Gender disparities in colloquium speakers at top universities.

Colloquium talks at prestigious universities both create and reflect academic researchers' reputations. Gender disparities in colloquium talks can arise through a variety of mechanisms. The current study examines gender differences in colloquium speakers at 50 prestigious US colleges and universities in 2013-2014. Using archival data, we analyzed 3,652 talks in six academic disciplines. Men were more likely than women to be colloquium speakers even after controlling for the gender and rank of the available speakers. Eliminating alternative explanations (e.g., women declining invitations more often than men), our follow-up data revealed that female and male faculty at top universities reported no differences in the extent to which they (i) valued and (ii) turned down speaking engagements. Additional data revealed that the presence of women as colloquium chairs (and potentially on colloquium committees) increased the likelihood of women appearing as colloquium speakers. Our data suggest that those who invite and schedule speakers serve as gender gatekeepers with the power to create or reduce gender differences in academic reputations.

Chess knowledge predicts chess memory even after controlling for chess experience: Evidence for the role of high-level processes.

The expertise effect in memory for chess positions is one of the most robust effects in cognitive psychology. One explanation of this effect is that chess recall is based on the recognition of familiar patterns and that experts have learned more and larger patterns. Template theory and its instantiation as a computational model are based on this explanation. An alternative explanation is that the expertise effect is due, in part, to stronger players having better and more conceptual knowledge, with this knowledge facilitating memory performance. Our literature review supports the latter view. In our experiment, a sample of 79 chess players were given a test of memory for chess positions, a test of declarative chess knowledge, a test of fluid intelligence, and a questionnaire concerning the amount of time they had played nontournament chess and the amount of time they had studied chess. We determined the numbers of tournament games the players had played from chess databases. Chess knowledge correlated .67 with chess memory and accounted for 16% of the variance after controlling for chess experience. Fluid intelligence accounted for an additional 13% of the variance. These results support the conclusion that both high-level conceptual processing and low-level recognition of familiar patterns play important roles in memory for chess positions.

Safety and Feasibility of Repeatable Hepatic Vascular Isolation Chemotherapy: A Pilot Study.

BACKGROUND: The authors herein describe a novel method of repeatable hepatic isolation using an implantable access system allowing simultaneous control of hepatic arterial and portal flows by multiple endovascular catheters. PURPOSE: The aim of this study was to assess the feasibility and safety of the system and to compress standard intravenous chemotherapy into 4 weeks of targeted intra-arterial delivery. METHODS: An arterial access system was implanted to the axillary artery via an anastomosis. Infusions of oxaliplatin were performed biweekly for 4 weeks, using balloon catheters to achieve hepatic isolation and segmental selectivity for 20-25 min. Fifty-seven treatments under general anesthetic were performed in ten patients with inoperable chemotherapy-refractory metastatic colorectal cancer. Systemic, intrahepatic, and hepatic venous pressures were recorded to assess vascular isolation, and platinum levels were measured to assess chemotherapy distribution. RESULTS: Pressure verified, multiple day-only hepatic vascular isolation infusions were achieved in nine of ten patients, with a single patient receiving multiple hepatic arterial infusions. Positron emission tomography-computed tomography (PET-CT) imaging confirmed partial response in three of ten patients and stable disease in three of ten patients. Systemic toxicity was minimal as all treatment-related gastrointestinal and neuropathic symptoms reported throughout the 4 weeks were grades 1-2. CONCLUSIONS: Intra-arterial chemotherapy infusions with hepatic vascular isolation can be achieved repeatedly with targeted selectivity and minimal complications using an implantable multicatheter access system. Oxaliplatin infusions over a 4-week period may achieve tumor response in selected patients in the salvage setting. The technique should be further assessed in a phase Ib/II study.

There Is Time for Calculation in Speed Chess, and Calculation Accuracy Increases With Expertise.

