CDC: Behavior therapy before medication for kids with ADHD

May 5, 2016 Providence Health Team

When it comes to treating a child diagnosed with attention deficit/hyperactivity disorder (ADHD), parents and health care providers often rely on medication. But a new report from the federal Centers for Disease Control and Prevention (CDC) encourages them to try behavior therapy before a prescription.

About half the children receiving care for the disorder are not receiving psychological services, even though a combination of therapy and medication is effective for 70 to 80 percent of children with ADHD, the report says.

The CDC acknowledges that behavioral therapy for children demands more time, energy and money than a prescription. “Yet the lasting benefits make it worth the investment,” it says.

Risks of medication

Widely prescribed medications like Ritalin and Aderall can help tame the symptoms of ADHD, a disorder with effects ranging from an inability to pay attention to unacceptable or even dangerously impulsive behaviors. But medication may also cause side effects.

CDC researchers say short-term side effects can include:

  • Poor appetite
  • Stomachaches
  • Irritability
  • Sleep problems
  • Slowed growth

Longer-term effects of medication still aren’t well understood, Anne Schuchat, M.D., the CDC’s principal deputy director, said in a prepared statement. “Until we know more, the recommendation is to refer parents for training in behavior therapy for children under 6 years of age with ADHD," she said.

How behavior therapy works

Behavior therapy typically begins with parents attending eight or more individual or group sessions with a therapist, learning appropriate techniques for working with their children.

As the CDC describes it, parents practice and encourage positive communication and behavior, provide positive reinforcement and impose structure and discipline.

What providers and parents should do

While medication may be appropriate in many cases, it shouldn’t be the first thing parents and health care providers try, the CDC report says.

The agency calls for providers to follow clinical guidelines for diagnosing ADHD.

After the diagnosis, providers should first discuss with parents the value of behavior therapy for young children, then refer parents for training, the American Academy of Pediatrics recommends. Also, parents should take the initiative to ask their children’s providers about behavior therapy, says the CDC.

More help needed, CDC says

The agency also calls on states and the federal government to work to improve availability of –  and reimbursement for – behavior therapy.

If you believe your child might have ADHD, talk with your provider about the next steps. Find a Providence provider here.

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