When it comes to treating attention-deficit hyperactivity disorder (ADHD) a lot of kids are getting the meds they need—but they may be missing out on other treatments. Despite clinical guidelines that urge that behavioral therapy always be used alongside medication, less than half of the children with ADHD received therapy as part of treatment in 2009 and 2010, according to the first nationally representative study of ADHD treatment in U.S. children.
The findings, published online March 31 in The Journal of Pediatrics, come from data collected during that period on 9,459 children, aged four to 17, with diagnosed ADHD—just before the American Academy of Pediatrics (AAP) issued its clinical practice guidelines on treatments of the condition in 2011.
Medication alone was the most common treatment for children with ADHD: 74 percent had taken medication in the previous week whereas 44 percent had received behavioral therapy in the past year.
Just under a third of children of all ages had received both medication and behavioral therapy, the AAP-recommended treatment for all ages.
“It’s not at all surprising that medication is the most common treatment,” says Heidi Feldman, a professor of developmental and behavioral pediatrics at Stanford University School of Medicine who served on the AAP clinical practice guidelines committee.
“It works very effectively to reduce the core symptoms of the condition,” she adds, “and stimulants are relatively safe if used properly. The limitation of stimulant medications for ADHD is that studies do not show a long-term functional benefit from medication use.”
Regardless of the reasons, experts hope to see the rates of behavioral therapy increase across all the surveyed groups. Those with ADHD face greater long-term difficulties, including lower employment and educational attainment, higher high school dropout, divorce and severe car accident rates as well as more involvement with the criminal justice system.
“Medicine is important to address the biological component of the disorder but it doesn’t teach a person how to manage their own symptoms and behavior, and it is that lack of self-management that leads to these really poor outcomes as adults,” Spinks-Franklin says. “Pills don’t teach you social skills, coping strategies and self-control. Behavior therapy does.”
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