The recognition-action theory of chess skill holds that expertise in chess is due primarily to the ability to recognize familiar patterns of pieces. Despite its widespread acclaim, empirical evidence for this theory is indirect. One source of indirect evidence is that there is a high correlation between speed chess and standard chess. Assuming that there is little or no time for calculation in speed chess, this high correlation implies that calculation is not the primary factor in standard chess. Two studies were conducted analyzing 100 games of speed chess. In Study 1, we examined the distributions of move times, and the key finding was that players often spent considerable time on a few moves. Moreover, stronger players were more likely than weaker players to do so. Study 2 examined skill differences in calculation by examining poor moves. The stronger players made proportionally fewer blunders (moves that a 2-ply search would have revealed to be errors). Overall, the poor moves made by the weaker players would have required a less extensive search to be revealed as poor moves than the poor moves made by the stronger players. Apparently, the stronger players are searching deeper and more accurately. These results are difficult to reconcile with the view that speed chess does not allow players time to calculate extensively and call into question the assertion that the high correlation between speed chess and standard chess supports recognition-action theory.

Pressure algometry measurement of canine muscular pain near the thoracolumbar junction: evaluation of a modified technique.

OBJECTIVE: To evaluate the utility of pressure algometry for measuring muscular pain in dogs by using a modified technique intended to prevent the development of a learned apprehension response. STUDY DESIGN: Prospective randomized clinical trial. ANIMALS: Sixty-three client-owned dogs with a history of restricted comfort or mobility. METHOD: Pressure algometry was used to measure the mechanical nociceptive threshold (MNT) in eight locations around the thoracolumbar junction. Dogs were assigned to one of two groups: group A dogs (n = 22) were placed on a restricted exercise program, while group B dogs (n = 25) were placed on a restricted exercise program and were administered combined acupuncture and manual therapy treatment (CAMT). After data collection in groups A and B was complete, animals were recruited for a third (control) group, C (n = 16), that had no exercise restriction or treatment. Algometry measurements were performed on four occasions over 28 days using a technique intended to prevent the dogs from developing a learned apprehension response. Measurements from eight locations were pooled and analyzed for changes over time. RESULTS: Increases in MNTs over time at all locations tested were identified in groups A and B. In group C there were no significant changes in MNT or evidence of a learned apprehension response. CONCLUSION AND CLINICAL RELEVANCE: MNTs in dogs without exercise restriction or CAMT were consistently repeatable and unchanged over time, indicating that there was no learned apprehension response to pressure algometry using the modified technique. Therefore, the increasing MNT values with time in dogs administered exercise restriction with or without CAMT suggests improved muscular comfort of the thoracolumbar region. Although further research is needed, use of this modified technique should improve the utility of pressure algometry for measuring muscular pain in dogs.

Effectiveness of combined acupuncture and manual therapy relative to no treatment for canine musculoskeletal pain.

Despite the rise in popularity of both acupuncture and manual therapy in veterinary medicine, and the increasing number of Canadian veterinarians practising these techniques, there is little research demonstrating their effectiveness. In this repeated measures, therapeutic trial, 47 client-owned dogs with naturally occurring lameness were assessed for clinical response to treatment. Owners were blinded to the treatment schedule and completed questionnaires to assess their dogs' comfort and mobility. Comparison between pre- and post-treatment results demonstrated that combined acupuncture and manual therapy provides immediate short-term improvement in comfort and mobility, as demonstrated by owner observed changes in play behavior (P = 0.015), walking (P < 0.001), trotting (P = 0.002), jumping (P < 0.001), descending stairs (P = 0.003), rising from a lying position (P < 0.001), and reduced stiffness after rest (P < 0.001) or following exercise (P < 0.001). Mood and attitude also improved, but did not attain statistical significance.

Efficacité de l'acupuncture et de la thérapie manuelle combinées par rapport à l'absence de traitement pour la douleur musculo-squelettique canine. Malgré la croissance de la popularité de l'acupuncture et de la thérapie manuelle en médecine vétérinaire et le nombre grandissant de vétérinaires canadiens qui pratiquent ces techniques, il existe peu de recherche démontrant leur efficacité. Dans cet essai thérapeutique à mesures répétées, 47 chiens appartenant à des clients atteints de boiterie naturelle ont été évalués pour leur réponse clinique au traitement. Les propriétaires n'ont pas été informés du calendrier de traitement et ils ont rempli des questionnaires afin d'évaluer le confort et la mobilité de leurs chiens. La comparaison entre les résultats avant et après le traitement ont démontré que l'acupuncture et la thérapie manuelle combinées offraient une amélioration immédiate à court terme pour le confort et la mobilité, comme le démontrent les observations faites par les propriétaires pour le comportement de jeu (P = 0,015), la marche (P < 0,001), le galop (P = 0,002), le saut (P < 0,001), la descente d'escaliers (P= 0,003), le lever d'une position couchée (P < 0,001) et une raideur réduite après le repos (P < 0,001) ou après de l'exercice (P < 0,001). L'humeur et l'attitude se sont aussi améliorées, mais sans atteindre une importance statistique.(Traduit par Isabelle Vallières).

