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Randomized Controlled Trial
. 2020 Nov;24(13):1824-1835.
doi: 10.1177/1087054717713640. Epub 2017 Jun 13.

Methylphenidate-Related Improvements in Math Performance Cannot Be Explained by Better Cognitive Functioning or Higher Academic Motivation: Evidence From a Randomized Controlled Trial

Anne Fleur Kortekaas-Rijlaarsdam  1 , Marjolein Luman  1 , Edmund Sonuga-Barke  2 , Pierre Bet  3 , Jaap Oosterlaan  1
Affiliations
Randomized Controlled Trial

Methylphenidate-Related Improvements in Math Performance Cannot Be Explained by Better Cognitive Functioning or Higher Academic Motivation: Evidence From a Randomized Controlled Trial

Anne Fleur Kortekaas-Rijlaarsdam et al. J Atten Disord. 2020 Nov.

Abstract

Objective: This study investigated whether improvements in working memory, reaction time, lapses of attention, interference control, academic motivation, and perceived competence mediated effects of methylphenidate on math performance. Method: Sixty-three children (ADHD diagnosis; methylphenidate treatment; age 8-13; IQ > 70) were randomly allocated to a 7-day methylphenidate or placebo treatment in this double-blind placebo-controlled crossover study and compared with 67 controls. Data were collected at schools and analyzed using mixed-model analysis. Methylphenidate was hypothesized to improve all measures; all measures were evaluated as potential mediators of methylphenidate-related math improvements. Results: Controls mostly outperformed the ADHD group. Methylphenidate did not affect measures of cognitive functioning (p = .082-.641) or academic motivation (p = .199-.865). Methylphenidate improved parent ratings of their child's self-perceived competence (p < .01), which mediated methylphenidate efficacy on math productivity. Conclusion: These results question the necessity of improvements in specific cognitive and motivational deficits associated with ADHD for medication-related academic improvement. They also stimulate further study of perceived competence as a mediator.

Keywords: ADD/ADHD; academic performance; cognition; competence; methylphenidate.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Prof. Dr. Edmund Sonuga-Barke (last three years): Speaker fees, consultancy and conference support from Shire Pharmaceuticals. Speaker fees from Janssen Cilag, Consultancy from Neurotech solutions, Aarhus University, Copenhagen University and Berhanderling, Skolerne, Copenhagen, KU Leuven. Book royalties from OUP and Jessica Kingsley.

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