Medication often moves in lockstep with an ADHD diagnosis.
This intervention can be invaluable. Attention deficit/hyperactivity disorder is the most common neurobehavioral disorder for a child, affecting about 10 percent of U.S. children, and it often isn’t diagnosed until age 7 or 8. By that point, symptoms may be seriously interfering with school and home life, as well as achievement. And medication takes effect quickly, addressing the 18 core symptoms of ADHD.
But a complementary treatment — one that the American Academy of Pediatrics recommends and that offers lasting, whole-family benefits — often gets overlooked.
Examining the evidence
A recent Stanford Medicine-led study examined preschoolers who were diagnosed with ADHD.
The study, published in JAMA Network Open, found that preschool-aged children often receive medication within a month (and sometimes immediately) after an ADHD diagnosis. Examining records for thousands of children with ADHD, researchers found that the median time from diagnosis to prescription was 28 days for 4-year-olds and 0 days for 5-year-olds.
Here’s the problem: For 4- and 5-year-olds diagnosed with ADHD, the American Academy of Pediatrics recommends starting with parent training in behavior management for six months, advancing to medication as a second-line treatment, “given stronger evidence for behavioral intervention than for medications in this age group.”
Behavioral therapy guides parents in managing their child’s behavior, providing tools to respond, helpful routines and habits, and ways to build a strong relationship.
Even for older children (6 and up), the AAP recommends medications in addition to parent training in behavior management and/or behavioral classroom interventions (preferably both).
Optimal care tends to stem from a combination of the two courses of treatment. And there’s an interesting note:
“Parents, however, were more satisfied with the effect of behavioral therapy, which addresses symptoms and functions in addition to ADHD’s core symptoms,” according to the AAP Clinical Practice Guideline. “The positive effects of behavioral therapies tend to persist, but the positive effects of medication cease when medication stops.”
A two-pronged approach
ADHD puts children at risk for social, emotional and academic problems, and parents understandably want to be proactive. Growing numbers of children receive an ADHD diagnosis before entering school.
Behavior therapy can be a vital ingredient to success.
Often, parents notice a child’s struggles well before that child is eligible for a clinical diagnosis. But parent training in behavior management does not require a diagnosis, meaning concerned parents and their children can get vital help earlier. (Early intervention also has significant benefits!)
“This helps parents feel less pressure to medicate rapidly, and it leaves room for behavior therapy, family support, and more, which is definitely a preferred route to support the symptoms and behaviors of ADHD,” said Dr. Carrie Fryzel, a licensed psychologist and clinical director of Pariva’s Diagnostic Division.
This was exactly the connect-all-the-dots vision that sparked the formation of Pariva. We saw how struggling parents wanted tools to help their children at home and to alleviate family stress. We wanted to equip neurodivergent children to thrive from early ages and offer mental health support for parents as part of a complete family care model. And we wanted to deliver all of this via telehealth so we could eliminate as many barriers to treatment as possible. Then, given this specialty in child neurodivergence, we expanded to diagnostics so we can offer firm diagnostic conclusions at younger ages.
If your family is struggling with a child’s challenging behaviors, we want to offer help and hope. Find out more about Pariva’s family support program, or get started today.