Prediction of stimulant response in children with ADHD
Date
2018-07-04
Authors
Thomson, Jennifer Blair
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Abstract
Stimulant drugs often have a profound calming effect on overactive and inattentive behaviors in children with attention deficit-hyperactivity disorder (ADHD), but only approximately 75 per cent of these children respond favorably to this treatment (Barkley, 1977). Discrimination of "responding" and "non-responding" groups on the basis of demographic, neurophysiological, or behavioral variables would be beneficial both for clinical (elimination of drug trial) and theoretical (description of subtypes) reasons.
Previous researchers have identified many promising predictor variables, but relationships between predictor and criterion variables have generally been modest (although statistically significant) in size, and criterion variables have been poorly delineated. In addition, few multivariate investigations have been reported which take into account the relative predictive weight of these variables.
The present study evaluated the multivariate relationship between several predictor variables and response to medication in 336 ADHD children, as measured through both rating scales and longer-term outcome measures. Multiple regression analyses revealed that measures of inattention and overactivity were the best predictors of response to a double-blind stimulant medication trial, as determined through parent and teacher rating scales. For cases in which rating scale data were not available, discriminant function analyses for "yes" versus "no" responders were also carried out, indicating results similar to those above. These relationships were highly significant but have limited clinical utility. Demographic variables were generally unsuccessful at prediction of medication response.
Additional findings indicated that the results of the clinical trial (as determined by parent and teacher behavioral ratings) were not strongly related to ultimate placement on medication. Further exploration of this issue is called for.
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Keywords
Attention-deficit hyperactivity disorder, Diagnosis, Hyperactive children, Stimulants