Attention Deficit Hyperactivity Disorder
Conditions
Keywords
ADHD, Attention Deficit Hyperactivity Disorder
Brief summary
The purpose of this trial is to determine if the study medication, CONCERTA (methylphenidate HCl), is safe and effective in improving academic performance and behavior in children with attention deficit hyperactivity disorder (ADHD), when compared to placebo.
Detailed description
The hypothesis is that CONCERTA (methylphenidate HCl) is safe and effective in improving academic performance and behavior in children with ADHD, when compared to placebo as demonstrated using specified study measures. This is a double-blind (neither participant nor investigator knows the name of the assigned study drug), randomized (study drug assigned by chance), placebo-controlled, crossover study evaluating the academic, behavioral, and cognitive effects of CONCERTA (methylphenidate HCl) on older children with ADHD. This means that all eligible children will receive treatment with methylphenidate HCl throughout the study (the titration and assessment periods) and inactive pill (placebo) on one of the two laboratory classroom days. On the other laboratory classroom day they will receive their regular dose of methylphenidate HCl. The primary efficacy variable in this study is the Permanent Product Math Test (PERMP) attempted score. Secondary Measures include: SKAMP (Swanson, Kotkin, Agler, M-Flynn, and Pelham), tests of inattention, reading fluency and comprehension, and memory. Assessments will be completed during each of the laboratory assessment days (12.5 hours). Participants will be assessed for adverse events throughout the study. Patients will initiate treatment with oral CONCERTA (methylphenidate HCl) 18 mg at baseline and continue morning dosing with increases every 3 to 7 days until an optimal dose is achieved, up to the maximum of 54 mg/day. Eligible patients will remain in the study for a maximum of 8 weeks.
Interventions
Placebo once daily on Lab School Day #1 and Optimal Subject Dose (18 mg-54 mg) once daily during Lab School Day #2
Optimal Subject Dose (18 mg-54 mg) once daily during Lab School Day #1 and Placebo once daily on Lab School Day #2
Sponsors
Study design
Eligibility
Inclusion criteria
* ADHD diagnosis of all subtypes (except Not Otherwise Specified) * Patients with total or subscale Attention Deficit Hyperactivity Disorder Rating Scale (ADHD RS-IV) scores \> =90th percentile relative to the general population of children by age and gender * Patients currently receiving ADHD medication must be inadequately managed on their current stimulant dose and meet this criteria at the screening visit * Ability to read and understand English * Ability to attend school regularly.
Exclusion criteria
* Estimated Full Scale IQ score of 80 or below * Severe Learning Disability * History of, or current, primary diagnosis of: severe anxiety disorder, conduct disorder, psychotic disorders, pervasive developmental disorder, eating disorder, obsessive-compulsive disorder, sleep disorder, major depressive disorder, bipolar disorder, substance use disorder, chronic tic disorder, personal or family history of Tourette's syndrome * Weight \< 3rd percentile for age * History of hospitalization for treatment of a mood, anxiety, or psychotic disorder * History of failed response to methylphenidate.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hour 4 Permanent Product Math Test Attempted Score (PERMP-Attempted) | Hour 4 of the of the Lab School Day during Double-Blind Assessment Period | PERMP (range: 0, 400) is a measure of academic productivity in children up to 14 years of age. These seatwork math tasks provide an objective measure of attention and accuracy in calculations. The level of difficulty is established on a screening math pretest. The subsequent laboratory school day assessments employed a series of 10-minute math tests (5 pages of 80 math problem each for a total of 400 problems available). Children were graded on the number of attempted problems. A higher number of problems attempted was indicative of greater attention to detail (higher score is preferable) |
| Hour 4 Permanent Product Math Test Correct Score (PERMP-Correct) | Hour 4 of the Lab School Day During the Double-Blind Assessment Period | PERMP (range: 0, 400) is a measure of academic productivity in children up to 14 years of age. These seatwork math tasks provide an objective measure of attention and accuracy in calculations. The level of difficulty is established on a screening math pretest performed at Visit 2. The subsequent laboratory school day assessments employed a series of 10-minute math tests (5 pages of 80 math problem each for a total of 400 problems available). Children were graded on the number of correct problems. A higher number of problems correct, of those attempted, was indicative of greater accuracy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Composite (SKAMP-Composite) | Hour 4 of the Lab School Day During the Double-Blind Assessment Period | The SKAMP scale measures the manifestations of ADHD using an independent observer (teacher) rating of the child's impairment in classroom behavior. A composite score (range: 0, 78) for the SKAMP variable (13 items total) was obtained by summing the SKAMP-D and SKAMP-A subscale scores. A lower score was preferable, as a higher score represented greater behavioral impairment. |
