Category: ADHD - Child

Symposium

Psychosocial Intervention to Delay Onset of Medication Use in Young Children With ADHD

Sunday, November 19
10:15 AM - 11:45 AM
Location: Cobalt 501, Level 5, Cobalt Level

Keywords: ADHD - Child / Adolescent | Early Intervention | Randomized Controlled Trial
Presentation Type: Symposium

Background.  Early intervention for children with ADHD may be more effective and more cost effective than later intervention, as has been found to be the case with other child mental health disorders.  Stimulant medication is the most commonly used intervention for ADHD, but issues of dose, breadth of effects, side effects, and long-term effects are less well understood in young ADHD children than in older populations, suggesting caution in the use of medication during early childhood.  Thus, the present study examined whether providing early behavioral intervention can reduce ADHD children’s need for and use of medication during early childhood.


Methods.  140 medication-naïve young children with ADHD were randomly assigned to receive either no, low-, or high-dose psychosocial intervention and tracked prospectively over the course of three years.  Child functioning at school and at home was assess biweekly, and medication was initiated when this assessment indicated additional (i.e., non-behavioral) treatment was necessary.  Primary outcomes of interest were time elapsed before beginning medication, dose of medication at school and at home, and cumulative medication exposure.  Other outcomes of interest were teacher- and parent-rated ADHD, ODD, and social skills.


Results.  Preliminary results indicated that randomization to intervention did not affect survival unmedicated at school, but was associated with approximately 40% lower probability of beginning medication at home at any given point in time (p < .10).  Growth models indicated that over the course of the three years, randomization to intervention resulted in greater improvements in teacher-rated social skills, as well as greater declines in parent-rated ADHD and ODD symptoms (ps < .05).


Discussion.  Preliminary results are consistent with other recent studies that suggest that behavioral intervention provided prior to the initiation of medication can reduce children’s need for medication at home, and to a lesser extent at school.  Despite having lower rates of medication use, children receiving behavioral intervention showed superior outcomes on teacher and parent ratings.  Together these results add to the existing evidence suggesting behavioral treatment may be a more effective first-line intervention for young ADHD children than medication.

William Pelham

Graduate Student
Arizona State University

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