No trials reported serious adverse events .
Subgroup analysis by dose did not identify any significant differences in effect on our primary outcomes between low- , medium- or high-dose ranges .
We found that short-term use of methylpheni date might improve symptoms of hyperactivity and possibly inattention in children with ASD who are tolerant of the medication , although the low quality of evidence means that we can not be certain of the true magnitude of any effect .
There was no evidence that methylpheni date has a negative impact on the core symptoms of ASD , or that it improves social interaction , stereotypical behaviours , or overall ASD .
BACKGROUND Children with autistic spectrum disorder ( ASD ) frequently present with inattention , impulsivity and hyperactivity , which are the cardinal symptoms of attention deficit hyperactivity disorder ( ADHD ) .
The effectiveness of methylpheni date , a commonly used ADHD treatment , is therefore of interest in these children .
OBJECTIVES To assess the effects of methylpheni date for symptoms of ADHD ( inattention , impulsivity and hyperactivity ) and ASD ( impairments in social interaction and communication , and repetitive , restricted or stereotypical behaviours ) in children and adolescents aged 6 to 18 years with ASD .
Randomized controlled double-blind trial of optimal dose methylphenidate in children and adolescents with severe attention deficit hyperactivity disorder and intellectual disability.
BACKGROUND Attention deficit hyperactivity disorder is increased in children with intellectual disability . Previous research has suggested stimulants are less effective than in typically developing children but no studies have titrated medication for individual optimal dosing or tested the effects for longer than 4 weeks . METHOD One hundred and twenty two drug-free children aged 7 - 15 with hyperkinetic disorder and IQ 30 - 69 were recruited to a double-blind , placebo-controlled trial that r and omized participants using minimization by probability , stratified by referral source and IQ level in a one to one ratio .  Methylpheni date was compared with placebo . Dose titration comprised at least 1 week each of low ( 0.5 mg/kg/day ) , medium ( 1.0 mg/kg/day ) and high dose ( 1.5 mg/kg/day ) . Parent and teacher Attention deficit hyperactivity disorder ( ADHD ) index of the Conners Rating Scale-Short Version at 16 weeks provided the primary outcome measures . Clinical response was determined with the Clinical Global Impressions scale ( CGI-I ) . Adverse effects were evaluated by a parent-rated question naire , weight , pulse and blood pressure . Analyses were by intention to treat . TRIAL REGISTRATION IS RCT N 68384912 . RESULTS Methylpheni date was superior to placebo with effect sizes of 0.39 [ 95 % confidence intervals ( CIs ) 0.09 , 0.70 ] and 0.52 ( 95 % CIs 0.23 , 0.82 ) for the parent and teacher Conners ADHD index . Four ( 7 % ) children on placebo versus 24 ( 40 % ) of those on methylpheni date were judged improved or much improved on the CGI . IQ and autistic symptoms did not affect treatment efficacy . Active medication was associated with sleep difficulty , loss of appetite and weight loss but there were no significant differences in pulse or blood pressure . CONCLUSIONS Optimal dosing of methylpheni date is practical and effective in some children with hyperkinetic disorder and intellectual disability . Adverse effects typical of methylpheni date were seen and medication use may require close monitoring in this vulnerable group
No trials reported serious adverse events .
Subgroup analysis by dose did not identify any significant differences in effect on our primary outcomes between low- , medium- or high-dose ranges .
We found that short-term use of methylpheni date might improve symptoms of hyperactivity and possibly inattention in children with ASD who are tolerant of the medication , although the low quality of evidence means that we can not be certain of the true magnitude of any effect .
There was no evidence that methylpheni date has a negative impact on the core symptoms of ASD , or that it improves social interaction , stereotypical behaviours , or overall ASD .
BACKGROUND Children with autistic spectrum disorder ( ASD ) frequently present with inattention , impulsivity and hyperactivity , which are the cardinal symptoms of attention deficit hyperactivity disorder ( ADHD ) .
The effectiveness of methylpheni date , a commonly used ADHD treatment , is therefore of interest in these children .
OBJECTIVES To assess the effects of methylpheni date for symptoms of ADHD ( inattention , impulsivity and hyperactivity ) and ASD ( impairments in social interaction and communication , and repetitive , restricted or stereotypical behaviours ) in children and adolescents aged 6 to 18 years with ASD .