Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders of childhood, affecting approximately 5% to 10% of school-age children in the United States. Researchers have estimated that in a classroom of 25-30 children, at least 1 child will likely have ADHD. Children with ADHD experience significant problems at school, resulting in a higher risk for school failure and grade retention. Family interactions also suffer significantly, with ADHD children being less compliant with parents' instructions than same-age peers. Likewise, their parents are more controlling, more disapproving, and experience more stress than parents of children without ADHD.[5,6] Longitudinal research has suggested that ADHD is a relatively chronic condition, with at least 50% to 70% of diagnosed children continuing to manifest symptoms into adulthood. Taking into account the chronicity, prevalence, and level of impairment associated with ADHD, Pelham and colleagues noted that "effective treatment for childhood ADHD is a major public health agenda."
In a 2001 Clinical Practice Guideline, the American Academy of Pediatrics (AAP), suggested that when treating target ADHD symptoms, clinicians should recommend stimulant medication and/or behavior therapy, "as appropriate." Drawing upon the available research, the AAP noted that although "stimulant medication is highly effective in the management of the core symptoms of ADHD . . . behavioral interventions are valuable as primary treatment or as an adjunct . . . based on the nature of coexisting conditions, specific target outcomes and family circumstances." Unfortunately, specific referral guidelines are notably absent, leaving the clinician to consider whether a trial of behavior therapy is appropriate in a given case. This column reviews the current research on the effectiveness of behavior therapy with ADHD children and identifies patients who are likely to benefit from behavioral treatment.
Medscape Psychiatry. 2006;11(2) © 2006 Medscape
Cite this: Nonpharmacologic Approaches to Treating ADHD - Medscape - Aug 01, 2006.