| Hour 5.5 Test of Variables of Attention (TOVA) ADHD Composite Cutoff Score | Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period | The TOVA (range: unbounded) is a computerized, visual continuous performance test providing a measure of attention. The stimulus, presented for 100 milliseconds (ms) at the rate of 30 per minute, is a computer-presented square containing a square hole near the top (target) or bottom (non-target) edge. Higher scores indicate better performance, lower scores indicate worse performance. Clinical interpretation: an ADHD scores of -1.80 or lower (\<= -1.80) are considered not within normal limits scores above -1.80 (\> -1.80) are considered inconclusive (meaning, neither like-ADHD nor like-normal). |
| Hour 5.5 Test of Variables of Attention (TOVA) Reaction Time Standard Score | Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period | The TOVA (range: unbounded) is a computerized, visual continuous performance test providing a measure of attention. The stimulus, presented for 100 milliseconds (ms) at the rate of 30 per minute, is a computer-presented square containing a square hole near the top (target) or bottom (non-target) edge. Higher scores indicated better performance, lower scores indicate worse performance. Clinical interpretation: scores below 80 are considered abnormal, 80-85 are considered borderline, and scores above 85 are considered within normal limits. |
| Hour 5.5 Test of Variables of Attention (TOVA) Reaction Time Variability Standard Score | Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period | The TOVA (range: unbounded) is a computerized, visual continuous performance test providing a measure of attention. The stimulus, presented for 100 milliseconds (ms) at the rate of 30 per minute, is a computer-presented square containing a square hole near the top (target) or bottom (non-target) edge. Higher scores indicated better performance, lower scores indicate worse performance. Clinical interpretation: scores below 80 are considered abnormal, 80-85 are considered borderline, and scores above 85 are considered within normal limits. |
| Hour 5.5 Wide Range Assessment of Memory and Learning (WRAML-2) Finger Windows Backwards | Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period | WRAML-2 (range: 0, 28) is designed to evaluate a child's ability to learn and to memorize information, consists of 9 subtests from which 4 summary indexes can be calculated: verbal memory index, visual memory index, learning index, and general memory index. During this test the investigator pointed to a longer and longer series of windows on a card at the rate of 1 location per second, and then the child was asked to reproduce the sequence exactly in reverse order. One point was given for each correctly recalled sequence, and the test was discontinued after 3 consecutive errors. |
| Hour 5.5 Wide Range Assessment of Memory and Learning (WRAML-2) Finger Windows Forwards | Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period | WRAML-2 (range: 0, 28) is designed to evaluate a child's ability to learn and to memorize information, consists of 9 subtests from which 4 summary indexes can be calculated: verbal memory index, visual memory index, learning index, and general memory index. During this test the investigator pointed to a longer and longer series of windows on a card at the rate of 1 location per second, and then the child was asked to reproduce the sequence exactly. One point was given for each correctly recalled sequence, and the test was discontinued after 3 consecutive errors. |
| Hour 5.5 Test of Variables of Attention (TOVA) Commissions Standard Score | Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period | The TOVA (range: unbounded) is a computerized, visual continuous performance test providing a measure of attention. The stimulus, presented for 100 milliseconds (ms) at the rate of 30 per minute, is a computer-presented square containing a square hole near the top (target) or bottom (non-target) edge. Higher scores indicated better performance, lower scores indicate worse performance. Clinical interpretation: scores below 80 are considered abnormal, 80-85 are considered borderline, and scores above 85 are considered within normal limits. |
| Hour 5.5 Wechsler Intelligence Scale for Children - 3rd ed. (WISC-III-PI) Digit Span Backwards | Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period | Each child individually was given a sequence of numbers with the sequence becoming progressively longer. The child was then asked to repeat the digits in the same sequence, either forwards or backwards. Each sequence length was attempted twice. The test was complete after failure on both trials of any sequence length. One point was awarded if the participant passed only 1 trial of a sequence length. Zero points were given if the participant failed both trials. The maximum raw scores were 16 forwards and 14 backwards. A higher score was indicative of better recall and attention (range: 0, 14). |