Synthesis of surgeon and rehabilitation therapist treatment methods of bicipital tenosynovitis in dogs allows development of an initial consensus therapeutic protocol.

OBJECTIVE: To compare the therapeutic approach of surgical specialists, sports medicine and rehabilitation specialists, and veterinarians with rehabilitation certification when treating bicipital tendon disease or tenosynovitis in dogs and to combine this information with existing research to develop a treatment algorithm that provides a framework for treating bicipital tenosynovitis. SAMPLE: 223 respondents to an internet survey of board-certified veterinary surgeons, board-certified sports medicine and rehabilitation therapists, and veterinarians with rehabilitation certification. METHODS: The survey was promoted via multiple listservs, specialist college newsletters, and private relevant social media sites. Answers were compiled and submitted for statistical analysis. RESULTS: Compared to rehabilitation therapists (RTh), surgeons placed less value on the stabilizing function of the biceps tendon and its role in preventing other shoulder morbidities. Similarly, compared to RTh, surgeons were more inclined to select surgery as the primary therapeutic approach and attributed a less optimistic prognosis to conservative therapy outcomes. There were multiple differences between surgeons and RTh in executing a conservative therapy program, with RTh more likely to recommend therapeutic exercise, extracorporeal shockwave, regenerative medicine, therapeutic ultrasound, exercise restriction, photobiomodulation, and pulsed electromagnetic field therapy. RTh were less likely to prescribe NSAIDS or inject corticosteroids. Despite the above noted differences, there were also multiple areas of agreement. CLINICAL RELEVANCE: Consensus agreement, combined with existing research, was used to create a treatment algorithm suggesting how to best address multiple manifestations of bicipital tendinopathy. Such guidelines can be considered to direct therapeutic strategies for this common condition.

Executive Function in Autism: Association with ADHD and ASD Symptoms.

There is substantial comorbidity between autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD), and there are well-documented executive functioning (EF) deficits in both populations. An important question concerns whether EF deficits in children with ASD are related to severity of ASD, ADHD, or both. We examined ADHD and ASD symptoms in relation to ratings of EF in the home and classroom. The sample comprised 64 children (55 males) diagnosed with ASD (mean age = 9.26 years; mean FSIQ = 92). Analyses indicated that parent and teacher ratings of EF (except Shift and Emotional Control) were consistently related to ADHD symptom severity, but not to ASD severity. Thus, functioning in the domains of Shift and Emotional control appear relatively spared, whereas performance in all other EF was impaired in relation to ADHD symptoms.

The relationship between urethral sphincter mechanism incompetency and lower back pain: Positing a novel treatment for urinary incontinence in dogs.

Background: In humans, multiple researchers have not only determined that there is a relationship between urinary incontinence (UI) and lower back pain (LBP), but that by treating the LBP, clinicians are able to improve or resolve the UI. Up until now, no equivalent canine research has investigated whether treatment of LBP can improve the clinical signs of acquired, non-neurologic UI in dogs. Aim: To determine if a relationship exists between LBP and urethral sphincter mechanism incompetence (USMI) in dogs. Methods: Review of medical records of all patients that presented to Points East West Veterinary Services with a history of naturally occurring acquired UI from May 2013 to December 2019. Thirty-nine patients treated for LBP using combined acupuncture and manual therapy, and 33/39 patients that also received concurrent photobiomodulation (PBM) therapy, qualified for this study. Results: Treated patients showed a statistically significant reduction in both the frequency (p < 0.01) and volume (p < 0.01) of UI episodes. Treatment responses ranged from no improvement, to complete resolution of the USMI clinical signs. Conclusion: The reduction of USMI clinical signs following LBP treatment suggests a relationship between these two conditions. Combined acupuncture, manual therapy, with or without PBM was shown to be an effective treatment for USMI. By corollary, USMI incontinence should be considered a potential pain symptom.

Shared medical appointments for Innu patients with well-controlled diabetes in a Northern First Nation Community.

