Best treatment for preschoolers with ADHD is not meds, CDC urges

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Many young children with attention deficit hyperactivity disorder (ADHD) aren't receiving the top recommended treatment for the condition, a new report suggests.

The report, from the Centers for Disease Control and Prevention, looked at insurance claims for 5 million U.S. children, ages 2 to 5, who were all receiving treatment for ADHD. The researchers said they wanted to see how many of these children received behavioral therapy, now recommended as the first treatment to try for young kids who have the condition.

The researchers found that, between 2008 and 2014, only about half of children in the study received psychological services for the condition, which includes behavior therapy. In contrast, 75 percent of the kids received medication for ADHD. Although medication can help children with ADHD, it can also have side effects, including appetite suppression, sleep problems and slowed growth, the report said.

The CDC is calling for more doctors to prescribe behavioral therapy to young kids with ADHD.

"We are missing opportunities for young children with ADHD to receive behavior therapy," Dr. Anne Schuchat, principal deputy director at the CDC, said in a news conference May 3. "Behavior therapy has been shown to help improve symptoms in young children with ADHD and can be as effective as medicine, but without the side effects," Schuchat said. [Typical Toddler Behavior or ADHD? 10 Ways to Tell]

In behavior therapy, a therapist trains parents in parenting skills that can improve the behavior of their children. These parents learn strategies to encourage positive behavior, discourage unwanted behaviors and improve communication with their children. This kind of therapy requires more time, effort and resources than does treatment with medications, but studies show that the effects may be longer-lasting than those of medication, Schuchat said.

The American Academy of Pediatrics issued guidelines in 2011 recommending behavior therapy as the first-line treatment for young kids with ADHD. But despite this recommendation, the percentage of kids receiving psychological services for ADHD has not increased in recent years. In fact, the percentage slightly decreased among kids with private insurance, from 44 percent in 2011 to 42 percent in 2014, the new report said.

Although medications for kids with ADHD may be appropriate in some cases, it is important for doctors to discuss behavior therapy with parents as a first step in treatment, Schuchat said.

"We recognize that these are not easy treatment decisions for parents to make," Schuchat said. "We know that behavior therapy is effective, and the skills parents learn can help the whole family be successful."

The report is published online today in the CDC's journal Morbidity and Mortality Weekly Report.

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