| Hour 8.75 Gray Silent Reading Test (GSRT) Reading Quotient | Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period | Gray Silent Reading Test (GSRT)Reading Quotient is a reliable, validated measure of reading comprehension administered in the group setting during the first half hour of the homework session (range: 0,unbounded). A higher score is preferable as it means more questions were answered correctly. |
| Hour 7.5 Test of Handwriting Skills (Revised) (THS-R) Standard Score | Hour 7.5 of the Lab School Day During the Double-Blind Assessment Period | The THS-R (range: unbounded) is a standardized, untimed assessment designed to evaluate neurosensory integration manifested in manuscript and cursive writing. The test includes subtests: writing from memory or dictation the letters of the alphabet in order, single digit-numbers out of order, selected words, and copying selected letters, words, and sentences. Each subtest was scored from zero (poorly formed letters) to 3 (perfectly formed letters). 100 is the normal mean; scores lower than 100 indicate performance worse than normal, scores above 100 indicate performance better than normal. |
| Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Deportment (SKAMP-Deportment) | Hour 4 of the Lab School Day During the Double-Blind Assessment Period | The SKAMP scale measures the manifestations of ADHD using an independent observer (teacher) rating of the child's impairment in classroom behavior. The SKAMP-Deportment (SKAMP-D) (range: 0, 36) is a sum of ratings on 6 deportment items (interacting with other children, interacting with adults, remaining quiet, staying seated, complying with the teacher's directions, and following the classroom rules). Each item was rated on a 7-point impairment scale (0=normal, 6=maximum impairment), with higher scores indicating more severe symptoms. |
| Hour 5.5 Wechsler Intelligence Scale for Children - 3rd ed. (WISC-III-PI) Digit Span Forwards | Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period | Each child individually was given a sequence of numbers with the sequence becoming progressively longer. The child was then asked to repeat the digits in the same sequence, either forwards or backwards. Each sequence length was attempted twice. The test was complete after failure on both trials of any sequence length. One point was awarded if the participant passed only 1 trial of a sequence length. Zero points were given if the participant failed both trials. The maximum raw scores were 16 forwards and 14 backwards. A higher score was indicative of better recall and attention (range: 0, 16). |
| Hour 5.5 Test of Variables of Attention (TOVA) Omissions Standard Score | Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period | The TOVA (range: unbounded) is a computerized, visual continuous performance test providing a measure of attention. The stimulus, presented for 100 milliseconds (ms) at the rate of 30 per minute, is a computer-presented square containing a square hole near the top (target) or bottom (non-target) edge. Higher scores indicated better performance, lower scores indicate worse performance. Clinical interpretation: scores below 80 are considered abnormal, 80-85 are considered borderline, and scores above 85 are considered within normal limits. |
| Hour 3.0 Grammar Task | Hour 3.0 of the Lab School Day During the Double-Blind Assessment Period | This task, presented once during a laboratory school day, was designed to index attention to detail by determining how many grammatical mistakes each child could identify and circle in a brief paragraph. The errors were not difficult to identify and were designed to show attention to task, not comprehension. A higher number of errors identified, of those possible, was indicative of better attention - identification of grammatical errors(range: 0, 1 represents correct responses divided by the number of possible responses). |
| Hour 8.75 Packet Activity Short Story With Questions for Comprehension | Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period | Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses). |
| Hour 8.75 Packet Activity Identify Root Word | Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period | Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses). |
| Hour 8.75 Packet Activity Alphabetize List of Words | Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period | Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses). |
| Hour 8.75 Packet Activity Identify Multiple Meanings for Words | Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period | Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses). |
| Hour 8.75 Packet Activity Complete Sentences Using Words Provided | Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period | Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses). |
| Hour 8.75 Packet Activity Word Search | Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period | Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses). |
| Hour 8.75 Packet Activity Decode the Mystery Sentence | Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period | Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses). |
