Anne Fleur Kortekaas-Rijlaarsdam

29 MPH AND ACADEMIC PERFORMANCE: META-ANALYSIS 2 primary diagnosis of ADHD (established using the DSM-III, DSM-III-Revised [DSM- III-R] or DSM-IV/DSM-IV-Text Revisions [DSM-IV-TR] or ICD-10 criteria); (3) evaluated the effects of methylphenidate (MPH) (immediate or extended release formulations or transdermal) on standardized achievement tests for math, reading or spelling; and (4) used a placebo-controlled crossover design or between-subjects design. This review focused on primary school children as it is at this age that school teachers, concerned about academic performance, often drive the referral process, advising parents to seek help for their children’s ADHD. Further, there is a big difference in medication use in primary school age students and high school students (e.g. non- compliance rates are much higher in high school, see for example (Thiruchelvam, Charach, & Schachar, 2001)). The computerized databases PubMed, EMBASE, ERIC and PsycINFO were used to identify relevant studies up to October 2017. The following search terms and all possible equivalents were used to search article title and abstract: (1) disorder terms: e.g., ‘ADHD’; (2) treatment terms: e.g., ‘methylphenidate’, including all brand names; (3) outcome terms: e.g., ‘academic’, ‘school’, ‘classroom’, ‘math’, ‘reading’, ‘spelling’, ‘writing’, ‘on-task’, ‘off-task’. In case of missing or incomplete data, authors were contacted twice for additional data. When data were presented in graphs only, we used GetData Graph Digitizer version 2.26 (“GetData Graph Digitizer,” 2013) to extract the exact numbers, which was done successfully for one study (Pelham et al., 2001). In cases where multiple articles were based on the same sample, we selected the original, most comprehensive report on that study, resulting in the exclusion of four studies (Armstrong et al., 2012; Forness, Swanson, Cantwell, Youpa, & Hanna, 1992; Forness, Swanson, Cantwell, Guthrie, & Sena, 1992; Williamson et al., 2014) as these data were originally described elsewhere (Forness, Cantwell, Swanson, Hanna, & Youpa, 1991; Murray et al., 2011; Wigal, Gupta, et al., 2011). See Figure 2.1 for a flow diagram of the meta-analytic search and study selection. The first author (AK) and a second independent investigator reviewed titles and abstract for eligibility. Full texts were also reviewed by the first author as well as by an independent investigator. A third independent investigator conciliated discrepancies. Reference lists of included articles were searched for additional articles meeting the inclusion criteria. A total of 3084 records was identified corresponding to 2594 unique articles. Thirty- four articles met the inclusion criteria for meta-analysis (Fig. 2.1). Study characteristics, including design, medication titration, dependent variables, mediators and moderators obtained from each study are displayed in supplementary material Table E1.