In children with ADHD, behavioral treatment could be safer, and more effective, than prescribed medication. A recent study, which was published in the Journal of Clinical Child & Adolescent Psychology, compared children who were treated with ADHD medication with those who were treated with behavioral therapy. When used as an initial treatment, behavioral treatment appeared to be more effective in children between the ages of five and 12.
As reported by Taylor & Francis Online, the researchers observed 146 children for a period of eight months during one school year. The children, who were all diagnosed with attention deficit/hyperactivity disorder, were randomized to receive an initial treatment of an extended-release methylphenidate drug or behavioral parent treatment combined with daily feedback from the students’ teachers.
Eight weeks into the study, treatment was modified for the children who did not respond to their initial treatment plan. The modifications included increasing the dose of their medication or the intensity of their behavioral treatment. In some cases, a secondary treatment was added to the children’s initial treatment plan.
At the conclusion of the study, the researchers determined the children who began with “behavioral treatment displayed significantly lower rates of observed classroom rule violations… and tended to have fewer out-of-class disciplinary events.”
The researchers also noted positive results in children who initially received behavioral treatment and began taking medication at a later date. However, those who started with medication, and either switched to or added behavioral treatment, did not experience significant improvement in their ADHD symptoms.
The results of the study are significant for adults and children with ADHD. As behavioral treatment does not include any drugs, patients could avoid undesirable, and even dangerous, side-effects.
— Everyday Health (@EverydayHealth) February 18, 2016
One of the most commonly diagnosed childhood disorders, ADHD is a behavioral disorder characterized by hyperactivity, impulsivity, and inattention.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, children must display a specific pattern of behavior, which interferes with their quality of life, in two or more settings over a period of six months or more. Prior to formal diagnosis, physicians must rule out other disorders — which may have similar symptoms.
As reported by the Centers for Disease Control and Prevention, the American Academy of Pediatrics currently recommends a combined treatment of medication and behavioral treatment for ADHD in children between the ages of six and 11. However, medication is often used as the initial treatment option.
Traditional ADHD medications include amphetamine and methylphenidate stimulants. However, some patients are prescribed non-stimulant drugs including anti-depressants and blood pressure medications.
— BrainBalance Wexford (@BBofWexfordPA) February 9, 2016
Unfortunately, as discussed by CDC Principal Deputy Director Ileana Arias, Ph.D., the side-effects are a serious concern.
“We do not know what the long-term effects of psychotropic medication are on the developing brains and bodies of little kids.”
As a safer and possibly more effective alternative, Arias suggests behavioral treatment for ADHD.
“What we do know is that behavioral therapy is safe and can have long-term positive impacts on how a child with ADHD functions at home, in school, and with friends… behavioral therapy is the safest ADHD treatment… “
Behavioral treatment uses routines, structure, and positive reinforcement to encourage children with ADHD to develop good habits and stay on task. The treatment is specifically effective, as it can be modified to fit the needs of the individual.
Unfortunately, many children are prescribed medication as an initial treatment for ADHD. According to the recent study, those who have behavioral treatment after taking medication may never realize the full benefits of the secondary treatment.
For many children with ADHD, behavioral treatment could replace prescribed medication. However, the researchers admitted more data is necessary to assess the long-term effectiveness of each treatment.
[Image via Daniel Jedzura/Shutterstock]