American Pediatric Specialists Fail to Correctly Treat Preschoolers with ADHD
According to a new study conducted by pediatrics and behavioral science specialists at the Cohen Children’s Medical Center of New York, only 10 percent of medical doctors reported following the national guidelines on treating preschoolers with ADHD.
These findings come at a time when 11 percent of school-aged boys in the United States currently suffer from medically diagnosed ADHD—a 16 percent increase since 2007 and a 41 percent increase since 2003.
Current clinical guidelines for American pediatricians and child psychiatrists recommend that preschoolers with ADHD generally receive treatment with behavioral modification before prescription drugs, and that methylphenidate (MPH) be used as the first line medication.
Of the 611 preschool ADHD specialists who participated in the survey, 20 percent said they recommend prescription drugs as a first line treatment, regardless of available behavioral therapy options, and 30 percent said they rarely try medication if behavioral therapy proves unsuccessful.
The study also found that some doctors are choosing to prescribe drugs other than MPH. Though the American Academy of Pediatrics recommends that only MPH be used with 4- and 5-year-olds, about 19 percent of the respondents use amphetamines such as Adderall or Dexedrine. (Both drugs are approved in children ages 3 or older.) Another 18 percent are prescribing other non-stimulant drugs for ADHD treatment. One such drug, Clonidine, is FDA-approved for use in youth aged 6 or older.
In conclusion, the researchers behind the study said that an overwhelming majority of pediatric subspecialists deviate from current guidelines for treating preschoolers with ADHD. In an interview, Dr. Adesman, a lead researcher, said that the results could reflect that children who see specialists may have more severe symptoms, or that doctors are more familiar with medications. However, another explanation could be that some doctors “are reluctant to recommend behavior therapy, or to give it a chance.”
Dr. Adesman emphasized that teachers can play a meaningful and important role in implementing behavior modification techniques with young children. He also added that medication has a place in treating ADHD if other methods are not successful. “Teachers may want to educate parents that the AAP does see medication as a possible option,” he said.
This may be easier said than done, however, as issues around ADHD diagnosis and the misuse of prescription drugs have become increasingly contentious.