Health experts estimate that ADHD affects between 6 and 16 percent of children in the U.S. — that's at least 5 million kids ages 4 to 17 years. More than 2.5 times as many boys have a diagnosis of ADHD as girls, and children from lower income families are at nearly double the risk than those from higher income households. The following is a guide to help parents understand ADHD treatment options for children preschool-age and up, based on CEPAC's review of treatment options outlined in the Agency for Healthcare Research and Quality's (AHRQ's) ADHD report. Also check out these 6 action steps for parents of children with ADHD.
CEPAC's Stance on Parent-Behavior Training:
- Parent-behavior training is effective in improving the outcomes of preschoolers (children ages 4 and 5) with ADHD and is an appropriate first-line treatment for most preschoolers. (Medications may still be appropriate as a first-line therapy for preschoolers with severe symptoms or certain psychological conditions.)
- For children over age 6 with ADHD, there is not enough evidence to indicate parent-behavior training is beneficial in the long-term.
While other FDA-approved medications are available, the ones that were evaluated in the AHRQ's report include methylphenidate (such as Ritalin®), dextroamphetamine (such as Dexedrine®), and mixed amphetamine salts (such as Aderall®).
CEPAC's Stance on Medication:
- Taking methylphenidate (such as Ritalin®) can be as good or better than usual care (taking no medications or treatment steps to manage ADHD) for preschoolers, and better than usual care for children over age 6.
- For children over age 6 with ADHD, other medications may be as effective as methylphenidate, particularly in the cases of certain symptoms or issues (such as tics). However, other medications have comparatively lower long-term effectiveness than methylphenidate.
CEPAC's Stance on Combined Therapy:
- For children under age 6, there is not enough long-term evidence to indicate that combined therapy is as good as or better than medication alone.
- For children over age 6, combined therapy is better than medication alone.
Specialized classroom environments may have teachers and aides specifically trained and supervised by child psychologists, using behavioral techniques and unique treatment curriculums. Use of communication tools, such as daily school behavior report cards, facilitates communication about behavior trends in children. Positive reinforcement, peer-tutoring, and organizational skills training are other school-based approaches for children with ADHD.
CEPAC's Stance on School-Based Approaches:
- School-based interventions are an especially important component of ADHD treatment, as they may provide the only access to behavioral/psychosocial interventions for children from low-income households and/or rural areas.