Tuesday, 18 September, 2018

Behavioral Therapy Recommended First for ADHD — CDC

Too many young children are being prescribed drugs to treat their ADHD before behavior therapy is tried health officials have warned Too many young children are being prescribed drugs to treat their ADHD before behavior therapy is tried health officials have warned
Melissa Porter | 05 May, 2016, 04:05

Among the littlest people diagnosed with attention deficit and hyperactivity disorder - ADHD - almost half get no more help dealing with their distractedness, impulsiveness and hyperactivity than that provided by prescription medication, says a new government report.

The results, published as two studies in the Journal of Clinical Child and Adolescent Psychology, made headlines with their important findings that treating children first with behavior therapy may take time and effort but it works better, lasts longer and is even more cost-effective than treating with ADHD medicine first - even when drugs are added later. The findings from the Centers for Disease Control and Prevention (CDC) come despite AAP guidelines that recommend using behavior therapy first.

The CDC is also calling on doctors, nurses, and other health professionals who work with families coping with ADHD to talk with their patients about the benefits of behavior therapy and refer parents to resources.

Another advantage of using behavior modification therapy for ADHD treatment is that it does not have side effects.

Dr. Pelham and his team studied children with ADHD who were treated first with medication then behavioral therapy and compared then with ADHD children who started first with behavioral therapy then were treated with ADHD drugs if needed.

"Medication should be used at best as an adjunct to behavioral therapy".

The American Academy of Pediatrics issued guidelines in 2011 recommending behavior therapy as the first-line treatment for young kids with ADHD. More than 6 million USA children have been diagnosed with it.

Studies have shown medications like ritalin help older children with ADHD.

Georgina Peacock, director of the CDC's human development and disability division, said that experts recommend parent- or teacher-led behavior therapy for children with ADHD at this age as opposed to therapies like Applied Behavior Analysis, which focuses on the child and is considered by some to be the gold standard for treating children on the autism spectrum. And experts say that in some areas, therapists are in short supply.

Brandon Korman, chief of neuropsychology at Nicklaus Children's Hospital, in Miami, agrees with the report.

"When parents cannot only learn to deal with their children's behavior but also be a conduit to improving behavior... that's the best way to go", stated Dr. Brandon Korman, chief of neuropsychology at Miami's Nicklaus Children's Hospital. Those skills can translate to better skills and behavior at school and in relationships outside the family, too. They learn how to praise their children when they do something right and how to set up and follow routines. This shows you're listening and care about what they say.

ADHD behavior therapy comprises exercises on positive reinforcement, communication and discipline. And responding to the child's behavior the same way each time fosters faster learning.

"It's as effective as medications, but doesn't have side effects", said Schuchat. However, some centers base their fees on income or offer group sessions, which are less costly than individual sessions, she said.

The report, from the Centers for Disease Control and Prevention, looked at insurance claims for 5 million USA children, ages 2 to 5, who were all receiving treatment for ADHD.

Overall, a little more than 75 percent of young children received ADHD medicine.

The agency says preschoolers should get psychological services before doctors prescribe medicine.