Experts have found that children with attention deficit issues can improve more quickly if the first treatment they are given is behavioral in nature.
An example of this would be instructing kids in fundamental social interaction. Researchers say this method, which proves to be less expensive over time, is more productive than starting young ones on medication immediately upon being diagnosed, writes Benedict Carey for The New York Times.
A new study, if duplicated in further studies, could change the way physicians treat attention deficit disorders. Currently, Adderall and Ritalin are the first-line therapies for the over four million children and teenagers in the US who have been diagnosed with attention-deficit hyperactivity disorder (ADHD).
Published in the Journal of Clinical Child & Adolescent Psychology, the new report found that amphetamines should be a secondary treatment if necessary, and at lower dosages than have previously been prescribed.
This study is thought to be the first to evaluate the results of changing the types of treatment for ADHD in this manner.
“We showed that the sequence in which you give treatments makes a big difference in outcomes,” said William E. Pelham of Florida International University, a leader of the study with Susan Murphy of the University of Michigan. “The children who started with behavioral modification were doing significantly better than those who began with medication by the end, no matter what treatment combination they ended up with.”
Experts not involved in the study said the researchers tracked behavior but left out measuring other abilities that medication could improve in a short amount of time, such as attention and academic function.
Mark Stein, a professor of psychiatry and pediatrics at the University of Washington, noted that although he agreed with the study’s findings, behavioral therapy is seldom an option for parents.
The behavior modification program for patients with ADHD is based on a simple “rewards and consequences” system. Appropriate or cooperative actions are rewarded. If the child is paying attention for a some period of time, he or she gets a stroke on the back or a “good job.” Finishing homework without objecting could earn the child some time on a tablet or smartphone. Defiance or poor behavior could result in privileges being taken away or a “time out.”
The researchers had the parents and the children’s teachers rate the kids’ behaviors, which included giving feedback on disciplinary concerns. Teachers’ assessments were a “daily report card” describing the actions the child displayed during the school day.
The research included 146 children with a diagnosis of ADHD from ages 5 to 12. Half of the group were prescribed a moderate dose of Ritalin, and the other half received no medication but were taught behavioral management techniques, according to the New Hampshire Voice’s Emma Tiller.
Two months into the study, researchers measured the improvements made by the participants. Those who showed no change were placed in one of two groups. One set was provided a more heightened variant of the same treatment. The other was given an added supplement, such as a dose per day of medication along with the behavioral adjustments.