Benefits of Methylphenidate for Long-Term Attention Problems After Traumatic Brain Injury in Childhood: A Randomized, Double-Masked, Placebo-Controlled, Dose-Titration, Crossover Trial.

The final sample size was 20, and 26 were randomized, so this is a small trial. The sample was mostly male and white, with primarily moderate injuries and a mean time since injury of 5.2 years, so results may not generalise to other children. The primary outcome was parent proxy report, and the paper does not know how many hours per day caregivers spent with the child. Teacher reports were not usable because teachers were hard to engage and visits often overlapped school holidays. Child self-report did not improve, so the medication effect may not be experienced by the child in the same way as by the parent. The trial did not use a washout period, although carryover was included in the analysis. The authors note a potential placebo effect at lower doses, which may have contributed to early improvement.

The provided article text does not include an author conflicts declaration. The publication metadata lists NIH extramural and U.S. government research support.

Do not read the parent-rated improvement as proof that methylphenidate improves every child's own attention or daily function. The child self-report score did not differ, and the trial was small.