Commentary: RCT of optimal dose methylphenidate in children and adolescents with severe ADHD and ID - a reply to Arnold (2013)



Emily Simonoff, Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, DeCrespigny Park London SE5 8AF, UK; Email:


The commentary by Arnold (2013) raises a number of interesting issues and speculations about the action of methylphenidate in children with intellectual disability (ID) and associated neurodevelopmental disorders, such as autism spectrum disorders. In our article (Simonoff et al., 2013), we were careful to stick closely to the statistical analysis plan drawn up (and approved by the Data Monitoring Committee) during data collection and prior to any exploratory analysis. However, a number of the issues raised by Arnold warrant further response, with the aim of clarifying the lessons that can reasonably be drawn for clinical practice.