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Methylphenidate (Ritalin) in the treatment of Autism.

Posted Oct 03 2008 11:31am
A review of: Laudan B. Jahromi, Connie L. Kasari, James T. McCracken, Lisa S-Y. Lee, Michael G. Aman, Christopher J. McDougle, Lawrence Scahill, Elaine Tierney, L. Eugene Arnold, Benedetto Vitiello, Louise Ritz, Andrea Witwer, Erin Kustan, Jaswinder Ghuman, David J. Posey (2008). Positive Effects of Methylphenidate on Social Communication and Self-Regulation in Children with Pervasive Developmental Disorders and Hyperactivity Journal of Autism and Developmental Disorders DOI: 10.1007/s10803-008-0636-9

Methylphenidate is a psycho-stimulant that is used extensively in the treatment of children with attention deficit hyperactivity disorder (ADHD). Given the high co-morbidity between ADHD and autism, a few studies have examined the efficacy and effectiveness of Ritalin in the treatment of autism (e.g., Aman & Langworthy, 2000). However, most these studies examined the effects of Ritalin on attention and hyperactivity symptoms among kids with autism spectrum disorders (ASD). The present study attempted to examine the effects of Methylphenidate on social-communication and self-regulation behaviors among kids with ASDs.

The sample included 33 children with pervasive developmental disorder (29 boys) with a mean age of 6.93 years (range 5-13). This was a 4-week randomized, double-blind, cross-over placebo study, with treatment changing each week between 4 conditions: placebo, low dose, medium dose, and high dose. In this design, neither the experimenters nor the families know which of the 4 treatments the child is receiving at any given time. In addition, the treatment condition changes randomly each week, without anyone knowing the nature of the old or new condition. This allows the experimenters to assume that consistent changes in behaviors that occur during a particular treatment is truly due to the effect of that treatment and not to the expectation of the treatment (placebo effect).

The results indicate that children showed significantly more joint attention behaviors when receiving Methylphenidate than when receiving the placebo (although the most effective dosage varied by individual). Furthermore, at a group level, the low dose of Methylphenidate resulted in significantly improved joint attention behaviors when compared to the placebo, but no differences were noted between the low, medium, and high doses. Low and medium doses of Methylphenidate also resulted in improved self-regulation behavior when compared to placebo.

The study presents compelling preliminary evidence suggesting that Methylphenidate is effective in improving some social behaviors among children with ASDs.
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