P 327. Is Video-Assisted Methylphenidate Dose Finding for Children with ADHD a Suitable Procedure for Medical Practitioners?—Results after 4-Year-Follow-up

Objectives: Video-assisted observation of facial expression changes and performance during math tests allows titration of optimal methylphenidate doses for children with ADHD (Kühle et al, J Attention Disorders 10, 2007). In this study—conducted in a community-based outpatient pediatric practice—patients were followed up for 4 years to evaluate the long-term benefit of this diagnostic procedure.

Fragestellung: Bleiben die unter präziser Methylphenidatbehandlung erzielten Regulations- und Verhaltensverbesserungen auch nach vier Jahren bestehen?

Results: Friedman’s two-factor variance analysis and Wilcoxon’s test for paired samples showed significant improvement of parent ratings of attention, impulsivity, and hyperactivity during the first year of treatment, which remained stable during follow-up. School reports improved in the first year but returned to pretherapy levels after 4 years. All children grew on the same growth percentile of the time before therapy; blood pressure remained normal. Fifteen patients maintained the dosage of the first determination; three patients lowered the single dose by 5, 7.5, and 10 mg; two patients increased their single dose by 2.5 and 5 mg.

Conclusion: Video-assisted observation of involuntary behaviors in children with ADHD supports clinical diagnostic procedures and offers sustainable long-term benefit. Moreover, the methodology is applicable in community-based clinical practice and (though not measured) improves interaction between patient and parents and the treating physician.