The relative efficacy of methylphenidate (ritalin) and behavior-modification techniques in the treatment of a hyperactive child.

Drug versus placebo effects were contrasted with those of contingency management in the treatment of a hyperactive child. Several criterion behaviors were monitored in two different settings to gauge the breadth and generalizability of drug and behavior-management effects. Medication and contingency management effects were both found to be situation specific. No interaction effects were found. Accuracy of task performance, amount of eye contact with the experimenters, frequency of repetitive hand movements, and distractible behavior were apparently unaffected by medication (Ritalin versus placebo) within the clinic. A multiple-baseline design incorporating contingency reversals revealed the reinforcement contingencies to be the crucial variable controlling behavior within the clinic. Medication effects were shown to be significant within the home setting where reinforcement contingencies were not changed. While aggressive behavior decreased as a function of Ritalin, repetitive hand movements increased