Journal of Consulting and Clinical Psychology 1990, Vol. 58, No. 1,130-133 Copyright 1990 by the American Psychological Association, Inc. 0022-006X/90/$00.75 Methylphenidate and Baseball Playing in ADHD Children: Who's On First? William E. Pelham, Jr. Western Psychiatric Institute and Clinic Gary W. Harper Purdue University Keith McBurnett University of Georgia Richard Milich University of Kentucky Debra A. Murphy and Joseph Clinton Western Psychiatric Institute and Clinic Cathy Thiele Florida State University The effects of 0.3 and 0.6 mg/kg methylphenidate were analyzed in a double-blind, placebo-con- trolled, cross-over study in which 17 boys (ages 7.8-9.9 years) with attention deficit hyperactivity disorder (ADHD) played in baseball games. Drug effects were evaluated on children's attention during the game, as indicated by their on-task behavior on the field and their ability to answer questions about the status of the game at all times. Judgment during batting, batting skill during the game, and performance on skill drills prior to the game were also assessed as a function of medica- tion. Results revealed that methylphenidatehad a beneficial effect on attending during the game. One of the major areas of deficit for children with attention deficit hyperactivity disorder (ADHD) is peer relationships. ADHD children are impulsive, inattentive, intrusive, bossy, ag- gressive, and disruptive around peers, and these behaviors elicit extreme ratings of dislike from peers (Pelham & Bender, 1982). Unfortunately, evidence for the efficacy of psychosocial treat- ments for peer problems in this population is weak (Krehbiel & Milich, 1986). In recent studies researchers have focused on whether psychostimulant drugs, the most common form of in- tervention for ADHD children, have beneficial effects on these children's peer relations, and these researchers have reported mixed results. One possible explanation for these discrepant findings is that researchers who have examined dyadic interac- tions have generally reported few drug effects (e.g., Cunning- ham, Siegel, & Offord, 1985), whereas researchers studying ADHD children in group settings have often reported beneficial effects of medication (e.g., Hinshaw, Henker, Whalen, Erhardt, &Dunnington, 1989; Pelham &Hoza, 1987). In existing studies of social relationships in ADHD children, researchers have examined directly observed or reported anti- social and prosocial behaviors thought to be important compo- nents of peer relationships. An additional potentially important but, to date, unstudied component of peer relationships is a child's performance in group recreational activities, such as baseball, that are likely to occur after school or during recess. Children spend a great deal of time in these activities, and the activities are likely an important setting for social development in childhood. Although no researchers have compared the be- Correspondence concerning this article should be addressed to Wil- liam E. Pelham, Jr., Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213. havior and performance of ADHD and normal children in such activities, parents and therapists of these children provide nu- merous anecdotes of their children's dismal failure in organized sports activities. Perhaps nothing can ruin an ADHD boy's rep- utation among his playmates more quickly than when he is play- ing first base in a closely contested game and is not paying atten- tion and therefore misses the ball thrown or hit to him. It has been our observation that peers respond extremely negatively to such mistakes. These difficulties in organized recreational activities go beyond what has typically been studied in ADHD children's peer relationships, and they may be important con- tributors both to the negative peer relationships that character- ize ADHD children and to the children's self-esteem. To our knowledge there are no studies in which researchers have evaluated the effects of psychostimulant medication on ADHD children's functioning in such activities. Nevertheless, clinicians, researchers, and private practitioners have recom- mended afternoon and weekend medication for ADHD chil- dren with the specific purpose of improving functioning in these kinds of activities. Many parents similarly appear to be following this dosing regimen even in the absence of profes- sional recommendations. In our study we determined whether this increasingly common practice has empirical justification. Method Seventeen ADHD boys, 15 White and 2 Black, ranging in age from 7.8 to 9.9 years (M = 8.3), were the subjects in the study. All had re- ceived diagnoses of ADHD on the basis of structured interviews, stan- dardized rating scales, and observations of the children during the 8 weeks of the 1987 Summer Treatment Program (STP) at Western Psy- chiatric Institute and Clinic. The structured interview was that em- ployed in the Diagnostic and Statistical Manual of Mental Disorders 130