Methylphenidate and hyperactivity: effects on teacher behaviors.

Teacher interactions with hyperactive and comparison boys were observed during classroom activities. A double-blind, methylphenidate-placebo cross-over design was used within the hyperactive group. With no knowledge of any child's diagnosis or drug status, the teacher was more intense and controlling toward hyperactive boys taking placebo than toward either medicated hyperactive boys or comparison boys; her behavior did not differ toward the latter two groups. Discussion focused on the need to consider the broad social ramifications of pharmacologic treatment programs.

A social ecology of hyperactive boys: medication effects in structured classroom environments.

Hyperactive boys on methylphenidate (Ritalin), hyperactive boys on placebo, and comparison boys were observed in quasi-naturalistic classroom settings. Ambient stimulation (quiet versus noisy conditions) and source of regulation (self-paced versus other-paced activities) were varied in a 2 x 2 design. Compared to their peers, hyperactive boys on placebo showed lower rates of task attention and higher rates of gross motor movement, regular and negative verbalization, noise-making, physical contact, social initiation, disruption, and acts that were perceived as energetic, inappropriate, or unexpected. Self-paced activities resulted in increased rates of verbalization, social initiation, and high-energy episodes. High ambient noise levels reduced task attention and increased the rates of many other behaviors including verbalization, physical contact, gross motor movement, and high-energy acts. Medication-by-situation interactions emerged for both classroom dimensions, with hyperactive boys on placebo being readily distinguishable from their peers under some classroom conditions and indistinguishable under other conditions. Moderate relationships were found between teacher ratings and many individual behavior categories. Discussion focused on (a) the merits and limitations of a social ecological research perspective, and (b) the implications of these findings for the design of intervention strategies.

Teacher response to the methylphenidate (ritalin) versus placebo status of hyperactive boys in the classroom.

The effects of children's medication status on teacher behaviors were studied in a classroom setting. Teacher behaviors toward hyperactive boys on methylphenidate were compared to those toward hyperactive boys on placebo, as well as those toward normal comparison peers. A medication crossover design was used within the hyperactive group, and the teacher had no knowledge of diagnoses or medication condition. Across 4 different classroom experiments, the teacher was more intense and controlling toward hyperactive boys on placebo than toward the other 2 groups. No differences emerged between the comparison and medicated hyperactive groups, suggesting that methylphenidate served to "normalize" teacher-pupil interactions. Teacher behaviors toward individual boys were also moderately to strongly related to teacher global impressions of these youngsters, as indexed by qualitative rating scales. Discussion focuses on the social ramifications of medication and the need for broader monitoring of treatment outcomes.

Child and adolescent perceptions of normal and atypical peers.

Students at 4 grade levels (grades 4, 6, 8, and 10) evaluated hypothetical male age-mates who were portrayed as normal, hyperactive, antisocial, or mildly mentally retarded. The focus was on behavioral characteristics, predicted outcomes, anticipated peer reactions, recommended parental interventions, and diagnostic labels. The results indicated that the students made social inferences that extended far beyond the specific behavioral information provided. The atypical boys were viewed as substantially more deviant than the normal boy within broad-ranging social, affective, and intellectual domains. Future problems were predicted for all 3 atypical boys, and parental interventions were recommended. Within this global negative perspective, clear distinctions were drawn among the 3 types of atypicality. The mildly retarded boy was viewed as most similar to the normal boys, and the antisocial boy was seen as the most dissimilar. Some gender differences and grade trends also emerged, with females and older students generally expressing more benign views of the atypical youths.