| Hour 3.5 Dynamic Indicators of Basic Early Literacy Skills (DIBELS) | Hour 3.5 of the Lab School Day During the Double-Blind Assessment Period | The DIBELS (range: 0, 376), used to assess reading fluency, consists of standardized, individually administered measures of early literacy development. These short (1 minute) fluency measures were developed based upon essential early literacy domains to assess development of phonological awareness, alphabetic understanding, and automaticity and fluency. Only the paragraph fluency component of an age/grade-appropriate DIBELS was used. A higher score indicated better performance, as it represented that the subject orally read a greater number of words correctly within the time allowed. |
| Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Attention (SKAMP-Attention) | Hour 4 of the Lab School Day During the Double-Blind Assessment Period | The SKAMP scale measures the manifestations of ADHD using an independent observer (teacher) rating of the child's impairment in classroom behavior. The SKAMP-Attention (SKAMP-A) (range: 0, 42) is a sum of the ratings on 7 attention items (getting started, sticking with tasks, attending to an activity, making activity transitions, completing assigned tasks, performing work accurately, and being neat and careful while writing or drawing). Each item was rated on a 7-point impairment scale (0=normal, 6=maximum impairment), with higher scores indicating more severe symptoms. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Not Randomized Children who started dose adjustment period, but were not randomized | 7 |
| Placebo/Concerta Children randomized to receive Placebo at lab school day 1 and an individualized, optimal dose of Concerta (18mg, 36mg, or 54mg tablet) once daily at lab school day 2 | 36 |
| Concerta/Placebo Children randomized to receive an individualized, optimal dose of Concerta (18mg, 36mg, or 54mg tablet) once daily at lab school day 1 and Placebo at lab school day 2 | 35 |
| Total | 78 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Did not attend lab school day 1 | 1 | 0 | 0 |
| Overall Study | Failure to follow study protocol) | 1 | 0 | 0 |
| Overall Study | Lost to Follow-up | 1 | 0 | 0 |
| Overall Study | medication compliance | 1 | 0 | 0 |
| Overall Study | Optimal Dose Not Achieved | 2 | 0 | 0 |
| Overall Study | Withdrawal by Subject | 1 | 0 | 0 |
Baseline characteristics
| Characteristic | Not Randomized | Placebo/Concerta | Concerta/Placebo | Total |
|---|---|---|---|---|
| Age, Continuous | 9.9 years STANDARD_DEVIATION 0.69 | 10.3 years STANDARD_DEVIATION 1.07 | 10.0 years STANDARD_DEVIATION 1.14 | 10.1 years STANDARD_DEVIATION 1.08 |
| Region of Enrollment USA | 7 participants | 36 participants | 35 participants | 78 participants |
| Sex: Female, Male Female | 3 Participants | 14 Participants | 6 Participants | 23 Participants |
| Sex: Female, Male Male | 4 Participants | 22 Participants | 29 Participants | 55 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 1 / 71 | 0 / 71 | 34 / 78 |
| serious Total, serious adverse events | 0 / 71 | 0 / 71 | 0 / 78 |
Outcome results
Hour 4 Permanent Product Math Test Attempted Score (PERMP-Attempted)
PERMP (range: 0, 400) is a measure of academic productivity in children up to 14 years of age. These seatwork math tasks provide an objective measure of attention and accuracy in calculations. The level of difficulty is established on a screening math pretest. The subsequent laboratory school day assessments employed a series of 10-minute math tests (5 pages of 80 math problem each for a total of 400 problems available). Children were graded on the number of attempted problems. A higher number of problems attempted was indicative of greater attention to detail (higher score is preferable)
Time frame: Hour 4 of the of the Lab School Day during Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point. Intent-to-Treat for Placebo and Concerta columns in the primary and secondary results are comprised of the 36 children randomized to Placebo/CONCERTA (lab day 1/lab day 2) plus the 35 children randomized to CONCERTA/Placebo
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 4 Permanent Product Math Test Attempted Score (PERMP-Attempted) | 74.8 Problems attempted | Standard Deviation 42.05 |
| Concerta | Hour 4 Permanent Product Math Test Attempted Score (PERMP-Attempted) | 103.5 Problems attempted | Standard Deviation 38.51 |
Hour 4 Permanent Product Math Test Correct Score (PERMP-Correct)
PERMP (range: 0, 400) is a measure of academic productivity in children up to 14 years of age. These seatwork math tasks provide an objective measure of attention and accuracy in calculations. The level of difficulty is established on a screening math pretest performed at Visit 2. The subsequent laboratory school day assessments employed a series of 10-minute math tests (5 pages of 80 math problem each for a total of 400 problems available). Children were graded on the number of correct problems. A higher number of problems correct, of those attempted, was indicative of greater accuracy.
