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Biomedical subjects

E K Sleator

Publications and source records attributed to E K Sleator.

At least 19 recordsLinked to original sources
PubMed1986

Responders, nonresponders, and placebo responders among children with attention deficit disorder. Importance of a blinded placebo evaluation.

The responses to methylphenidate of 118 children with attention deficit disorder (ADD) were studied under double-blind conditions. Three distinct types of response to medication and placebo were found, as determined by teacher ratings. One group, called "responders," improved dramatically in attention and hyperactivity ratings on active medication but showed essentially no change from baseline when on placebo. The group called "nonresponders" showed minimal change in ratings on either placebo or medication. The third group, "placebo responders," showed almost as much improvement as the responders on medication, but their ratings were not very different from medication ratings during the placebo trial. The placebo responders, 18 percent of the group, would have been considered responders in a nonplacebo-controlled study. Double-blind placebo evaluation of ADD children can and should be done by practitioners to avoid medicating children who are responding to nonspecific effects of drugs.

Analysis of Variance↗
PubMed1985

A change of mind: the Conners abbreviated rating scales reconsidered.

A cutoff score of 15 on the Conners 10-item Abbreviated Teacher Rating Scale (ATRS), based on a study from this laboratory, has been widely used by investigators for diagnosis of the syndrome known now as Attention Deficit Disorder with or without Hyperactivity. A replication of the original research employing a larger norm sample indicates that the suggested score of 15 is too low. Comparing the norm sample with hyperactive subjects selected by cutoff of 15 on the ATRS showed that the groups differed greatly on hyperactivity but not on inattention. The abbreviated form of the Conners scale does not effectively select children with attention deficits. Numerous problems with both the 39-item teacher scale and the abbreviated form suggest strongly that they be abandoned as research tools.

Attention↗
PubMed1985

Attention deficit disorder children with or without hyperactivity. Which behaviors are helped by stimulants?

Each patient with Attention Deficit Disorder (ADD), with or without hyperactivity, is unique in the variety and severity of the handicapping conditions associated with ADD. The use of a well-designed teacher rating scale can provide the clinician with a behavioral profile of each patient. The importance of knowing the child's specific problems is emphasized by the results of this research, which show that methylphenidate has a major effect in improving attention, is helpful in decreasing activity level, but often has only a minor effect on deficient social skills and oppositional (aggressive) behavior.

Aggression↗
PubMed1982

Effect of methylphenidate hydrochloride on stature of hyperactive children.

Twenty-six hyperactive children receiving methylphenidate hydrochloride, eight hyperactive non-medicated children and 25 normal children participated in a study of the effect of such medication on stature of hyperactive children. All the children were below 13 years of age and all but two were male. Predicted adult stature before methylphenidate treatment and predicted adult stature after one year, two years and three years of treatment were calculated by means of the Roche-Weiner-Thissen Adult Stature Prediction Formula. Total milligrams per day dosage, milligrams per kilogram per day dosage and duration of treatment per year were analysed in the medicated hyperactive children and their growth was compared with the other two groups. No significant differences were found for any of the above variables. This study indicates that stature suppression does not occur in male children below 13 years of age when methylphenidate is used up to 0.8mg/kg/day for one or two years and up to 0.6mg/kg/day for three years.

Attention Deficit Disorder with Hyperactivity↗
PubMed1981

Can the physician diagnose hyperactivity in the office?

Office diagnosis of hyperactivity can present a problem to the pediatrician because only about 20% of the potential patients show hyperactive behavior during office examination. Exclusion of the children who appear normal in the physician's office can eliminate from medical treatment a large number of patients for whom treatment is appropriate. Eighty percent of the children ultimately accepted into the project on the basis of home and school reports showed exemplary behavior and no sign of hyperactivity in the office. Nonetheless, at a three-year follow-up, these children were rated the same as those who were obviously hyperactive in the presence of the pediatrician. The groups appeared no different on school grade, teachers' ratings of classroom behavior, amount of stimulant medication prescribed, or duration of drug treatment. The reported outcome data indicate that the physician can have confidence in historical information from the parents combined with current teacher reports as reliable aids in the diagnostic process with hyperactive children.

