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|Title:||Treatments for Hyperkinetic Children: A Literature Review and a Design for a Trial of Methylphenidate and Behaviour Modification|
|Authors:||Tausig, Townsend Frances|
|Keywords:||Medical Sciences;Medical Sciences|
|Abstract:||<p>Hyperkinetic children and their treatment are currently the subjects of heated discussions among medical persons, parents, teachers, government officials, the press and a concerned public. The focus of these discussions is often the appropriateness or inappropriateness of stimulant medications for hyperkinetic children.</p> <p>The first part of this thesis contains a review of a substantial portion of the literature on hyperkinesis including : definitions and diagnosis of hyperkinesis, prevalence of hyperkinetic symptoms and of hyperkinesis, characteristics of children considered hyperkinetic, drug treatments for hyperkinesis, and non-drug treatments for hyperkinesis. The major purpose of the literature review is to examine all available studies of the effectiveness of methylphenidate for hyperkinesis and all available studies of the effectiveness of non-drug treatments for hyperkinesis. This review indicates that methylphenidate is the most effective drug treatment tested and that behaviour modification or operant conditioning is the best tested, effective non-drug treatment for hyperkinesis. The relative effectiveness of methylphenidate and behaviour modification alone or in combination for the treatment of hyperkinesis is not known.</p> <p>In the literature review, Tables are provided which summarize information gleaned from an extensive selection of publications. These Tables include : A) Estimates of the Prevalence of Hyperkinetic Symptoms and of the Hyperkinetic Disorder in Children; B) Some Characteristics which Distinguish Children Diagnosed as Hyperkinetic from Normal Children; C) Some Characteristics which Distinguish Children Diagnosed as Hyperkinetic from Neurotic or Normal Children; D) A Summary of Studies of Methylphenidate for Hyperkinesis; E) The Effectiveness of Methylphenidate versus Placebo for Hyperkinesis : measures on which M and P have differed significantly in therapeutic effectiveness; F) The Effectiveness of Methylphenidate versus other Active Drugs for Hyperkinesis; G) A Summary of Studies of Non-Drug Treatments for Hyperkinesis; H) Evaluation of Miscellaneous Non-Drug Treatments for Hyperkinesis, and I) The Effectiveness of conditioning in the Treatment of Hyperkinesis.</p> <p>The second part of this thesis is a research proposal which has been developed on the basis of the current state of knowledge pertaining to the treatment of Hyperkinesis. The proposed research is designed to determine which of three very promising treatments for hyperkinesis has the greatest effectiveness and fewest side-effects: methylphenidate, behaviour modification, or methylphenidate plus behaviour modification. The protocol covers the following areas : Rationale for the study; Selection criteria for hyperkinetlc children; Collection of the sample of children; Sample size required; Pre-treatment assessments; Assignment to treatments; Methylphenidate treatment at .7mg/kg/day; Behaviour modification program including 8 sessions; Methylphenidate and behaviour modification in combination; Post-treatment assessments; Data analysis and budget for the study. This protocol could be adapted for use by other investigators interested in the area.</p>|
|Appears in Collections:||Open Access Dissertations and Theses|
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