Behavioral Intervention May Reduce the Need to Medicate Children with ADHD

A new study, conducted by by researchers at Florida International University’s Center for Children and Families and published in the Journal of Clinical Child & Adolescent Psychology, indicates that most children with ADHD who receive behavioral intervention do not need medication.

The study evaluated 127 unmedicated children with ADHD, ages 5 to 13. First, the children participated in the center’s Summer Treatment Program, a comprehensive summer camp program for children with ADHD and related behavioral, emotional and learning challenges. Then, at the end of the summer program, children were randomly selected to receive low, high or no behavioral intervention, and were evaluated by teachers and parents each week during the school year to determine if medication was needed.

Researchers found that the children who received continued behavioral intervention after the end of the Summer Treatment Program were about half as likely as those who did not receive intervention to initiate medication use each week at school or at home, and used lower doses when they were medicated at school.

The behavioral interventions included a Daily Report Card to help track and manage the behavior and academic performance of students in the study. Other classroom interventions included

• School-based rewards
• Response-cost systems
• Point systems
• Escalating-deescalating time out procedures
• Additional behavioral interventions specific to the individual child

In the study, parents of children who received behavioral interventions met with a clinician at the beginning of the school year to establish a Daily Report Card for the child. Parents could also get additional support through monthly parenting group sessions and one-on-one consultations if they had problematic parenting situations at home.Teachers of the children receiving intervention had support for implementing the Daily Report Card and received additional consultations to establish classroom interventions.

In addition to the reduction in medication use, researchers also noted the added benefit that treatment costs did not significantly differ, regardless of whether the child was receiving behavioral therapy or medication.

Erika Coles, lead author and clinical director at the Center for Children and Families.noted, “These results add to a growing literature of research suggesting that the use of low-intensity behavioral intervention as a first-line treatment for children with ADHD reduces or eliminates the need for medication.”

He also highlighted the key role that parents and teachers play in how well a child responds to the behavioral intervention. The study offers parents another treatment option with positive, long-term benefits.