ADHD Treatment: Too Much Medication, Too Little Therapy

ADHD in kids may be treated with medication too often while behavioral therapy may be underused

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) All children have those days when they’re bouncing off the walls, but kids with ADHD may need more help than average to manage their behavior. And the kind of help they get may make a big difference in their health.

In a first-ever national study on the topic, the Centers for Disease Control and Prevention (CDC) reported on current treatment trends for children with ADHD. Behavioral therapy was recommended as the first choice, especially for younger children, because it was the safest option.

But the CDC found that behavioral therapy was not being used as much as it should be — while medication may be overused. The authors of this study expressed concerns about medicating young children because of issues related to brain development.

Susanna N. Visser, DrPH, an epidemiologist at the National Center on Birth Defects and Developmental Disabilities at the CDC, led this study.

“Treatment decisions for ADHD in children can be complex," Dr. Visser said in a press release. "Parents, health professionals, psychologists, and educators can work together to ensure that children receive the best treatment available. The good news is that we now have strong clinical guidelines to support the more than 5 million children living with ADHD.”

ADHD is a relatively common childhood disorder that affects brain function and causes behavioral problems. Children with ADHD may be inattentive, hyperactive, or easily distracted or have trouble controlling impulses.

The American Academy of Pediatrics (AAP) released ADHD treatment guidelines in 2011. These guidelines called for behavioral therapy alone for preschool-age children and both behavioral therapy and medication for kids from 6 to 17.

The CDC report noted that the AAP now allows short-acting medication for younger children if behavioral therapy is ineffective.

The data for the study came from the 2009-2010 National Survey of Children with Special Health Care Needs. This data covered over 40,000 children.

The CDC study looked at children with special health care needs (CSHCN) as well as ADHD. These children had problems like cerebral palsy, autism, learning disorders and developmental disabilities, as well as diseases like asthma or diabetes.

For this study, parents of CSHCN also diagnosed with ADHD answered phone surveys. Children in the study ranged in age from 4 to 17.

Less than half of children with ADHD received behavioral therapy in 2009-2010, Dr. Visser and team found. However, this study was finished before the new AAP guidelines went into effect.

Dr. Visser and colleagues found that of every 10 children aged 4 to 17 with ADHD, four received medications alone, one received behavioral therapy alone, three received both medication and therapy and one received no treatment. One child in 10 took dietary supplements for ADHD.

In preschoolers, around half received behavioral therapy and medication. One-quarter received only medication. This is a matter for concern, Dr. Visser and team said, because the long-term effect of ADHD medications on children’s developing brains is unknown.

This study was published in the April issue of The Journal of Pediatrics.

This research did not receive outside funding. Study author Dr. Steven P. Cuffe received support for research on navigated transcranial magnetic stimulation — a treatment sometimes used for ADHD — from Nexstim Oy.

Review Date: 
April 3, 2015
Last Updated:
April 8, 2015