ABSTRACT
High- and low-dose methylphenidate administration was evaluated prospectively for 3 elementary school-age children with cerebral palsy, cognitive impairments, and attention-deficit hyperactivity disorder (ADHD) symptoms using single-case, randomized, double-blind, placebo-controlled designs. An observational time sampling protocol was used to directly measure and quantify classroom behavior. Summary level analysis showed that (1) low-dose (0.3 mg/kg/dose) administration was associated with clinically significant (>50%) reductions in stereotyped and disruptive behavior relative to baseline and placebo conditions, (2) high-dose (0.5 mg/kg/dose) administration was associated with exacerbated amounts of stereotyped and disruptive behavior, and (3) no changes were directly observed for task-related behavior at either dose. Results are discussed with respect to previous research with methylphenidate administration and cerebral palsy, and the suggestion is made that further work using larger, randomly selected study samples with complementary measures of behavior and performance appears warranted.
Subject(s)
Central Nervous System Stimulants/therapeutic use , Cerebral Palsy/drug therapy , Cerebral Palsy/physiopathology , Methylphenidate/therapeutic use , Schools , Social Behavior , Attention Deficit and Disruptive Behavior Disorders/drug therapy , Attention Deficit and Disruptive Behavior Disorders/etiology , Child , Dose-Response Relationship, Drug , Double-Blind Method , Female , Humans , Male , Observation , Stereotyped Behavior/drug effectsABSTRACT
We studied instructional interactions through semi-structured observation of 13 student- teacher dyads involving elementary students with cognitive disabilities. Special educators' use of directions and responses of differing modes and types was analyzed. Student task-engagement behaviors (i.e., active engage, disruptive, passive on-task, off-task) provided a context for understanding differences in teacher styles. Results indicate that teacher directions were followed by student active engagement; and teacher responses, by student passive task-orientation. This higher quality feedback from students, together with outerdirectedness of students with cognitive disabilities, is postulated as a mechanism that maintains a high level of teacher directiveness. Sequential relationship patterns changed as student engagement levels varied, suggesting a child-driven model of teacher-child instructional interactions.
