44(4). DOI:10.1007/s10803-013-1963-z · 3.06 Impact Factor
[Show abstract] [Hide abstract]
- "Advances in joint attention measurement have also begun to make it possible to provide more direct tests of our hypotheses with older children with autism. Jahromi et al. (2009) described such a method (called JAMES) in their study of 5-to 13-year-olds with autism. Mosconi et al. (2009) described a method called the Social Orienting Continuum and Response Scale (SOC-RS), which can be applied to video records of Autism Diagnostic Observation Schedule (ADOS) assessments to provide continuous measurements of IJA and RJA. "
ABSTRACT: This article describes a parallel and distributed processing model (PDPM) of joint attention, self-referenced processing and autism. According to this model, autism involves early impairments in the capacity for rapid, integrated processing of self-referenced (proprioceptive and interoceptive) and other-referenced (exteroceptive) information. Measures of joint attention have proven useful in research on autism because they are sensitive to the early development of the 'parallel' and integrated processing of self- and other-referenced stimuli. Moreover, joint attention behaviors are a consequence, but also an organizer of the functional development of a distal distributed cortical system involving anterior networks including the prefrontal and insula cortices, as well as posterior neural networks including the temporal and parietal cortices. Measures of joint attention provide early behavioral indicators of atypical development in this parallel and distributed processing system in autism. In addition it is proposed that an early, chronic disturbance in the capacity for integrating self- and other-referenced information may have cascading effects on the development of self awareness in autism. The assumptions, empirical support and future research implications of this model are discussed.Autism 09/2010; 14(5):408-29. DOI:10.1177/1362361310366315 · 3.50 Impact Factor