Stimulant Treatment Reduces Lapses in Attention among Children with ADHD: The Effects of Methylphenidate on Intra-Individual Response Time Distributions
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Recent research has suggested that intra-individual variability in reaction time (RT) distributions of children with ADHD is characterized by a particularly large rightward skew that may reflect lapses in attention. The purpose of the study was to provide the first randomized, placebo-controlled test of the effects of the stimulant methylphenidate (MPH) on this tail and other RT distribution characteristics. Participants were 49 9- to 12-year-old children with ADHD. Children participated in a 3-day double-blind, placebo-controlled medication assessment during which they received long-acting MPH (Concerta), with the nearest equivalents of 0.3 and 0.6 mg/kg t.i.d. immediate-release MPH. Children completed a simple two-choice speeded discrimination task on and off of medication. Mode RT and deviation from the mode were used to examine the peak and skew, respectively, of RT distributions. MPH significantly reduced the peak and skew of RT distributions. Importantly, the two medication effects were uncorrelated suggesting that MPH works to improve both the speed and variability in responding. The improvement in variability with stimulant treatment is interpreted as a reduction in lapses in attention. This, in turn, may reflect stimulant enhancement of self-regulatory processes theorized to be at the core of ADHD.
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The effect of acute methylphenidate on reaction time variability in a simple choice discrimination task was moderately correlated with its effect on reducing omissions on a separate continuous performance task.
“Consistent with this interpretation, Spencer et al. [43] observed that the effect of acute methylphenidate on RTV in a simple choice discrimination task was moderately correlated with the effect of the same medication in being able to reduce omissions on a separate continuous performance task.”
From Reaction Time Variability in ADHD: A Review (2012) · cites this paper as [43]
Other studies show that medication reduces tau and reduces the peak and skew of reaction time distributions.
“These results suggest that medication specifically reduces intermittent long RTs, which is consistent with other studies showing that medication reduces tau [100] and reduces the peak and skew of RT distributions [43].”
From Reaction Time Variability in ADHD: A Review (2012) · cites this paper as [43]
These results suggest that medication specifically reduces intermittent long reaction times.
“These results suggest that medication specifically reduces intermittent long RTs, which is consistent with other studies showing that medication reduces tau [100] and reduces the peak and skew of RT distributions [43].”
From Reaction Time Variability in ADHD: A Review (2012) · cites this paper as [43]
Psychostimulant treatment improves DFN suppression during active task engagement and decreases reaction time variability in youth with ADHD.
“psychostimulant treatment has been found to improve DFN suppression during active task engagement in youth with ADHD (Peterson et al., 2009), as well as to decrease reaction time variability (Spencer et al., 2009).”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Spencer et al., 2009
Increased variability in reaction time is among the most consistently reported deficits in children with ADHD.
“increased variability in reaction time (RT) is among the most consistently reported deficits in children with ADHD (Castellanos et al., 2002b; Russell et al., 2006; Spencer et al., 2009).”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Spencer et al., 2009
The evaluation of dose effects on mode reaction time suggests that the full effect of cognitive enhancement was manifested at the low dose.
“The evaluation of the effects of dose on mode RT suggests that the full effect of cognitive enhancement was manifested at the low dose.”
From Understanding the Effects of Stimulant Medications on Cognition in Individuals with Attention-Deficit Hyperactivity Disorder: A Decade of Progress (2011) · cites this paper as Spencer et al (2009)
Spencer et al. (2009) found in a double-blind, dose-response, crossover study that methylphenidate produced a significant reduction of the mode and SD from the mode for low and high doses, not due to a speed-accuracy tradeoff, reflecting increased efficiency of responding.
“Spencer et al (2009) evaluated the cognitive response of children with ADHD to stimulant medication based on an RT task of discriminating two stimuli (X or O) in a double-blind, dose-response, crossover study of placebo, low (0.9 mg/kg/day) and high (1.8 mg/kg/day) MP doses delivered by controlled-release formulations.Medication produced a significant reduction of the mode and SD from the mode”
From Understanding the Effects of Stimulant Medications on Cognition in Individuals with Attention-Deficit Hyperactivity Disorder: A Decade of Progress (2011) · cites this paper as Spencer et al (2009)
Intra-individual variability in neuropsychological tasks, rather than a constant level of impairment, is characteristic of ADHD.
“Intra-individual variability in neuropsychological tasks, rather than a constant level of impairment, is characteristic of ADHD (Spencer et al. 2009; Tamm et al. 2012)”
From Associations of sleep disturbance with ADHD: implications for treatment (2015) · cites this paper as Spencer et al. 2009
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- Authors
- Spencer, S. V., Hawk, L. W., Richards, J. B., Shiels, K., Pelham, W. E., & Waxmonsky, J. G.
- Affiliations
- University at Buffalo, State University of New York (US)
- Corresponding author
- Hawk, Larry W.
- Venue
- Journal of Abnormal Child Psychology
- Published
- 2009-03-17
- Volume
- 37
- Issue
- 6
- Pages
- 805-816
- ISSN
- 0091-0627 (ISSN-L)
- 1573-2835
- PMC
- PMC2709162
- OpenAlex
- W2069028385
- Cited by
- 93
- References
- 47
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 3 · 2016: 9 · 2015: 8 · 2014: 11 · 2013: 10 · 2012: 14
- FWCI
- 5.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH069434, MH069434)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- attention deficit hyperactivity disorder, methylphenidate, stimulant medication, attentional lapses, reaction time distribution, reaction time variability, processing speed, self-regulation, children
- MeSH terms
- Central Nervous System Stimulants, Attention, Attention Deficit Disorder with Hyperactivity, Child, Discrimination, Psychological, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Male, Methylphenidate, New York, Reaction Time, Task Performance and Analysis
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