PEDIATRICS Vol. 60 No. 4 October 1977, pp. 512-518
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Stimulant Drug Therapy in Hyperactive Children: Research and Clinical Implications

Mark L. Wolraich, M.D.

From the Department of Pediatrics, University of Iowa, Iowa City

In spite of 39 years of experience in stimulant drug use for children since it was first reported by Bradley,1 there is still some controversy over its effectiveness. During the past ten years stimulant therapy has gone through periods of great popularity and periods of disfavor. In an article in 1973 Wender described stimulant therapy as the "mainstay of treatment for children with minimal brain dysfunction"2 and Eisenberg in 1972 described it as the most effective and best documented available method.3 Meanwhile in 1976, Bax wrote that "in my own experience medication has little to offer in the way of help either to the children who present primarily as having learning difficulties or to those whose behavior is the outstanding problem. Virtually no children in normal schools should, I believe, be on treatment."4

After all these years why is there still such difference of opinion? What valid data are available? Several articles review the research in this area.5-7 A recent article reviews the results of 110 studies but does not consider methodological criteria.8 It is helpful to look at the numerous research studies done with stimulant drugs in light of research criteria. There are two studies that discuss methodological criteria required for valid research on psychotropic medication.9,10 Sprague and Werry9 define six minimum requirements for valid drug studies. These are (1) placebo control, (2) random assignment of subjects, (3) double-blind method, (4) standardized dosage, (5) standardized evaluations, and (6) appropriate statistical analysis. Fish10 amplifies the problem of subject selection, stating

Received for publication Mar 26, 1977; Accepted Apr 25, 1977.




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Modification of Inattentive Classroom Behavior: Hyperactive Children's Use of Self-Recording with Teacher Guidance
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[Abstract]

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 CLIN PEDIATRHome page
M. L. Wolraich
Behavior Modification Therapy in Hyperactive Children: Research and Clinical Implications
Clinical Pediatrics, September 1, 1979; 18(9): 563 - 570.
[Abstract] [PDF]