ADHD Without Drugs

Posting Date: 09/01/2004

One ongoing National Institute of Mental Health-funded study of children enrolled in the UB summer program found that children who received behavioral therapy in advance of drug treatment required much lower doses than children who were put on drugs without first undergoing behavioral therapy. Doses given to children while in school were halved, and most parents elected not to use medication at all at home.

text continues below

"This is a significant finding because children who receive lower doses may be less susceptible to potential ADHD drug side effects, such as loss of appetite and stunting of growth," Pelham says.

Another very large NIMH study by Pelham and co-researchers found that ADHD children treated with medication alone grew a centimeter less per year on medication. Children who received behavior modification in this study, which included parent and teacher consultation and participation in Pelham's summer program, did not have any reduction in growth. Moreover, only about a third of behaviorally treated children were taking medication after two years, and among those who were, doses were reduced by almost half compared to the medicated groups.

According to Pelham, behavioral therapy, unlike drug therapy, also may produce long-term benefits for ADHD children, such as teaching them coping and behavior skills that carry into adulthood. When ADHD children treated with medication become teens, they typically refuse to continue taking their medication, he points out. "As a result the beneficial effects of the medicine go away," he says. "And it is much harder to implement behavioral treatments with adolescents than with younger children, so a window of opportunity for effective treatment in childhood may have been lost if parents relied solely on medication.

"Thirty years of research show that ADHD drugs used alone do not help children avoid long-term outcomes that are a hallmark of the disorder -- substance abuse, domestic problems, school dropout, delinquency and criminal behaviors," Pelham concludes. "More parents would opt out of using medication as the first line or sole treatment if they were provided with this information, and if physicians didn't opt for medication first."