Trial reportJournal of child psychology and psychiatry, and allied disciplines2018
How do stimulant treatments for ADHD work? Evidence for mediation by improved cognition.
Trial report in Journal of child psychology and psychiatry, and allied disciplines, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD).The Cochrane database of systematic reviews · 2023Pooled it
- The effect of stimulant medication on the learning of academic curricula in children with ADHD: A randomized crossover study.Journal of consulting and clinical psychology · 2022Trial
- Baseline performance moderates stimulant effects on cognition in youth with ADHD.Experimental and clinical psychopharmacology · 2021Trial
- A randomized controlled trial of central executive training (CET) versus inhibitory control training (ICT) for ADHD.Journal of consulting and clinical psychology · 2020Trial
- Attention-Deficit/Hyperactivity Disorder-Related Deficits and Psychostimulant Medication Effects on Comprehension of Audiovisually Presented Educational Material in Children.Journal of child and adolescent psychopharmacology · 2018Trial
- Cannabinoid type 1 receptor availability imaging in attention-deficit/hyperactivity disorder using [EJNMMI reports · 2026Article
- The interplay between executive function and learning disabilities: Developmental cognitive neuroscience perspectives on reading, math, and ADHD.Developmental cognitive neuroscience · 2026Review
- Examination of Peer Interactions During Cooperative and Competitive Board Games Among Children with Attention-Deficit/Hyperactivity Disorder on and off Methylphenidate.Research on child and adolescent psychopathology · 2026Article
- Factors associated with stimulant persistence among children with ADHD: a retrospective cohort study.Frontiers in pharmacology · 2026Article
- Cognitive Profiles are Better Predictors of Literacy Attainment Than Diagnostic Outcomes in Children with High ADHD Symptoms.Journal of autism and developmental disorders · 2025Article
- A parametric investigation of binaural beats for brain entrainment and enhancing sustained attention.Scientific reports · 2025Article
- "Everything's a Challenge": An Interview Study of ADHD Individuals in the Midst of the Prescription Stimulant Shortage.Journal of attention disorders · 2025Article
- Differentiating the neurobiological correlates for reading gains in children with reading difficulties with and without attention-deficit/hyperactivity disorder using fMRI.Journal of the International Neuropsychological Society : JINS · 2025Article
- Effects of methylphenidate on children with attention deficit hyperactivity disorder: a study using clinical and multimodal approaches including go/no-go task and functional near-infrared spectroscopy.Frontiers in pharmacology · 2025Article
- Neural markers of methylphenidate response in children with attention deficit hyperactivity disorder and the impact on executive function.Frontiers in psychiatry · 2025Article
- Biomarkers for Cognitive Control, Response Inhibition, Aggressivity, Impulsivity, and Violence.Advances in neurobiology · 2024Review
- An evaluation of the effect of methylphenidate on working memory, time perception, and choice impulsivity in children with ADHD.Experimental and clinical psychopharmacology · 2022Article
- Current Pharmacological Treatments for ADHD.Current topics in behavioral neurosciences · 2022Review
- Caffeine enhances sustained attention among adolescents.Experimental and clinical psychopharmacology · 2021Article
- Inhibition in developmental disorders: A comparison of inhibition profiles between children with autism spectrum disorder, attention-deficit/hyperactivity disorder, and comorbid symptom presentation.Autism : the international journal of research and practice · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundStimulant medications such as methylphenidate (MPH) are the frontline treatment for Attention-Deficit/Hyperactivity Disorder (ADHD). Despite their well-documented efficacy, the mechanisms by which stimulants improve clinical outcomes are not clear. The current study evaluated whether MPH effects on classroom behavior were mediated by improved cognitive functioning.
methodsChildren with ADHD (n = 82; 9-12 years old) participated in a week-long summer research camp, consisting of cognitive testing, classroom periods, and recreational activities. After a baseline day, participants completed a 3-day randomized, double-blind, placebo-controlled trial of MPH (at doses approximating 0.3 and 0.6 mg/kg of immediate-release MPH dosed TID). Cognitive domains included inhibitory control (Stop Signal Task and prepulse inhibition of startle), attention (Continuous Performance Task and reaction time variability), and working memory (forward and backward spatial span). Clinical outcomes included math seatwork productivity and teacher-rated classroom behavior. A within-subjects path-analytic approach was used to test mediation. MPH-placebo and dose-response contrasts were used to evaluate drug effects.
resultsMethylphenidate improved seatwork productivity and teacher ratings (ds = 1.4 and 1.1) and all domains of cognition (ds = 0.3-1.1). Inhibitory control (Stop Signal Task, SST) and working memory backward uniquely mediated the effect of MPH (vs. placebo) on productivity. Only working memory backward mediated the impact of MPH on teacher-rated behavior. The dose-response (0.6 vs. 0.3 mg/kg) effects were more modest for clinical outcomes (ds = 0.4 and 0.2) and cognition (ds = 0-0.3); there was no evidence of cognitive mediation of the clinical dose-response effects.
conclusionsThese findings are novel in demonstrating that specific cognitive processes mediate clinical improvement with stimulant treatment for ADHD. They converge with work on ADHD theory, neurobiology, and treatment development in suggesting that inhibitory control and working memory may be mechanisms of stimulant treatment response in ADHD. More work is necessary to evaluate the degree to which these findings generalize to chronic treatment, a broader array of clinical outcomes, and nonstimulant treatments.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.