Of great concern is the dramatic increase in prescriptions for psychostimulants among preschool children. A major long-term 2006 study funded by the U.S. National Institute of Mental Health found that low doses of methylphenidate (Ritalin) may help preschoolers (ages 3 - 5 years) with ADHD. However, the Preschool ADHD Treatment Study (PATS) also reported that the drug caused considerable side effects in many of the children. These side effects included insomnia, nervousness, anxiety, loss of appetite and weight, and slowed growth. Children in the study grew about half an inch less and weighed about 3 pounds less than normal. The researchers recommended that doctors carefully consider the risks versus benefits when prescribing ADHD drugs to preschoolers. Children who do receive these drugs need to be carefully monitored by their doctors.
Another major study reported that children with ADHD will benefit to some degree from any treatment, whether behavioral therapies, medication, or simple mental health intervention. Combinations of behavioral therapy and medications appear to be best, however. Stimulants are not a cure-all, and children should not grow up believing that taking a pill will solve life's problems without their having to make self-efforts.
Help for Families and Teachers
Research increasingly supports the view that interventions for the ADHD child must also include the parents if they are to be successful. Teachers and school officials should also be educated and involved in the process.
Parents who feel they have the most control over their child's situation experience the least psychological stress and depression. Parents who are responsive in a positive way also help reduce the chances for their child developing oppositional behaviors. But it can be very difficult, particularly for parents who have ADHD themselves. In fact, parents who have severe ADHD symptoms are less likely to respond to parent training programs unless they get help for themselves.
In addition to behavioral therapy for the child, family therapy may help ADHD children and their parents and siblings cope with the emotional conflicts that nearly always arise in the lifelong process of managing the condition. Separate psychological therapies for specific family members might be needed, particularly in light of the high incidence of psychiatric and other emotional problems in families with ADHD children.
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