A Prescription Trend Analysis of Methylphenidate: Relation to Study Reports on Efficacy.

Use of methylphenidate in children has increased substantially, despite conflicting evidence regarding efficacy. In this study, prescription data were analyzed in relation to the publication of new evidence regarding efficacy. Incidence rates and prescribed doses of methylphenidate increased, with a decline during the last few years. Duration of use is still increasing. In half of the cases, starting dosages are higher than recommended in guidelines. There was little evidence that publication of new evidence directly influenced the use of methylphenidate. Recent and critical study findings should receive more attention to contribute to the development and use of treatment guidelines for ADHD and evidence-based methylphenidate use.

Wild and Willful Kids: Can We Help Parents? The Effectiveness of a Group Parent Training Program Without a Psychiatric Label.

Many children with a classification of attention-deficit/hyperactivity disorder exhibit mild-to-moderate problem behavior. For these children, a stepped diagnosis and stepped care approach has been proposed. Although a psychiatric classification may bring support to families, it may also have negative consequences. Therefore, in this preliminary study, the effect of a group parent training program without child-bound classifications (named Wild & Willful, Druk & Dwars in Dutch) was investigated. In 7 sessions, groups of parents (experimental, n=63; waiting list control, n=38) learned strategies to deal with wild and willful behavior in their children. Outcome variables were assessed by questionnaires. Multilevel analyses showed that, compared with the control group, the intervention group had significantly lower scores on parental stress and communication problems (Cohen d=0.47 and 0.52, respectively), but not on attention and hyperactivity problems, oppositional defiant problems, and responsivity. Zooming in on the course of outcome variables over time in the intervention group, improvements on all variables were seen, with small to moderate effect sizes (Cohen d=0.30 to 0.52). Overall, the group parent training program without the need for a classification for children seemed beneficial. The training is low cost, brings together parents who are facing similar problems in rearing their children, and may help to reduce overdiagnosis of mild and moderate problems, without risking undertreatment of severe difficulties.

Attractor States in Teaching and Learning Processes: A Study of Out-of-School Science Education.

In order for out-of-school science activities that take place during school hours but outside the school context to be successful, instructors must have sufficient pedagogical content knowledge (PCK) to guarantee high-quality teaching and learning. We argue that PCK is a quality of the instructor-pupil system that is constructed in real-time interaction. When PCK is evident in real-time interaction, we define it as Expressed Pedagogical Content Knowledge (EPCK). The aim of this study is to empirically explore whether EPCK shows a systematic pattern of variation, and if so whether the pattern occurs in recurrent and temporary stable attractor states as predicted in the complex dynamic systems theory. This study concerned nine out-of-school activities in which pupils of upper primary school classes participated. A multivariate coding scheme was used to capture EPCK in real time. A principal component analysis of the time series of all the variables reduced the number of components. A cluster revealed general descriptions of the components across all cases. Cluster analyses of individual cases divided the time series into sequences, revealing High-, Low-, and Non-EPCK states. High-EPCK attractor states emerged at particular moments during activities, rather than being present all the time. Such High-EPCK attractor states were only found in a few cases, namely those where the pupils were prepared for the visit and the instructors were trained.