Challenging status quo: Why shouldn’t behavioral therapy, instead of medication, be first-line treatment for ADHD?
“Behavioral therapy should be used before medication in treating children with attention-deficit hyperactivity disorder (ADHD), according to new research.
One paper found that children’s ADHD problems improve faster when their first therapy is behavioral — such as being taught basic social skills — rather than medication…Another paper said using behavioral therapy first is less expensive over time.
Medications were most effective when used as supplemental, second-line treatment for children with ADHD who required the drugs. In many cases, the drugs were effective at doses lower than normally prescribed, according to the findings in the Journal of Child & Adolescent Psychology.”
Study: Treatment Sequencing for Childhood ADHD: A Multiple-Randomization Study of Adaptive Medication and Behavioral Interventions (Journal of Clinical Child & Adolescent Psychology)
- From the abstract: Behavioral and pharmacological treatments for children with attention deficit/hyperactivity disorder (ADHD) were evaluated to address whether endpoint outcomes are better depending on which treatment is initiated first and, in case of insufficient response to initial treatment, whether increasing dose of initial treatment or adding the other treatment modality is superior…The group beginning with behavioral treatment displayed significantly lower rates of observed classroom rule violations (the primary outcome) at study endpoint and tended to have fewer out-of-class disciplinary events…Parents who began treatment with behavioral parent training had substantially better attendance than those assigned to receive training following medication. Beginning treatment with behavioral intervention produced better outcomes overall than beginning treatment with medication.
To learn more:
- To improve academic outcomes, children with ADHD need both medication and non-medication treatments
- Why cognitive behavioral therapy (CBT) should be first-line treatment for chronic insomnia
- Should Cognitive Behavioural Therapy (not antidepressant drugs) be the first-line treatment for depression?