Taylor 1987.

Study characteristics
Methods	Double‐blind, randomised, placebo‐controlled, cross‐over trial with 2 arms MPH placebo Each treatment period lasted for 3 weeks with a washout period of 1 week planned between treatments and up‐titration to optimum dosage during the 3 weeks
Participants	Number of participants screened: 64 Number of participants included: 39 (all boys). Of these, 26 had an ADHD diagnosis according to DSM‐III Number of participants followed up: 38 Number of withdrawals: 1 Diagnosis of ADHD: DSM‐III (n = 26; type not stated)   The following data reflect the whole trial (n = 38) Age: mean 8.6 years (range 6‐10) IQ: all > 65; mean 93.4 MPH‐naive: 100% Ethnicity: not stated Country: UK Setting: outpatient clinic Comorbidity: no attentive or restless behaviour, but antisocial, disruptive or aggressive in conduct (n = 6), hyperactive but not antisocial or aggressive (n = 9), with both hyperactive and disruptive behaviour (n = 23), CD (n = 7), relationship problems (n = 2) and disturbance of emotions specific to childhood (n = 3) Comedication: not stated Other sociodemographics: 40% from broken homes Inclusion criteria IQ > 65 Free of autistic features Lives in a family home, not an institution Attending primary school Problems assessed at the clinic as severe enough to warrant psychiatric treatment Free of contraindications to stimulant medication No treatment with stimulant drugs No psychotropic drugs given for ≥ 6 months previously Exclusion criteria Children with severe intellectual disability or neurological disease Autistic and psychotic children Pre‐school children Adolescents Female
Interventions	Participants were randomly assigned to 1 of 2 possible drug condition orders of MPH and placebo Mean MPH dosage: 9 received doses from 0.2 mg/kg to 0.5 mg/kg, 21 from 0.5 mg/kg to 0.9 mg/kg and 8 from 0.9 mg/kg to 1.4 mg/kg Administration schedule: time points not stated Duration of each medication condition: 3 weeks Washout before trial initiation: all were stimulant‐naive Medication‐free period between interventions: 1 week Titration period: a flexible dosage regimen was used after randomisation. Each child began with 5 mg daily, with dosage adjustments made at 2‐ to 3‐day intervals. The optimum dosage was assessed for each child, in the light of clinical response and the occurrence of side effects, to a maximum of 30 mg daily Treatment compliance: compliance with medication was rated as good or very good in 89%
Outcomes	ADHD symptoms CTRS: rated at the end of each treatment period, that is, day 21 Parental Account of Childhood symptoms (PACS), hyperactivity scale: rated at the end of each treatment period, that is, day 21 Serious AEs No serious physical effects of medication were encountered Non‐serious AEs Unwanted effects of medication were assessed by using the physician’s ratings of 26 possible symptoms with full physical examination, rated at the end of each treatment period, that is, day 21
Notes	Sample calculation: no Ethics approval: not stated Comment from trial authors Long‐term treatment with stimulant drugs could not be assessed in this short‐term trial Key conclusion of trial authors A good response to MPH was predicted by higher levels of inattentive and restless behaviour, impaired performance on tests of attention, clumsiness, younger age and absence of symptoms of overt emotional disorder. DSM‐III and ICD‐9 diagnoses of "hyperactivity" were not good predictors Comments from review authors Long‐term treatment with stimulant drugs could not be assessed in this short‐term trial Children with tics or cardiovascular disease were excluded Demographic characteristics and mean dose include the whole sample (n = 38). However, upon receipt of correspondence from the trial author, outcomes measured included the 26 individuals diagnosed with ADHD (DSM‐III) Investigators tested both for MPH vs placebo (effects of treatment) and for end of first treatment period vs end of second treatment period (effects of occasion), as well as the interaction between treatment and occasion. "The two order groups were combined together for those measures that had shown no significant effects of test occasion or interaction of occasion with treatment. For measures th did show main or interactive effects of occasion, the two order groups were considered separately" Inclusion of MPH responders only/exclusion of MPH non‐responders/children who have previously experienced AEs while taking MPH before randomisation: no; all MPH treatment‐naive Any withdrawals due to AEs: yes; 1 in the placebo group Funding source: partially funded by grant from CIBA Ltd., which provided medicine and placebo Email correspondence with trial authors: October 2013. We received from trial authors no supplemental information regarding data.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Children were randomly allocated to receive drug first or placebo first. This was carried out by pharmacy staff, who knew only the name and identifying number of each case
Allocation concealment (selection bias)	Low risk	Allocation was carried out by pharmacy staff, who knew only the name and identifying number of each case
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Tablets were dispensed to a trial member, who did not know what they contained and handed them to parents
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Psychiatrist supervising treatment also assessed and recorded side effects, physical findings and parents’ general impressions at the end of each treatment; other assessors of outcomes were blinded to the treatment given but also to possible clues arising from physical effects of the drug. Behavioural measures were carried out independently of one another by investigators blind to results of the other tests and to teacher ratings
Incomplete outcome data (attrition bias) All outcomes	Low risk	Data were missing for 3 children: 1 child had missing data on the Parental Account of Childhood Symptoms because he had been taken into care, and 2 children had missing data on the CTRS hyperactivity factor because they had been excluded from school. Method of imputation not described Selection bias (e.g. titration after randomisation → exclusion): no
Selective reporting (reporting bias)	Unclear risk	No protocol identified