Time frame: Hour 4 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 4 Permanent Product Math Test Correct Score (PERMP-Correct) | 69.0 Problems correct | Standard Deviation 41.02 |
| Concerta | Hour 4 Permanent Product Math Test Correct Score (PERMP-Correct) | 97.4 Problems correct | Standard Deviation 38.99 |
Hour 3.0 Grammar Task
This task, presented once during a laboratory school day, was designed to index attention to detail by determining how many grammatical mistakes each child could identify and circle in a brief paragraph. The errors were not difficult to identify and were designed to show attention to task, not comprehension. A higher number of errors identified, of those possible, was indicative of better attention - identification of grammatical errors(range: 0, 1 represents correct responses divided by the number of possible responses).
Time frame: Hour 3.0 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 3.0 Grammar Task | 0.241 Units on a scale | Standard Deviation 0.1704 |
| Concerta | Hour 3.0 Grammar Task | 0.327 Units on a scale | Standard Deviation 0.2204 |
Hour 3.5 Dynamic Indicators of Basic Early Literacy Skills (DIBELS)
The DIBELS (range: 0, 376), used to assess reading fluency, consists of standardized, individually administered measures of early literacy development. These short (1 minute) fluency measures were developed based upon essential early literacy domains to assess development of phonological awareness, alphabetic understanding, and automaticity and fluency. Only the paragraph fluency component of an age/grade-appropriate DIBELS was used. A higher score indicated better performance, as it represented that the subject orally read a greater number of words correctly within the time allowed.
Time frame: Hour 3.5 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 3.5 Dynamic Indicators of Basic Early Literacy Skills (DIBELS) | 106.2 Units on a scale | Standard Deviation 35.15 |
| Concerta | Hour 3.5 Dynamic Indicators of Basic Early Literacy Skills (DIBELS) | 112.0 Units on a scale | Standard Deviation 35.51 |
Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Attention (SKAMP-Attention)
The SKAMP scale measures the manifestations of ADHD using an independent observer (teacher) rating of the child's impairment in classroom behavior. The SKAMP-Attention (SKAMP-A) (range: 0, 42) is a sum of the ratings on 7 attention items (getting started, sticking with tasks, attending to an activity, making activity transitions, completing assigned tasks, performing work accurately, and being neat and careful while writing or drawing). Each item was rated on a 7-point impairment scale (0=normal, 6=maximum impairment), with higher scores indicating more severe symptoms.
Time frame: Hour 4 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Attention (SKAMP-Attention) | 11.8 Units on a scale | Standard Deviation 6.48 |
| Concerta | Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Attention (SKAMP-Attention) | 6.7 Units on a scale | Standard Deviation 5.03 |
Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Composite (SKAMP-Composite)
The SKAMP scale measures the manifestations of ADHD using an independent observer (teacher) rating of the child's impairment in classroom behavior. A composite score (range: 0, 78) for the SKAMP variable (13 items total) was obtained by summing the SKAMP-D and SKAMP-A subscale scores. A lower score was preferable, as a higher score represented greater behavioral impairment.
Time frame: Hour 4 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Composite (SKAMP-Composite) | 20.8 Units on a scale | Standard Deviation 11.23 |
| Concerta | Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Composite (SKAMP-Composite) | 9.9 Units on a scale | Standard Deviation 7.44 |
Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Deportment (SKAMP-Deportment)
The SKAMP scale measures the manifestations of ADHD using an independent observer (teacher) rating of the child's impairment in classroom behavior. The SKAMP-Deportment (SKAMP-D) (range: 0, 36) is a sum of ratings on 6 deportment items (interacting with other children, interacting with adults, remaining quiet, staying seated, complying with the teacher's directions, and following the classroom rules). Each item was rated on a 7-point impairment scale (0=normal, 6=maximum impairment), with higher scores indicating more severe symptoms.
