Is methylphenidate a safe and effective treatment of ADHD-like symptoms in children with pervasive developmental disorders?

Children with autistic disorder and related pervasive developmental disorders (PDDs) frequently have symptoms of hyperactivity and impulsivity similar to the symptoms of attention-deficit/hyperactivity disorder (ADHD). Clinicians often treat these symptoms with methylphenidate (MPH), but historically there are little available data about the use of MPH in children with PDD. The Research Units on Pediatric Psychopharmacology (RUPP) group set out to determine whether MPH is a safe and effective treatment for the ADHD-like symptoms associated with PDD. MPH was found to be superior to placebo in reducing hyperactivity scores on the Aberrant Behavior Checklist. However there was a lower magnitude of response and a higher incidence of medication discontinuation than previously reported in typically developing children with ADHD. Although MPH seems to be a reasonable choice for the treatment of ADHD-like symptoms in children with PDD, clinicians should consider the findings from the RUPP MPH study before prescribing MPH to children with PDD.