Combined Modality Intervention for ADHD With Comorbid Reading Disorders: A Proof of Concept Study

• Published in: Journal of learning disabilities 2018-01, Vol.51 (1), p.55-72
• Main Authors: Tannock, Rosemary, Frijters, Jan C., Martinussen, Rhonda, White, Erin Jacquelyn, Ickowicz, Abel, Benson, Nancy J., Lovett, Maureen W.
• Format: Article
• Language: English
• Subjects: Attention Deficit Disorder with Hyperactivity - drug therapy; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - therapy; Attention Deficit Hyperactivity Disorder; Central Nervous System Stimulants - administration & dosage; Central Nervous System Stimulants - pharmacology; Child; Child Behavior; Children; Classrooms; Clinical Diagnosis; Combined Modality Therapy; Comorbidity; Conceptual Tempo; Control Groups; Drug Therapy; Drugs; Dyslexia - epidemiology; Dyslexia - therapy; Efficacy; Elementary School Students; Female; Foreign Countries; Humans; Hyperactivity; Intelligence Tests; Interpersonal Competence; Intervention; Interviews; Learning disabilities; Male; Matched Groups; Methylphenidate; Methylphenidate - administration & dosage; Methylphenidate - pharmacology; Outcome Assessment (Health Care); Phonology; Pretests Posttests; Program Effectiveness; Proof of Concept Study; Reading Ability; Reading difficulties; Reading disabilities; Reading Instruction; Reading Programs; Reading Skills; Reading Strategies; Reading Tests; Remedial Instruction; Remedial Teaching - methods; Screening Tests; Skill development; Social education; Social skills; Special education; Statistical Analysis; Stimulants; Symptoms (Individual Disorders); Teachers
• ISSN: 0022-2194; 1538-4780
• DOI: 10.1177/0022219416678409

To evaluate the relative efficacy of two reading programs with and without adjunctive stimulant medication for children with attention-deficit/hyperactivity disorder and comorbid reading disorder (ADHD+RD). Sixty-five children (7–11 years in age) were assigned randomly to one of three intensive remedial academic programs (phonologically or strategy-based reading instruction, or general academic strategy and social skills training) in combination with either immediate-release methylphenidate or placebo. Multiple-blind procedures were used for medication/placebo, given twice daily. Children received 35 hours of instruction in 10 weeks, taught by a trained teacher in a separate school classroom, in small matched groups of 2 to 3. Children’s behavior and reading abilities were assessed before and after intervention. Stimulant medication produced expected beneficial effects on hyperactive/impulsive behavioral symptoms (reported by classroom teachers) but none on reading. Children receiving a reading program showed greater gains than controls on multiple standardized measures of reading and related skills (regardless of medication status). Small sample sizes precluded interpretation of possible potentiating effects of stimulant medication on reading skills taught in particular reading programs. Intensive reading instruction, regardless of treatment with stimulant medication, may be efficacious in improving reading problems in children with ADHD+RD and warrants further investigation in a large-scale study.