Concerns have recently been expressed about pharmacological intervention in the treatment of hyperkinesis. Increases in heart rate and blood pressure,1.2 and a decrease in growth rate3 have been reported, and there are serious questions regarding the long-term effectiveness of pharmacotherapy.4 The following case illustrates the effectiveness of behavioral psychotherapy in a child with hyperkinesis.
Report of a Case.—A 9-year-old boy had been diagnosed as hyperkinetic and had received medication since age 6. Initially, he received 20 mg methylphenidate hydrochloride in the morning and 10 mg after school. The boy's problems consisted of noncompliance with teacher and parental requests, teasing and fighting with siblings and classmates, and failure to complete academic tasks and homework. Treatment involved establishing a behavioral intervention program in home and school, while concurrently withdrawing the methylphenidate.
Therapy, which was approached through a combination of assigned readings,5 discussion and feedback, and videotaped interactions,