Medication effects in the classroom: three naturalistic indicators.

Hyperactive and comparison boys participated in 5-week summer enrichment programs that included classroom activities and structured assessments of peer interaction patterns. During the 3rd and 4th weeks of these programs, a double-blind, methylphenidate-placebo crossover design was implemented within the hyperactive group. Three heterogeneous indicators of everyday behaviors were obtained: number of negative incidents noted by staff, quality of handwriting, and number of times the teacher called the boys' names aloud in the classroom. Medication effects emerged for each of these indicators. When hyperactive boys were taking placebos, they were involved in more negative incidents, their handwriting was poorer, and their names were called more-frequently than when the boys were taking methylphenidate. Interrelationships among the measures suggest moderate cross-situational generality of medication responsiveness. Discussion focused on the bandwidth of medication effects and the need to examine the social ramifications of child treatments.