Despite concerns, ADHD medication for U.S. children on rise

The new data in the study stands in stark contrast to the medical recommendations outlined by the American Academy of Pediatrics

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Despite medical concerns, a recent study released last week revealed that nearly half of U.S. children aged 4-5 years with Attention Deficit/Hyperactivity Disorder (ADHD) were being treated with prescription medications. The percentage is staggering, given that according to 2011 numbers by the Centers for Disease Control (CDC), six million children in the U.S. were reported to be diagnosed with ADHD.

The CDC characterizes ADHD as a disorder that leaves people with fidgety, impulsive behaviors that make it difficult for children to pay attention. Parents and teachers find it difficult to manage children with ADHD since they are more likely to daydream, forget or misplace things, and make careless mistakes, according to the CDC.

In the study released last week, by the Journal of Pediatrics, the data revealed that while more than fifty percent of preschoolers with ADHD were treated with behavioral therapy alone, a large percentage of preschoolers, 46.6 percent, were being treated with a combination of behavioral therapy and medication or medication alone.

“There may be many reasons why only one in two preschoolers with ADHD were receiving behavior therapy for ADHD in 2009-10,” Dr. Susanna Visser, the lead author of the study, told Al Arabiya News.

“First, the guidelines had not yet been released and physicians may not have known that behavior therapy is an effective treatment for ADHD and that it is safer than medication for these young children. Second, there may be too few behavioral therapists, including psychologists, who are trained and available to treat young children with ADHD or physicians may not know to what kind of services they should refer,” she added.

Trends in ADHD treatment

The data analyzed in the study was collected two years before the American Academy of Pediatrics (AAP) released guidelines detailing ADHD treatment for specific age groups, and allowed researchers to analyze the trends in ADHD treatment.

“The goal [of the study] was to describe ADHD treatment in the years just before the release of the 2011 diagnosis and treatment guidelines, so that we could compare ADHD treatment to recommended treatment as described in the guidelines, over time,” said Dr. Susanna Visser, the lead author of the report. “We think this information is important for health care providers so that they can gain a greater understanding of the patterns of treatment for ADHD and what more may need to be done to improve the quality of care for children with ADHD,” Visser said.

The new data in the study stands in stark contrast to the medical recommendations outlined by the American Academy of Pediatrics (AAP), which states that behavioral therapy should be the first-line of treatment for preschoolers with ADHD.

“Healthcare professionals are cautious about prescribing psychotropic educations for young children for two main reasons, Dr. Mark Wolraich, a pediatrician from the University of Oklahoma Health Sciences Center who was involved in the study, told Al Arabiya News. “It is more difficult to make clear diagnoses in young children and there are too few scientific studies to establish their efficacy and safety on that age group,” he added.

Treating ADHD

In response to the study, the CDC emphasized the importance of following the 2011 ADHD clinical practice guidelines published by the AAP in a press release issued last Wednesday. Children under the age of six should be treated with behavioral therapy first, before contemplating the necessity of medication while children aged six-17 should be treated with a combination of behavioral therapy and medication.

Behavioral therapy requires the involvement of not only the child, but also parents and teachers as well. According to the AAP guidelines, behavioral therapy encompasses a wide-range of programs that are focused on shaping a child’s behavior through changes in their physical and social environment. There are currently public and private trainings aimed at providing parents and teachers with specific techniques that help to improve children’s behavior in either the home or class-room setting.

“The behavior therapy that has the strongest evidence for preschoolers with ADHD is parent training, which helps parents develop a positive parent-child relationship and learn how to discipline their child in a consistent and age-appropriate way, said Dr. Visser.

“Behavior therapy may also help the child understand how to manage their problematic behaviors and reward them for good behavior through reward systems, like token strategies,” she added.