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Friday, April 5, 2013

Best Options for Preschool Children at Risk for ADHD



Parent behavior training has shown to be more effective than medications and other interventions for preschool children at risk of ADHD (attention-deficit/hyperactivity disorder). Eight studies conducted of parent behavior training produced the best and most consistent results. Only one study of medical treatment with methylphenidate showed positive results, with combined home and school/daycare intervention results being inconsistent.
Parent behavior training improves parenting skills and children’s disruptive behavior, including core symptoms of ADHD. Family doctors play an important part in guiding this type of treatment, initiating required assessments, guiding parents to evidence-based programs, monitoring these conditions, and advocating for increased community resources.
Studies conducted evaluating interventions for these children where guided by a single question: "Among children younger than 6 years with ADHD or disruptive behavior disorder, what are the effectiveness and adverse-event outcomes after treatment?" The study was also limited to children younger than 6 with clinically significant disruptive behavior as determined by referral for treatment; reliable and valid screening instruments; and a diagnosis of ADHD, oppositional defiant disorder, or conduct disorder.
Interventions reviewed included pharmacologic and nonpharmacologic treatment and excluded alternative/complementary interventions. Reviewed interventions were parent behavior training, psychostimulants, and combination of parent behavior training and day care or school-based interventions. A majority of the studies that have been conducted yielded positive results for parent behavior training and less positive results were achieved with pharmacological management. 

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