Original Research

The effect of methylphenidate-OROS® on the narrative ability of children with attention-deficit hyperactivity disorder

Tessa L. Rausch, Diane L. Kendall, Sara T. Kover, Elizabeth M. Louw, Ursula L. Zsilavecz, Anita van der Merwe
South African Journal of Communication Disorders | Vol 64, No 1 | a180 | DOI: https://doi.org/10.4102/sajcd.v64i1.180 | © 2017 Tessa L. Rausch, Diane L. Kendall, Sara T. Kover, Elizabeth M. Louw, Ursula L. Zsilavecz, Anita van der Merwe | This work is licensed under CC Attribution 4.0
Submitted: 20 August 2016 | Published: 27 February 2017

About the author(s)

Tessa L. Rausch, Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
Diane L. Kendall, Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa; Department of Speech and Hearing Sciences, University of Washington, United States
Sara T. Kover, Department of Speech and Hearing Sciences, University of Washington, United States
Elizabeth M. Louw, Department of Statistics, University of Pretoria, South Africa
Ursula L. Zsilavecz, Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
Anita van der Merwe, Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa


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Abstract

Background and objective: Children with attention-deficit hyperactivity disorder (ADHD) experience difficulty with expressive language, including form (e.g. grammatical construction) and content (e.g. coherence). The current study aimed to investigate the effect of methylphenidate-Osmotic Release Oral System® (MPH-OROS®) on the narrative ability of children with ADHD and language impairment, through the analysis of microstructure and macrostructure narrative elements.

Method: In a single group off–on medication test design, narratives were obtained from 12 children with ADHD, aged 7–13 years, using wordless picture books. For microstructure, number of words, type–token ratio and mean length of utterance were derived from narrative samples using Systematic Analysis of Language Transcripts conventions. For macrostructure, the narratives were coded according to the Narrative Scoring Scheme, which includes seven narrative characteristics, as well as a composite score reflecting the child’s overall narrative ability.

Results: The administration of MPH-OROS® resulted in a significant difference in certain aspects of language macrostructure: cohesion and overall narrative ability. Little effect was noted in microstructure elements.

Conclusion: We observed a positive effect of stimulant medication on the macrostructure, but not on the microstructure, of narrative production. Although stimulant medication improves attention and concentration, it does not improve all aspects of language abilities in children with ADHD. Language difficulties associated with ADHD related to language content and use may be more responsive to stimulant medication than language form, which is likely to be affected by cascading effects of inattention, hyperactivity and impulsivity beginning very early in life and to progress over a more protracted period. Therefore, a combination of treatments is advocated to ensure that children with ADHD are successful in reaching their full potential.


Keywords

Attention-deficit hyperactivity disorder; stimulant medication; narrative; speech-language therapy; children

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