Behavioral intervention reduces need to medicate kids with ADHD

Most children with ADHD who receive behavioral intervention do not need medication, according to a new study by researchers at FIU's Center for Children and Families.

Researchers evaluated 127 unmedicated children with ADHD, ages 5 to 13, during the school year, following their participation in the center's Summer Treatment Program, a comprehensive summer camp program for children with ADHD and related behavioral, emotional and learning challenges. Children were randomly assigned after the end of the program to receive low or high behavioral intervention, or no behavioral intervention, and were evaluated by teachers and parents each week 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 medicated at school.

Behavioral interventions included a Daily Report Card— a tool that helps manage the behavior and academic performance of students. Other classroom interventions included school-based rewards, response-cost systems, point systems, escalating-deescalating time out procedures, and additional individualized behavioral interventions.

"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," said Erika Coles, lead author and clinical director at the Center for Children and Families.

Researchers also found that treatment costs did not significantly differ, regardless of whether the child was receiving behavioral therapy or medication.

In the study, parents of children who received low or high behavioral intervention met with a clinician at the beginning of the school year to establish a Daily Report Card. Parents also had the option of receiving additional support through monthly parenting group sessions and one-on-one consultations if they faced difficult parenting situations at home.

The teachers of the children receiving intervention also had support to implement the Daily Report Card and received additional consultations to establish classroom interventions.

"Parents and teachers play a key role in how well a child responds to the behavioral intervention," Coles said. "It's crucial for them to learn effective strategies that will benefit the child long-term because medication alone does not provide any long-term benefits."

The study was published in the Journal of Clinical Child & Adolescent Psychology.