Government health officials from the Centers for Disease Control and Prevention (CDC) are urging medical providers to refer parents of preschoolers who exhibit symptoms of ADHD to therapy sessions, rather than turning first to medication. Taking a closer look at the CDC’s viewpoint and discussing the benefits of a full cognitive and exercise program will help shed some light on why decisions regarding treatment are not easy ones for parents to make.
The recommendation issued by the Centers for Disease Control and Prevention arrives in tandem with a dispatch in the agency’s monthly report, Vital Signs, revealing that 75-percent of kids aged two to five with Attention Deficit Hyperactivity Disorder are already on some kind of medication. The chief concerns about this approach have run the gamut from the possibility of causing side effects like difficulty sleeping, irritability, curbing hunger and stunting growth to considering what long-term effects these medications may have for children in this group.
Interestingly enough, the American Academy of Pediatrics offered similar guidance when, in 2011, it had suggested medical providers should refer parents to behavior therapy training before seeking out medication. As an aside, it has been determined that approximately one-third of the 6.4 million children who suffer from ADHD – which causes children to exhibit overly impulsive and active characteristics and forces a difficulty concentrating – are diagnosed before the age of six, and at that point, professionals believe symptoms can already be extremely severe. Further, it is reported that only half of the children who are diagnosed are receiving recommended behavioral therapy.
Still, it is Dr. Anne Schuchat, the CDC’s principal deputy director, who believes that this type of therapy could be just as effective as medication. As she explains, “We recognize that these are not easy treatment decisions for parents to make, and it is possible that this type of treatment takes more time than medication.” In reference to this “time” insight Schuchat alludes to, it is further believed that behavior therapy programs can occur over the course of eight or more sessions, with therapists teaching parents how to give their children their full attention while reflecting words back to them – in this way, kids know parents are listening to them and care about what they have to say. What’s more, parents learn how to praise their children when they do something right, and when they follow routines they’ve set up.
In breaking this down, behavior therapy allows therapists to help parents build skills in guiding their child’s behavior, and these skills may include (though are certainly not limited to):
• Positive Communication – When parents give children their full attention and reflect their words back to them.
• Positive Reinforcement – Praising the child when he or she does something right.
• Structure and Discipline – Because children do better when their world is “predictable,” setting up routines and daily schedules will help the child know what to expect each day.
To this end, Georgina Peacock, director of the CDC’s Division of Human Development and Disability, adds, “It’s the equivalent to having one’s own personal coach for dealing with challenging conditions.”
The CDC’s Take on ADHD Therapy
The Centers for Disease Control and Prevention recognizes ADHD as a biological disorder that causes hyperactivity, impulsiveness and attention problems, with around two million of the more than six million children with ADHD diagnosed before the age of six, as alluded to earlier in the blog. Additionally, the CDC concedes, children diagnosed with ADHD at an early age tend to exhibit the most severe symptoms and thus, according to CDC reps, would benefit from early treatment. In delving deeper into the CDC’s Vital Signs report – which, as aforementioned, found that 75-percent of young children being treated for ADHD received medicine – it was unveiled that only about half received any form of psychological services, which may have indeed included behavior therapy.
Adding to her other comments, Dr. Schuchat said, “Parents may feel overwhelmed with decisions about their child’s treatment for ADHD, but healthcare providers, therapists, and family members can all work in tandem to help the child thrive. Parents of young children with ADHD may need support, and behavior therapy can be considered an important first step – it has been shown to be as effective as medication, but leaves out the risks of side effects. There’s no doubt, however, that we are still learning about the potential unintended effects of long-term use of ADHD medicine with regard to young children, and until we learn more, we should stand by the recommendation to first refer parents of children under the age of six with ADHD for training in behavior therapy before prescribing medicine.”
Exercise as ADHD Treatment?
When one thinks of “medicine,” immediately images of countless rows of little blue pills are conjured up – but new research has revealed just how critical physical movement is to academic performance, what with its ability to improve mental focus, memory, and cognitive flexibility. In fact, mental exercises to build – or rebuild – attention span have revealed promise as adjuncts or alternatives to classic amphetamines when addressing ADHD symptoms.
The medical journal Pediatrics recently conducted research which found that kids who took part in a regular physical activity program showed significant enhancement of cognitive performance and brain function. The findings, according to University of Illinois professor Charles Hillman and colleagues, “demonstrate a causal effect of a physical program on executive control and support for physical activity for improving childhood cognition and brain health.”
In the End…
All in all, the CDC “stopped short” of saying that young children shouldn’t be medicated for ADHD, adding its opinion that such a decision was for parents and doctors to make and that medication may sometimes be inappropriate. The topic is summarized by Georgina Peacock, who believes that with behavioral therapy, it is possible that some children may never need medication to address ADHD.