Attention Deficit Disorder with Hyperactivity↗
PubMed1980

Deleterious effects of drugs used for hyperactivity on patients with Gilles de la Tourette syndrome.

Two pediatricians failed to recognize Gilles de la Tourette syndrome in a child. The symptoms were exacerbated after the child took both pemoline and methylphenidate. All medications commonly used to treat hyperactivity may cause such exacerbation. Gilles de la Tourette syndrome is frequently associated with symptoms characteristic of hyperactivity and often goes unrecognized for long periods of time. The symptoms of the syndrome and the evidence that they are exacerbated by medication used to hyperactivity are briefly reviewed. Physicians should be aware of the possibility of Gilles de la Tourette syndrome in any hyperactive patient who manifests or has a history of a tic.

Child↗
PubMed1979

Methylphenidate in hyperkinetic children: differences in dose effects on impulsive behavior.

This research tested the hypothesis that in hyperactive children a low dose of methylphenidate (0.3 mg/kg) would produce scores superior to those with a high dose (1.0 mg/kg) or placebo on the matching familiar figures test (MFF), a primary index of impulsivity. The hypothesis was based on an earlier finding that the highest percentage of correct responses on a short-term memory task were found in hyperactive subjects who were receiving 0.3 mg/kg of methylphenidate whereas at 1.0 mg/kg the percentage correct returned to the placebo level. The hypothesis was verified in that the low dose reduced the number of errors on the MFF significantly more than did placebo or the high dose. This work demonstrates that, for both learning and impulsivity in hyperactive children, the lower dose of the two doses of methylphenidate studied produced the preferable effect.

Adolescent↗
PubMed1977

Methylphenidate in hyperkinetic children: differences in dose effects on learning and social behavior.

Methylphenidate (Ritalin) is widely prescribed for hyperkinetic children. This study showed a peak enchancement of learning in children after being given a dose of 0.3 milligram per kilogram of body weight, and a decrement in learning in those given larger doses; social behavior showed the most improvement in children given 1.0 milligram per kilogram. These results had been hypothesized from theoretical dose-response curves which indicate different target behaviors would improve at different doses.

Child↗
PubMed1976

Cardiovascular responses of hyperactive children to methylphenidate.

Heart rate, blood pressure, and oxygen consumption were measured in 27 hyperactive children during rest, exercise, and recovery, once taking placebo and again taking methylphenidate hydrochloride. Half were measured first taking the drug and half first taking the placebo. Twenty-three matched controls were also measured twice to test for reproducibility of results. Drug and placebo ECGs were recorded on 12 of the subjects. Oxygen consumption did not change (P = .40), but heart rate (P = .001) and blood pressure (P = .003) increased significantly with methylphenidate therapy. There was a significant correlation between size of dose in milligrams per kilogram and increase in heart rate (.38, P less than .05) and blood pressure (.50, P less than .05 systolic) (.46, P less than .05 diastolic). No evidence of the development of tolerance to these drug effects was found in children who had been taking methylphenidate from two months to more than a year. No ECG changes other than tachycardia were seen.

Age Factors↗
PubMed1975

A reproducible gas chromatographic mass spectrometric assay for low levels of methylphenidate and ritalinic acid in blood and urine.

A rapid, sensitive method of analysis for methylphenidate and ritalinic acid in blood and urine has been developed using gas chromatography mass spectrometry and selected ion monitoring for separation and detection. The methylphenidate is isolated by solvent extraction into chloroform and the ritalinic acid is isolated by salting out into isopropyl alcohol, followed by methylation and subsequent solvent extraction. The method has been applied to the study of methylphenidate metabolism and excretion in adults and hyperactive children undergoing treatment with methylphenidate.

Adult↗