Pharmacological treatment

Beneficial effects of stimulant medication are not infiniteEffects on behavior & academic productivity are immediate but temporary & cannot compensate for missed instruction and learningLack of synchronization between drug schedule and academic scheduleStimulants enhance some but not all aspects of cognitive function & so may not target critical cognitive impairments

of medical & academic treatment is essentialReading to Read instruction for ADHD boys at two intervals post-medication (Kastner et al., 2000)

Stimulant have limited effects on readingNo effect on phonological processing (e.g., Balthazor et al., 1991; Richardson et al 1988)Small effects on verbal retrieval mechanisms involved in word recognition (e.g., Ballinger, 1984; Evans et al., 1986; Peeke et al., 1984; Richardson et al., 1988; MTA Study 1999)Effects on comprehension are unknown (e.g, Brock & Knapp, 1996)

Stimulants have selective effects on Working MemoryStimulants improve but do not normalize impairments in visuo-spatial span & visuo-spatial working memory, in childhood & adult ADHD (Bedard et al., in press; Mehta et al., 2000a, 2000b; Barnett et al., 2002)Stimulants may improve verbal working memory but not verbal span in children, but may be mediated by stimulant effects on spatial working memory (CHI/PASAT;Tannock et al., 1995; Schweitzer et al., 2000)

Advances in psychopharmacological treatment of ADHDNewer, longer-acting medications for ADHD will facilitate synchronization of pharmacological treatment with educational interventionSeveral FDA-approved long-acting stimulants & a non-stimulant drug available in USAMany of which are or will soon be available in Canada

BUT. May still have temporary & selective beneficial effects on cognitive function