Abstract

The present study was designed to evaluate the short-term effects of stimulant medication on mother-child interactions and the cognitive and behavioral symptoms of Attention Deficit Hyperactivity Disorder(ADHD), to identify factors that might predict favorable response to the treatment, and also to study 6 months follow up. 15 ADHD boys(ages 5-10 years) were treated with metylphenidate(0.5 mg/kg per day) for 1 month and their mother-child interaction, as well as attention and behavior ratings were assessed before and after the treatment. The mother-child interaction patterns were recorded through one-way mirror using video tape in the playroom for 10 minute free play and 20 minute task performance period. Then the videotaped interaction were rated according to the Response Class Matrix developed by Mash, Terdal & Anderson (1973). ADHD children's sustained attention were evaluated by computer programmed Continuous Performance Task(CPT), and their behavior problems were rated by their mother using Abreviated Conners Parent Rating Scale-revised(ACPRS-R), Home Situation Questionnaire(HSQ) and Child Behavior Check List(CBCL). Result indiacted that the percentage of negative-aggressive behavior of the ADHD children and mothers during the task performance period decreased significantly after the treatment. The ADHD children also showed a significant decrease in the errors and an increase in the sensitivity level(d') and a decreasing tendency in the response criterion(β) after 4 weeks of stimulant medication. In the ratings of mothers on their children, hyperactivity and home situation behavior problems tend to decrease. These results indicate that stimulant medication is effective in improving attention difficulties and negative aspect of mother-child interaction behaviors of ADHD children, but it does not bring about overall improvement behavioral symptoms, nor does it bring the level of mother-child interaction to that of normal children. In the analysis of variables discriminating the Improved(N=6) and the Unimproved group (N=9), younger age and more severe cognitive and behavioral symptoms were associated with favorable response to stimulant treatment. The results were discussed in terms of clinical implications for the importance of early diagnosis and treatment of ADHD.