Research clearly indicates that attention-deficit hyperactivity disorder (ADHD) is a common behavioral concomitant of Tourette's syndrome (TS) and chronic tic disorder in child patients. Unfortunately, the most safe, effective, and widely used pharmacological treatment for ADHD, namely methylphenidate, has generally been thought to exacerbate tics and therefore to be contraindicated in such patients. Because (a) the pharmacological alternatives to methylphenidate are often associated with increased risk of adverse drug reactions or are less efficacious for ADHD behaviors, and (b) there is very little controlled research on the long-term use of stimulants in children with tic disorder, there is a compelling need to examine the safety and efficacy of methylphenidate for ADHD in children with tic disorder (ADHD/+tics) and to develop drug evaluation procedures for clinical application. The primary objectives of the proposed study are to (1) assess short- and long-term effects of stimulant drug therapy for children with ADHD/tics+, and (2) describe developmental changes in tics, ADHD and antisocial behaviors, and mood and anxiety symptoms. The proposed study is a continuation of a long-term follow-up study of 82 children between 6 and 12 years of age who have ADHD/+tics and who will (or have) participate (d) in an 8-week, placebo-controlled, double-blind methylphenidate evaluation. Drug response for both ADHD and tic disorder symptoms is assessed using direct observation procedures in a simulated clinic classroom and with physician, teacher, and parent rating scales. Systematic assessment of symptom status is conducted at 6-month intervals for a minimum of 2 years and then at 12-month intervals for an additional 3 years (i.e., minimum of 5 years). To evaluate the impact of tic severity and comorbid internalizing and externalizing symptoms on clinical outcome, children with ADHD/+tics will be compared with an additional sample of children with ADHD/-tics at ages 11 and 16 years.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Special Emphasis Panel (ZMH1-ITV-D (01))
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Vitiello, Benedetto
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State University New York Stony Brook
Schools of Medicine
Stony Brook
United States
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Gadow, Kenneth D; Guttmann-Steinmetz, Sarit; Rieffe, Carolien et al. (2012) Depression symptoms in boys with autism spectrum disorder and comparison samples. J Autism Dev Disord 42:1353-63
Volpe, Robert J; Briesch, Amy M; Gadow, Kenneth D (2011) The efficiency of behavior rating scales to assess inattentive-overactive and oppositional-defiant behaviors: applying generalizability theory to streamline assessment. J Sch Psychol 49:131-55
Gadow, Kenneth D; Nolan, Edith E (2011) Methylphenidate and comorbid anxiety disorder in children with both chronic multiple tic disorder and ADHD. J Atten Disord 15:246-56
Guttmann-Steinmetz, Sarit; Gadow, Kenneth D; DeVincent, Carla J et al. (2010) Anxiety symptoms in boys with autism spectrum disorder, attention-deficit hyperactivity disorder, or chronic multiple tic disorder and community controls. J Autism Dev Disord 40:1006-16
Gadow, Kenneth D; DeVincent, Carla J; Schneider, Jayne (2009) Comparative study of children with ADHD only, autism spectrum disorder + ADHD, and chronic multiple tic disorder + ADHD. J Atten Disord 12:474-85
Guttmann-Steinmetz, Sarit; Gadow, Kenneth D; Devincent, Carla J (2009) Oppositional defiant and conduct disorder behaviors in boys with autism spectrum disorder with and without attention-deficit hyperactivity disorder versus several comparison samples. J Autism Dev Disord 39:976-85
Schneider, Jayne; Gadow, Kenneth D; Crowell, Judith A et al. (2009) Anxiety in boys with attention-deficit/hyperactivity disorder with and without chronic multiple tic disorder. J Child Adolesc Psychopharmacol 19:737-48
Gadow, Kenneth D; Nolan, Edith E; Sverd, Jeffrey et al. (2008) Methylphenidate in children with oppositional defiant disorder and both comorbid chronic multiple tic disorder and ADHD. J Child Neurol 23:981-90
Gadow, Kenneth D; Sverd, Jeffrey; Nolan, Edith E et al. (2007) Immediate-release methylphenidate for ADHD in children with comorbid chronic multiple tic disorder. J Am Acad Child Adolesc Psychiatry 46:840-8
Gadow, Kenneth D; Sverd, Jeffrey (2006) Attention deficit hyperactivity disorder, chronic tic disorder, and methylphenidate. Adv Neurol 99:197-207

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