Sequential Evaluation of Behavioral Treatments and Methylphenidate Dosage for Children With Attention Deficit Hyperactivity Disorder

Abstract

We used a sequential approach to evaluate the relative and combined effects of different types of behavioral treatments, as well as dosage of methylphenidate (MPH), on the disruptive behavior of 3 students who had been diagnosed with attention deficit hyperactivity disorder. Results showed that individualized behavioral treatments produced decreases in disruptive behavior equivalent to MPH for all 3 participants and demonstrated the need to evaluate behavioral treatments and medication dosage on an individual basis.

Fundamentos Empíricos da Análise do Comportamento Aplicada para o Tratamento do Transtorno do Déficit de Atenção e Hiperatividade (TDAH)

“…Outro estudo (Gulley et al, 2003) evidenciou que a frequência de comportamentos inadequados para o contexto escolar diminuiu para níveis entre 0% e 20% do tempo de sessão quando o experimentador os ignorava ao mesmo tempo em que reforçava outros comportamentos com itens comestíveis, brinquedos, atividades, etc. Esse procedimento produziu o mesmo grau de redução de comportamentos-problema que o tratamento com metilfenidato, fosse este combinado ou não com a intervenção comportamental, demonstrando que, neste caso, o medicamento era dispensável.…”

Optimizing behavioral health interventions with single-case designs: from development to dissemination

“…For example, two doses of a medication, low versus high, labeled B and C, respectively, could be assessed using a reversal design [67]. There may be several possible sequences to conduct the assessment such as ABCBCA or ABCABCA.…”

Some Guidelines for Conducting Research in Applied Behavioral Pharmacology

“…In their study, only the school nurse was aware of whether placebo or medication had been administered on any given day. Others (e.g., Gulley et al, 2003;Larue et al, 2008) also used Ayllon et al (1975) X X X X X X Shafto and Sulzbacher (1977) X X Wulbert and Dries (1977) X X X X X X Whalen et al (1979) X X X X Pelham et al (1980) X X X X Rapport et al (1982) X X X Burgio et al (1985) X X X X Stoner et al (1994) X X X Blum et al (1996) X X Northup, Jones, et al (1997) X X X X X X Kayser et al (1997) X X X X X X X X X Gulley and Northup (1997) X X X X X Northup et al (1999) X X X X Murray and Kollins (2000) X X X X X Ardoin and Martins (2000 double-blind procedures. If double-blind procedures were implemented with fidelity, it can be stated more safely that data obtained in these studies were not influenced by experimenter bias or placebo effects.…”

“…The Journal of Applied Behavior Analysis (JABA) has published a considerable number of articles on the effects of pharmacological agents on socially relevant behaviors. Most of these studies involved the examination of the effects of psychomotor stimulant drugs on the behavior of individuals who had been diagnosed with some form of attention deficit hyperactivity disorder (ADHD; Ardoin & Martens, 2000;Ayllon, Layman, & Kandel, 1975;Blum, Mauk, McComas, & Mace, 1996;Burgio, Page, & Capriotti, 1985;Dicesare, McAdam, Toner, & Varrell, 2005;Gulley & Northup, 1997;Gulley et al, 2003;Kayser et al, 1997;Kelley, Fisher, Lomas, & Sanders, 2006;LaRue et al, 2008;Mace et al, 2009;Murray & Kollins, 2000;Neef, Bicard, Endo, Coury, & Aman, 2005;Northup et al, 1999;Northup, Fusilier, Swanson, Roane, & Borrero, 1997;Northup, Jones, et al, 1997;Pelham, Schnedler, Bologna, & Contreras, 1980;Rapport, Murphy, & Bailey, 1982;Shafto & Sulzbacher, 1977;Stoner, Carey, Ikeda, & Shinn, 1994;Whalen, Henker, Collins, Finck, & Dotemoto, 1979;Wulbert & Dries, 1977). A few studies concerned the behavioral effects of other pharmacological agents such as thioridazine (Burgio et al, 1985), chlorpromazine (Marholin, Touchette, & Stewart, 1979), risperidone (Yoo et al, 2003), and sertraline (Miguel, Clark, Tereshko, & Ahearn, 2009).…”