Time frame: Hour 4 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Deportment (SKAMP-Deportment) | 9.0 Units on a scale | Standard Deviation 6.68 |
| Concerta | Hour 4 Swanson, Kotkin, Alger, M-Flynn and Pelham Scale for Deportment (SKAMP-Deportment) | 3.1 Units on a scale | Standard Deviation 4.1 |
Hour 5.5 Test of Variables of Attention (TOVA) ADHD Composite Cutoff Score
The TOVA (range: unbounded) is a computerized, visual continuous performance test providing a measure of attention. The stimulus, presented for 100 milliseconds (ms) at the rate of 30 per minute, is a computer-presented square containing a square hole near the top (target) or bottom (non-target) edge. Higher scores indicate better performance, lower scores indicate worse performance. Clinical interpretation: an ADHD scores of -1.80 or lower (\<= -1.80) are considered not within normal limits scores above -1.80 (\> -1.80) are considered inconclusive (meaning, neither like-ADHD nor like-normal).
Time frame: Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 5.5 Test of Variables of Attention (TOVA) ADHD Composite Cutoff Score | -4.39 Units on a scale | Standard Deviation 3.31 |
| Concerta | Hour 5.5 Test of Variables of Attention (TOVA) ADHD Composite Cutoff Score | -1.34 Units on a scale | Standard Deviation 3.43 |
Hour 5.5 Test of Variables of Attention (TOVA) Commissions Standard Score
The TOVA (range: unbounded) is a computerized, visual continuous performance test providing a measure of attention. The stimulus, presented for 100 milliseconds (ms) at the rate of 30 per minute, is a computer-presented square containing a square hole near the top (target) or bottom (non-target) edge. Higher scores indicated better performance, lower scores indicate worse performance. Clinical interpretation: scores below 80 are considered abnormal, 80-85 are considered borderline, and scores above 85 are considered within normal limits.
Time frame: Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 5.5 Test of Variables of Attention (TOVA) Commissions Standard Score | 86.42 Units on a scale | Standard Deviation 33.261 |
| Concerta | Hour 5.5 Test of Variables of Attention (TOVA) Commissions Standard Score | 92.58 Units on a scale | Standard Deviation 34.545 |
Hour 5.5 Test of Variables of Attention (TOVA) Omissions Standard Score
The TOVA (range: unbounded) is a computerized, visual continuous performance test providing a measure of attention. The stimulus, presented for 100 milliseconds (ms) at the rate of 30 per minute, is a computer-presented square containing a square hole near the top (target) or bottom (non-target) edge. Higher scores indicated better performance, lower scores indicate worse performance. Clinical interpretation: scores below 80 are considered abnormal, 80-85 are considered borderline, and scores above 85 are considered within normal limits.
Time frame: Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 5.5 Test of Variables of Attention (TOVA) Omissions Standard Score | 25.98 Units on a scale | Standard Deviation 126.281 |
| Concerta | Hour 5.5 Test of Variables of Attention (TOVA) Omissions Standard Score | 64.07 Units on a scale | Standard Deviation 88.77 |
Hour 5.5 Test of Variables of Attention (TOVA) Reaction Time Standard Score
The TOVA (range: unbounded) is a computerized, visual continuous performance test providing a measure of attention. The stimulus, presented for 100 milliseconds (ms) at the rate of 30 per minute, is a computer-presented square containing a square hole near the top (target) or bottom (non-target) edge. Higher scores indicated better performance, lower scores indicate worse performance. Clinical interpretation: scores below 80 are considered abnormal, 80-85 are considered borderline, and scores above 85 are considered within normal limits.
Time frame: Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 5.5 Test of Variables of Attention (TOVA) Reaction Time Standard Score | 73.80 Units on a scale | Standard Deviation 23.74 |
| Concerta | Hour 5.5 Test of Variables of Attention (TOVA) Reaction Time Standard Score | 89.72 Units on a scale | Standard Deviation 21.32 |
Hour 5.5 Test of Variables of Attention (TOVA) Reaction Time Variability Standard Score
The TOVA (range: unbounded) is a computerized, visual continuous performance test providing a measure of attention. The stimulus, presented for 100 milliseconds (ms) at the rate of 30 per minute, is a computer-presented square containing a square hole near the top (target) or bottom (non-target) edge. Higher scores indicated better performance, lower scores indicate worse performance. Clinical interpretation: scores below 80 are considered abnormal, 80-85 are considered borderline, and scores above 85 are considered within normal limits.
