Many symptoms commonly attributed to stimulant medication are actually preexisting characteristics of children with ADHD and improve with stimulant treatment. At the doses investigated, both DEX and MPH caused appetite suppression, and DEX caused insomnia. Negative emotional symptoms were more severe on DEX than MPH.

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Our results suggest increased speed of prefrontal neural processing in children without ADHD following a priming stimulus, and a deficit in such processes in children with ADHD.

ABSTRACT. Objective. To compare methylphenidate (MPH) and dexamphetamine (DEX) in a sample of children with attention deficit hyperactivity disorder (ADHD).Method. A total of 125 children with ADHD received both MPH (0.3 mg/kg twice daily) and DEX (0.15 mg/kg twice daily) for 2 weeks a double-blind, crossover study. Outcome measures were Conners' Parent Rating ScaleRevised, Conners' Teacher Rating Scale-Revised, a Parent Global Perceptions questionnaire, the Continuous Performance Test, and the Barkley Side Effects Rating Scale.Results. There were significant group mean improvements from baseline score on all measures for both stimulants. On the Conners' Teacher Rating Scale-Revised, response was greater on MPH than DEX on the conduct problems and hyperactivity factors, as well as on the hyperactivity index. On the Conners' Parent Rating Scale-Revised, anxiety was the only factor to differ significantly, in favor of MPH. Parents rated 73% of subjects as globally improved on MPH and 69% improved on DEX, compared with baseline. Overall, 46% of parents chose MPH as the preferred drug, compared with 37% who chose DEX. On the Continuous Performance Test, there was no difference in the number of correct responses or errors between the two drugs.Conclusions. Most children with ADHD improve significantly on both MPH and DEX. There was a slight advantage to MPH on most measures. Pediatrics 1997;100(6). URL: http://www.pediatrics.org/cgi/ content/full/100/6/e6; attention deficit hyperactivity disorder, stimulant medication, methylphenidate, dexamphetamine.ABBREVIATIONS. ADHD, attention deficit hyperactivity disorder; MPH, methylphenidate; DEX, dexamphetamine; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th ed; CBCL, Child Behavior Checklist; TRF, Teacher Report Form; CPRS-R, Conners' Parent Rating Scale-Revised; CTRS-R, Conners' Teacher Rating Scale-Revised; CPT, Continuous Performance Test; SERS, side effect rating scale. S timulant medication is the most effective treatment for children with attention deficit hyperactivity disorder (ADHD).1,2 Stimulants have been shown to induce short-term enhancement of behavioral, academic, and social functioning. Many well-designed, placebo-controlled studies have demonstrated beyond doubt the benefits of stimulants in the vast majority of children with ADHD.2-4 In a review of 110 studies on the effects of stimulant drugs on more than 4200 children with ADHD, Barkley 4 found that ϳ75% of subjects were regarded as improved on stimulants. The mean placebo response was 39%.Methylphenidate (MPH) and dexamphetamine (DEX) are the two stimulants prescribed most frequently and have been shown to have similar types of positive effects in children with ADHD. However, it is not known whether one is more efficacious than the other in terms of probability of producing a positive response, magnitude of response, quality of improved performance, or side-effect profile. Some authors suggest that the two stimulants are equally effective 5 or that "there is little to choose between ...

This study was designed to look in detail at the paths to diagnosis for a group of 197 children with congenital sensorineural hearing impairment (SNHI), who were diagnosed between 1989 and 1991 in the state of Victoria, Australia. Despite the existence of universal infant screening at 7-9 months by distraction test or questionnaire, the median age at diagnosis for the study group was 18-0 months, with median age at aid fitting of 20-8 months,and median age at commencement of specialised intervention programmes of 22-3 months. Parent questionnaires completed for 143 (73%) of these children showed that 49% had known risk factors for hearing loss yet only 20% of them had been referred for audiological assessment before the 7-9 month screen. Only 63% of those eligible for the 7-9 month screen had received it. Of those children who were screened by distraction test 46% passed as did 57% of those screened by questionnaire. Twenty four parents (17%) described how they had initially 'denied' their own observations of their infants' abnormal hearing behaviour. When concerns were raised with professionals, 10% of parents were falsely reassured without audiological assessment. Detection methods are failing through a combination of poor screen test efficacy, incomplete population coverage, and parental and professional denial. (Arch Dis Child 1995; 72: 11-15)