Preliminary evidence of beneficial effects of methylphenidate on listening comprehension in children with attention-deficit/hyperactivity disorder

Objective: The effect of methylphenidate (MPH) on listening comprehension for information passages, and on working memory, was examined in a clinical sample of 16 children with attention-deficit/hyperactivity disorder (ADHD). Method: Drug effects on comprehension of spoken language at the levels of single sentences and passages, and on verbal and visual-spatial working memory (WM) skills were assessed over a 4-day placebo-controlled, double-blind, crossover treatment trial of MPH at low, medium, and high doses. Concurrent behavior ratings were also completed. Data were analyzed at both group and individual levels; individual improvements using average change scores were analyzed to explore interrelationships among comprehension, WM, and behavioral responses to MPH. Results: There was a significant effect of drug on comprehension of inferences from challenging listening passages (F = 3.1, p 0.05), and on visual-spatial working memory performance (F = 3.3, p 0.05), with significant linear dose-response relationships evident for both domains. Individual improvements in comprehension using averaged placebo-dose change scores were not related to improvements in behavior with MPH, or to improvements in WM in this sample. Conclusions: Findings provide preliminary evidence that MPH affects higher-level language comprehension skills, which require sustained attention and mental effort. If generalizable to classroom listening skills, these findings have implications for clinicians and teachers involved with children with ADHD.