Time frame: Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 5.5 Test of Variables of Attention (TOVA) Reaction Time Variability Standard Score | 62.87 Units on a scale | Standard Deviation 33.789 |
| Concerta | Hour 5.5 Test of Variables of Attention (TOVA) Reaction Time Variability Standard Score | 85.14 Units on a scale | Standard Deviation 34.906 |
Hour 5.5 Wechsler Intelligence Scale for Children - 3rd ed. (WISC-III-PI) Digit Span Backwards
Each child individually was given a sequence of numbers with the sequence becoming progressively longer. The child was then asked to repeat the digits in the same sequence, either forwards or backwards. Each sequence length was attempted twice. The test was complete after failure on both trials of any sequence length. One point was awarded if the participant passed only 1 trial of a sequence length. Zero points were given if the participant failed both trials. The maximum raw scores were 16 forwards and 14 backwards. A higher score was indicative of better recall and attention (range: 0, 14).
Time frame: Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 5.5 Wechsler Intelligence Scale for Children - 3rd ed. (WISC-III-PI) Digit Span Backwards | 5.1 Correct Trials | Standard Deviation 1.97 |
| Concerta | Hour 5.5 Wechsler Intelligence Scale for Children - 3rd ed. (WISC-III-PI) Digit Span Backwards | 5.4 Correct Trials | Standard Deviation 2.12 |
Hour 5.5 Wechsler Intelligence Scale for Children - 3rd ed. (WISC-III-PI) Digit Span Forwards
Each child individually was given a sequence of numbers with the sequence becoming progressively longer. The child was then asked to repeat the digits in the same sequence, either forwards or backwards. Each sequence length was attempted twice. The test was complete after failure on both trials of any sequence length. One point was awarded if the participant passed only 1 trial of a sequence length. Zero points were given if the participant failed both trials. The maximum raw scores were 16 forwards and 14 backwards. A higher score was indicative of better recall and attention (range: 0, 16).
Time frame: Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 5.5 Wechsler Intelligence Scale for Children - 3rd ed. (WISC-III-PI) Digit Span Forwards | 9.2 Correct Trials | Standard Deviation 1.88 |
| Concerta | Hour 5.5 Wechsler Intelligence Scale for Children - 3rd ed. (WISC-III-PI) Digit Span Forwards | 9.3 Correct Trials | Standard Deviation 1.7 |
Hour 5.5 Wide Range Assessment of Memory and Learning (WRAML-2) Finger Windows Backwards
WRAML-2 (range: 0, 28) is designed to evaluate a child's ability to learn and to memorize information, consists of 9 subtests from which 4 summary indexes can be calculated: verbal memory index, visual memory index, learning index, and general memory index. During this test the investigator pointed to a longer and longer series of windows on a card at the rate of 1 location per second, and then the child was asked to reproduce the sequence exactly in reverse order. One point was given for each correctly recalled sequence, and the test was discontinued after 3 consecutive errors.
Time frame: Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 5.5 Wide Range Assessment of Memory and Learning (WRAML-2) Finger Windows Backwards | 11.2 Correct Sequences | Standard Deviation 4.25 |
| Concerta | Hour 5.5 Wide Range Assessment of Memory and Learning (WRAML-2) Finger Windows Backwards | 12.2 Correct Sequences | Standard Deviation 3.57 |
Hour 5.5 Wide Range Assessment of Memory and Learning (WRAML-2) Finger Windows Forwards
WRAML-2 (range: 0, 28) is designed to evaluate a child's ability to learn and to memorize information, consists of 9 subtests from which 4 summary indexes can be calculated: verbal memory index, visual memory index, learning index, and general memory index. During this test the investigator pointed to a longer and longer series of windows on a card at the rate of 1 location per second, and then the child was asked to reproduce the sequence exactly. One point was given for each correctly recalled sequence, and the test was discontinued after 3 consecutive errors.
Time frame: Hour 5.5 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 5.5 Wide Range Assessment of Memory and Learning (WRAML-2) Finger Windows Forwards | 12.9 Correct Sequences | Standard Deviation 3.96 |
| Concerta | Hour 5.5 Wide Range Assessment of Memory and Learning (WRAML-2) Finger Windows Forwards | 14.3 Correct Sequences | Standard Deviation 3.64 |
Hour 7.5 Test of Handwriting Skills (Revised) (THS-R) Standard Score
The THS-R (range: unbounded) is a standardized, untimed assessment designed to evaluate neurosensory integration manifested in manuscript and cursive writing. The test includes subtests: writing from memory or dictation the letters of the alphabet in order, single digit-numbers out of order, selected words, and copying selected letters, words, and sentences. Each subtest was scored from zero (poorly formed letters) to 3 (perfectly formed letters). 100 is the normal mean; scores lower than 100 indicate performance worse than normal, scores above 100 indicate performance better than normal.
