Stimulant drugs in the developmental disabilities revisited

Abstract

In this paper, I attempt to update the evidence for a conceptual model published some years ago (Aman, 1982) that strived to account for variable responses to stimulant medication in children with normal IQ and in those with developmental disabilities. This model accounted for such variations in terms of differences in breadth of attention across clinical groups. Recent reports on the use of stimulant drugs in subjects with developmental disabilities were reviewed. The evidence shows that children with mental retardation and ADHD often benefit from such medication, although their response rate seems to be somewhat lower than that of ADHD children of normal IQ. There is a paucity of stimulant drug research with children having autism, but it is clear that some of them also benefit from stimulant medication. However, there are also reports of adverse behavioral reactions to the stimulants in some children with autism or PDD. Several studies examining predictor variables were reviewed. Breadth of attention, IQ, and mental age have been useful in predicting outcome in a number of studies, and I argue that this supports the model. There is a continuing need for stimulant drug research in children with developmental disabilities, especially in those with autism. There is also merit in assessing cognitive variables suggested by the model as well as demographic and clinical variables for their ability to predict clinical response in these children.