INTRODUCTION: The prevalence of diabetes and its complications in the Innu community of Sheshatshiu is high. We wanted to determine if shared medical appointments (SMAs) could provide culturally appropriate, effective treatment to Innu patients with relatively well-controlled diabetes, as an alternative to standard, 'one-on-one' care. METHODS: We conducted a mixed-method study including a randomised controlled trial comparing standard care versus SMAs for patients aged 18-65 years with haemoglobin A1C (HbA1C) of ≤7.5%, followed by a qualitative study using semi-structured interviews with patients who attended SMAs. RESULTS: Among 23 patients, 13 received the intervention. There were no significant differences of HbA1C level or HbA1C percentage of change between intervention and control groups at baseline, 6 months or 12 months. There were no statistical differences between standard care and SMA groups, concerning mortality or the need for haemodialysis. The qualitative analysis found that patients generally enjoyed the SMA model and the peer support and learning benefits of the SMAs. Patients did not believe that the SMA model was more or less culturally appropriate than standard care, but the majority said they felt that the SMAs were good for the community and could be a good venue for incorporating Innu healthy-lifestyle knowledge into medical diabetes care. CONCLUSIONS: SMAs may be an efficient way to manage well-controlled diabetic patients in the Innu community of Sheshatshiu and to provide peer support and opportunities for learning and incorporating community-specific knowledge into care.

Résumé Introduction: La prévalence du diabète et de ses complications est élevée dans la communauté innu de Sheshatshiu. Nous voulions déterminer si, plutôt que la norme de soins personnalisés, les rendez-vous médicaux partagés pourraient dispenser un traitement efficace et culturellement approprié aux patients innu dont le diabète est relativement bien maîtrisé. Méthodologie: Nous avons réalisé une étude à méthodologies mixtes, soit une étude avec répartition aléatoire et contrôlée pour comparer la norme de soins aux rendez-vous médicaux partagés auprès de patients de 18 à 65 ans dont le taux d'HbA1C était inférieur ou égal à 7,5 %, suivie d'une étude qualitative ayant eu recours à des entrevues semi-structurées auprès de patients s'étant présentés à des rendez-vous médicaux partagés. Résultats: Treize patients sur 23 ont reçu l'intervention. On n'a observé aucune différence significative du taux d'HbA1C ou du pourcentage de variation du taux d'HbA1C entre les groupes intervention et témoin, au départ, et à 6 ou 12 mois. On n'a observé aucune différence statistique entre les groupes norme de soins et rendez-vous médicaux partagés en ce qui concerne la mortalité ou le besoin d'hémodialyse. L'analyse qualitative a indiqué qu'en général, les patients appréciaient le modèle des rendez-vous médicaux partagés ainsi que le soutien par les pairs et l'apprentissage qu'ils en tiraient. Les patients ne croyaient pas que le modèle des rendez-vous médicaux partagés était plus ni moins approprié que la norme de soins sur le plan culturel, mais la majorité était d'avis que les rendez-vous médicaux partagés étaient favorables pour la communauté, et seraient l'occasion d'incorporer les connaissances sur le mode de vie sain innu dans les soins médicaux du diabète. Conclusions: Les rendez-vous médicaux partagés seraient une façon efficace de prendre en charge les patients dont le diabète est maîtrisé de la communauté innu de Sheshatshiu, et de fournir un soutien par les pairs, et l'occasion d'apprendre et d'incorporer dans les soins les connaissances sur la communauté. Mots-clés: Soins du diabète, rendez-vous médicaux partagés, communauté des Premières Nations, santé autochtone.

ADHD severity as a predictor of cognitive task performance in children with Autism Spectrum Disorder (ASD).

BACKGROUND: In recent years, a number of studies have begun to explore the nature of Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorder (ASD). In this study, we examined the relationship between both symptoms of ADHD and symptoms of ASD on cognitive task performance in a sample of higher-functioning children and adolescents with ASD. Participants completed cognitive tasks tapping aspects of attention, impulsivity/inhibition, and immediate memory. AIMS: We hypothesized that children with ASD who had higher levels of ADHD symptom severity would be at higher risk for poorer sustained attention and selective attention, greater impulsivity/disinhibition, and weaker memory. METHODS AND PROCEDURES: The sample included 92 children (73 males) diagnosed with ASD (Mean Age = 9.41 years; Mean Full Scale IQ = 84.2). OUTCOMES AND RESULTS: Using regression analyses, more severe ADHD symptomatology was found to be significantly related to weaker performance on tasks measuring attention, immediate memory, and response inhibition. In contrast, increasing severity of ASD symptomatology was not associated with higher risk of poorer performance on any of the cognitive tasks assessed. CONCLUSIONS AND IMPLICATIONS: These results suggest that children with ASD who have more severe ADHD symptoms are at higher risk for impairments in tasks assessing attention, immediate memory, and response inhibition-similar to ADHD-related impairments seen in the general pediatric population. As such, clinicians should assess various aspects of cognition in pediatric patients with ASD in order to facilitate optimal interventional and educational planning.