Time frame: Hour 7.5 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 7.5 Test of Handwriting Skills (Revised) (THS-R) Standard Score | 93.6 Units on a scale | Standard Deviation 20.77 |
| Concerta | Hour 7.5 Test of Handwriting Skills (Revised) (THS-R) Standard Score | 98.3 Units on a scale | Standard Deviation 21.81 |
Hour 8.75 Gray Silent Reading Test (GSRT) Reading Quotient
Gray Silent Reading Test (GSRT)Reading Quotient is a reliable, validated measure of reading comprehension administered in the group setting during the first half hour of the homework session (range: 0,unbounded). A higher score is preferable as it means more questions were answered correctly.
Time frame: Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 8.75 Gray Silent Reading Test (GSRT) Reading Quotient | 85.9 Units on a scale | Standard Deviation 23.6 |
| Concerta | Hour 8.75 Gray Silent Reading Test (GSRT) Reading Quotient | 91.9 Units on a scale | Standard Deviation 18.49 |
Hour 8.75 Packet Activity Alphabetize List of Words
Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses).
Time frame: Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 8.75 Packet Activity Alphabetize List of Words | 0.676 Units on a scale | Standard Deviation 0.34 |
| Concerta | Hour 8.75 Packet Activity Alphabetize List of Words | 0.676 Units on a scale | Standard Deviation 0.3369 |
Hour 8.75 Packet Activity Complete Sentences Using Words Provided
Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses).
Time frame: Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 8.75 Packet Activity Complete Sentences Using Words Provided | 0.652 Units on a scale | Standard Deviation 0.3251 |
| Concerta | Hour 8.75 Packet Activity Complete Sentences Using Words Provided | 0.741 Units on a scale | Standard Deviation 0.3221 |
Hour 8.75 Packet Activity Decode the Mystery Sentence
Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses).
Time frame: Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 8.75 Packet Activity Decode the Mystery Sentence | 0.960 Units on a scale | Standard Deviation 0.1566 |
| Concerta | Hour 8.75 Packet Activity Decode the Mystery Sentence | 0.987 Units on a scale | Standard Deviation 0.0501 |
Hour 8.75 Packet Activity Identify Multiple Meanings for Words
Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses).
Time frame: Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 8.75 Packet Activity Identify Multiple Meanings for Words | 0.694 Units on a scale | Standard Deviation 0.3123 |
| Concerta | Hour 8.75 Packet Activity Identify Multiple Meanings for Words | 0.795 Units on a scale | Standard Deviation 0.3019 |
Hour 8.75 Packet Activity Identify Root Word
Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses).
Time frame: Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 8.75 Packet Activity Identify Root Word | 0.744 Units on a scale | Standard Deviation 0.3058 |
| Concerta | Hour 8.75 Packet Activity Identify Root Word | 0.760 Units on a scale | Standard Deviation 0.3054 |
Hour 8.75 Packet Activity Short Story With Questions for Comprehension
Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses).
Time frame: Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 8.75 Packet Activity Short Story With Questions for Comprehension | 0.609 Units on a scale | Standard Deviation 0.2449 |
| Concerta | Hour 8.75 Packet Activity Short Story With Questions for Comprehension | 0.629 Units on a scale | Standard Deviation 0.2843 |
Hour 8.75 Packet Activity Word Search
Packet Activities: Assessment of ability to organize, listen to instructions, initiate task, complete task, and distractibility, by completing a word search, reading a short story for comprehension on a multiple choice test, reading a longer story for comprehension on a true/false test, decoding a mystery sentence, and completing various vocabulary assessments (word choice, homophones; base/root words, alphabetic order) (range: 0, 1 represents correct responses divided by the number of possible responses).
Time frame: Hour 8.75 of the Lab School Day During the Double-Blind Assessment Period
Population: Intent-to-Treat Analysis Set. Not randomized children were excluded from this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hour 8.75 Packet Activity Word Search | 0.935 Units on a scale | Standard Deviation 0.1952 |
| Concerta | Hour 8.75 Packet Activity Word Search | 0.979 Units on a scale | Standard Deviation 0.1123 |