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ObjectiveEvaluate whether stimulant medication improves acquisition of academic material in children with attention deficit hyperactivity disorder (ADHD) receiving small-group, content-area instruction in a classroom setting.MethodParticipants were 173 children between the ages of 7 and 12 years old (77% male, 86% Hispanic) who met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for ADHD and were participating in a therapeutic summer camp. The design was a triple-masked, within-subject, AB/BA crossover trial. Children completed two consecutive phases of daily, 25-min instruction in both (a) subject-area content (science, social studies) and (b) vocabulary. Each phase was a standard instructional unit lasting for 3 weeks. Teachers and aides taught the material to small groups in a summer classroom setting. Each child was randomized to be medicated with daily osmotic-release oral system methylphenidate (OROS-MPH) during either the first or second of the instructional phases, receiving placebo during the other.ResultsMedication had large, salutary, statistically significant effects on children's academic seatwork productivity and classroom behavior on every single day of the instructional period. However, there was no detectable effect of medication on learning the material taught during instruction: Children learned the same amount of subject-area and vocabulary content whether they were taking OROS-MPH or placebo during the instructional period.ConclusionsAcute effects of OROS-MPH on daily academic seatwork productivity and classroom behavior did not translate into improved learning of new academic material taught via small-group, evidence-based instruction. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Pharmacological and expectancy effects of 0.3 mg/kg methylphenidate on the behavior and attributions of boys with attention-deficit/hyperactivity disorder were evaluated. In a within-subject, balanced-placebo design, 136 boys received 4 medication-expectancy conditions. Attributions for success and failure on a daily report card were gathered. Assessments took place within the setting of a summer treatment program and were repeated in boys' regular classrooms. Expectancy did not affect the boys' behavior; only active medication improved their behavior. Boys attributed their success to their effort and ability and attributed failure to task difficulty and the pill, regardless of medication and expectancy. Results were generally equivalent across the two settings; where there were differences, beneficial effects of medication were more apparent in the school setting. The findings were unaffected by individual-difference factors.

In Experiment 1, 28 attention-deficit hyperactivity disorder (ADHD) boys underwent a double-blind, placebo-controlled medication assessment in a summer day-treatment program. Daily, boys were asked questions to assess their attributions for and evaluations of their behavior. Objective measures showed improved behavior with methylphenidate; however, boys tended to attribute their performance to effort rather than to medication, particularly when medicated. Experiment 2 involved 38 ADHD boys the following summer and replicated the procedures in Experiment 1, with the addition of a no-pill condition and a comparison of attributions for success and failure outcomes. Simply taking a pill (no-pill vs. placebo comparison) did not show significant effects, whereas the results of Experiment 1 were replicated with placebo-methylphenidate comparisons. Across drug conditions a self-enhancing attributional pattern was obtained; the majority of attributions for success were to ability or effort, whereas attributions for failure were to the pill or to counselors., Boys with attention deficit hyperactivity disorder showed behavioral improvements when treated with methylphenidate. These patients attribute this change in performance however, more on effort than to drug effects. Self-evaluation showed improved sense of well-being and that positive reports are associated more with effort attributions while negative outcomes are related to pill intake. Medication produced no harmful attributions and may even enhance positive outlooks of patients.