Effects of Extended-Release Methylphenidate Treatment on Cognitive Task Performance in Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder.

Objective: To examine the effectiveness of four doses of psychostimulant medication, combining extended-release methylphenidate (ER-MPH) in the morning with immediate-release MPH (IR-MPH) in the afternoon, on cognitive task performance. Method: The sample comprised 24 children (19 boys and 5 girls) who met the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Text Revision (DSM-IV-TR) criteria for an autism spectrum disorder (ASD) on the Autism Diagnostic Interview-R and the Autism Diagnostic Observation Schedule, and had significant symptoms of attention-deficit/hyperactivity disorder (ADHD). This sample consisted of elementary school-age, community-based children (mean chronological age = 8.8 years, SD = 1.7; mean intelligence quotient = 85; SD = 16.8). Effects of placebo and three dose levels of ER-MPH (containing 0.21, 0.35, and 0.48 mg/kg equivalent of IR-MPH) on cognitive task performance were compared using a within-subject, crossover, placebo-controlled design. Each of the four MPH dosing regimens (placebo, low-dose MPH, medium-dose MPH, and high-dose MPH) was administered for 1 week; the dosing order was counterbalanced across children. Results: MPH treatment was associated with significant performance gains on cognitive tasks tapping sustained attention, selective attention, and impulsivity/inhibition. Dose/response was generally linear in the dose range studied, with no evidence of deterioration in performance at higher MPH doses in the dose range studied. Conclusion: The results of this study suggest that MPH formulations are associated with significant improvements on cognitive task performance in children with ASD and ADHD.

Designing better graphs by including distributional information and integrating words, numbers, and images.

Statistical graphs are commonly used in scientific publications. Unfortunately, graphs in psychology journals rarely portray distributional information beyond central tendency, and few graphs portray inferential statistics. Moreover, those that do portray inferential information generally do not portray it in a way that is useful for interpreting the data. The authors present several recommendations for improving graphs including the following: (a) bar charts of means with or without standard errors should be supplanted by graphs containing distributional information, (b) good design should be used to allow more information to be included in a graph without obscuring trends in the data, and (c) figures should include both graphic images and inferential statistics presented in words and numbers.

Fronto-limbic functioning in children and adolescents with and without autism.

We used neuropsychological tasks to investigate integrity of brain circuits linking orbitofrontal cortex and amygdala (orbitofrontal-amygdala), and dorsolateral prefrontal cortex and hippocampus (dorsolateral prefrontal-hippocampus), in 138 individuals aged 7-18 years, with and without autism. We predicted that performance on orbitofrontal-amygdala tasks would be poorer in the Autism group compared to the Non-Autism group regardless of intellectual level (verbal mental age, VMA) and that performance on dorsolateral prefrontal-hippocampus tasks would be associated primarily with intellectual level. Predicted differences between Autism and Non-Autism groups on orbitofrontal-amygdala tasks were present but greater in individuals with higher VMA. On dorsolateral prefrontal-hippocampus tasks, poorer performance by the Autism compared to the Non-Autism group was found at all VMA levels. Group differences suggest both brain circuits are impaired in autism, but performance on all tasks is also associated with intellectual level.

Improving the reliability of autism diagnoses: examining the utility of adaptive behavior.

The classification agreement of the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) was examined in 129 children and adolescents (aged 7-18 years) who were evaluated for autism. Participants received a diagnosis of autism or non-autism based on the ADI-R. Linear discriminant analysis revealed adequate concordance between the ADI-R and ADOS, with 75% of the participants being correctly classified using the ADOS. Classification accuracy significantly improved to 84% when a measure of adaptive functioning (i.e., the Vineland Adaptive Behavior Scales) was included in the analysis. The findings suggest that when clinicians obtain discrepant information on the ADI-R and ADOS, assessment of an individual's adaptive functioning may reduce diagnostic errors.

