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Still, too few with disorder receive behavior therapy, child psychologist says

By Steven Reinberg


http://www.webmd.com/add-adhd/news/20161115/guidelines-may-have-helped-curb-adhd-diagnoses-in-preschoolers#1



TUESDAY, Nov. 15, 2016 (HealthDay News) — In a bit of good news, the rate of diagnoses for attention-deficit/hyperactivity disorder (ADHD) among U.S. preschoolers has leveled off, a new study finds.
At the same time, the prescribing rate of stimulant medications for these young patients has also stayed steady, a promising trend that researchers credit to treatment guidelines that were introduced in 2011.
The guidelines, issued by the American Academy of Pediatrics (AAP), called for a standardized approach to diagnosis, and recommended behavior therapy — not drugs — as the first-line therapy for preschoolers.
“There [was] a concern that preschoolers get too much behavioral diagnosis and medications for behavior problems,” explained study author Dr. Alexander Fiks. He is associate medical director of the Pediatric Research Consortium at Children’s Hospital of Philadelphia.
One in every three children diagnosed with ADHD is diagnosed during preschool years, Fiks said. Of these kids, 47 percent are treated with medication alone or in combination with behavior therapy, according to the study authors.
Among more than 87,000 children aged 4 to 5, about 0.7 percent were diagnosed with ADHD before the guidelines, the study showed.
After the guidelines, 0.9 percent of more than 56,000 kids were diagnosed with the disorder. And, the rate of prescribing stimulant medications such as Ritalin remained constant, at 0.4 percent of those diagnosed with ADHD, according to the report.
“One might have worried that if you were telling pediatricians how to manage preschool ADHD that all of a sudden there would be an explosion in the number of kids being diagnosed, or many more would be on medication. And the fact that the increasing trend leveled off is reassuring and that medication use didn’t increase is also reassuring,” Fiks said.
“It suggests pediatricians are taking the guidelines to heart and not using them as a reason to willy-nilly label kids with ADHD,” Fiks said. “When parents of preschoolers are confronted with a child with behavior problems, it’s reasonable to talk with their pediatrician.”