Peer interaction in a structured communication task: comparisons of normal and hyperactive boys and of methylphenidate (Ritalin) and placebo effects.

Peer communication patterns were assessed as school-aged boys participated in a dyadic referential communication task. The responses of comparison boys were compared to those of hyperactive boys on methylphenidate (Ritalin) and on placebo in a double-blind crossover design. 2 separate systems for assessing communication were developed, a qualitative system designed to capture the "flavor" of interaction and a quantitative system focused on specific types of communicative content. Task products and completion times were also scored. The results suggest that hyperactive children, regardless of medication status, are less likely than comparison peers to (a) modulate ongoing or habitual behavior patterns in response to externally imposed shifts in role-appropriate behaviors; (b) maintain consistent, uninterrupted goal orientation; and (c) respond to subtle social learning opportunities. In this situation, methylphenidate appeared to have a greater impact on behavioral style than on competence, decreasing perceived intensity without influencing efficiency. A mild medication-induced dysphoria was also documented. Directions for future research and the need for caution in clinical interpretation are discussed.