Multiresolution 3-D reconstruction from side-scan sonar images.

In this paper, a new method for the estimation of seabed elevation maps from side-scan sonar images is presented. The side-scan image formation process is represented by a Lambertian diffuse model, which is then inverted by a multiresolution optimization procedure inspired by expectation-maximization to account for the characteristics of the imaged seafloor region. On convergence of the model, approximations for seabed reflectivity, side-scan beam pattern, and seabed altitude are obtained. The performance of the system is evaluated against a real structure of known dimensions. Reconstruction results for images acquired by different sonar sensors are presented. Applications to augmented reality for the simulation of targets in sonar imagery are also discussed.

ADHD severity as it relates to comorbid psychiatric symptomatology in children with Autism Spectrum Disorders (ASD).

Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n=99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity-not ASD severity-were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning.

A comparison of behavioral and emotional functioning in children and adolescents with Autistic Disorder and PDD-NOS.

Behavioral symptomatology was compared in 26 children and adolescents with Autistic Disorder ("autism") and 25 children and adolescents with Pervasive Developmental Disorder, Not Otherwise Specified ("PDD-NOS"). Relative to individuals with PDD-NOS, those with autism had more symptoms of depression, social withdrawal, atypical behavior, and immature social skills--and fewer family problems. These differences remained even when group differences in intellectual ability were statistically controlled. No group differences emerged in somatization, anxiety, or hyperactivity. Findings suggest that although both groups demonstrate considerable evidence of behavioral and emotional problems, those with autism are at particularly high risk for comorbid behavioral and emotional disabilities.

Treatment effects of methylphenidate on behavioral adjustment in children with mental retardation and ADHD.

OBJECTIVE: The effects of stimulant medication treatment were investigated in children with mental retardation (MR) and attention-deficit/hyperactivity disorder (ADHD). METHOD: Parent and teacher behavioral ratings and reports of side effects were obtained for children (N = 24, mean age = 10.9 years, SD = 2.4) during a placebo-controlled, double-blind, crossover treatment trial with 0.15 mg/kg, 0.30 mg/kg, and 0.60 mg/kg b.i.d. dosages of methylphenidate. RESULTS: The most significant improvements occurred at the 0.60 mg/kg methylphenidate dose for teacher ratings of inattention (p =.024), hyperactivity (p <.001), aggression (p <.001), and asocial behavior (p =.009). No significant improvements, relative to placebo, occurred at the 0.15 mg/kg dosage. Of interest, nearly all significant medication-related behavioral improvements were detected by teachers. However, parents were sensitive raters of side effects, noting more sleeping problems and loss of appetite at the 0.60 mg/kg dose compared with placebo. CONCLUSIONS: These results suggest that symptoms of ADHD can be treated successfully in children with ADHD/MR, and consistent with MTA study results, higher doses were most effective. Furthermore, these improvements were not accompanied by increases in symptoms such as staring, social withdrawal, or anxiety.

Treatment effects of methylphenidate on cognitive functioning in children with mental retardation and ADHD.

OBJECTIVE: Cognitive effects of stimulant medication were investigated in children with mental retardation (MR) and attention-deficit/hyperactivity disorder (ADHD). METHOD: Performance on tasks tapping sustained attention, visual and auditory selective attention, inhibition, and immediate memory was assessed for 24 children (mean age 10.9 years) during a placebo-controlled, double-blind, crossover treatment trial with 0.15, 0.30, and 0.60 mg/kg b.i.d. dosages of methylphenidate (MPH). RESULTS: Successively higher MPH doses were associated with consistent gains in cognitive task performance, with optimal performance noted at the highest dose. Analysis of dose-response curves revealed significant linear components of trend on measures tapping sustained attention, visual selective attention, auditory selective attention, as well as two tasks tapping inhibition/impulsivity: delay of gratification and match-to-sample. No evidence of a curvilinear dose-response relationship emerged for any measure. CONCLUSIONS: Inattention and disinhibition/impulsivity decline with MPH treatment in children with ADHD/MR, and consistent with the Multimodal Treatment Study of ADHD, higher MPH doses are most effective. These findings also suggest that cognitive testing, together with behavioral and medical assessment, can be an effective tool in assessing stimulant response in children with ADHD/MR.