Behavioral Intervention vs. Medication: Which is more effective for children with ADHD? - PresenceLearning

ADHD letters spelled out on diceIn recent years, parents, educators and therapists alike have raised concerns over the popularity of prescribing long-acting stimulants to students diagnosed with ADHD. According to the Child Mind Institute, side effects from these medications include sleep problems, decreased appetite, delayed growth, headaches and stomachaches, tics, and irritability. Their effectiveness has been challenged, as well.

The Journal of Consulting and Clinical Psychology published a study last September analyzing what was more effective for treating children with ADHD: long-acting stimulants or behavioral interventions. The study examined 75 children 5-12 years old who had been diagnosed with ADHD. The students attended a summer school program with classes each weekday for eight weeks. Students were randomly assigned to receive medication or behavioral interventions that included daily report cards coaching parents to help with homework.

For the students assigned to take medication, doctors spent two weeks determining the correct dosage for each child. Researchers then randomly determined which children received the medication or a placebo for three weeks, then switched, so they could see if or how the medication impacted homework performance. The researchers found the medication did not have a significant effect on homework completion or accuracy when compared with a placebo.

The group of children who were assigned to behavioral intervention received six two-hour group sessions for two weeks and individual half-hour sessions for two weeks. These children finished 10-13% more homework and completed 8% more assignments accurately than they did without the treatment.

There were, however, limitations to the study. The researchers gave students medication first thing in the morning; therefore, the effect of the medication may have worn off by the time children began their homework. Regardless, the study suggests behavioral intervention is effective, which can be especially important to help students on medication complete their homework.

In the school setting, districts may struggle with staffing to serve the number of students who are referred for behavioral interventions, particularly those that already have high caseloads and/or large testing schedules. Using the same evidence-based techniques as onsite professionals, licensed PresenceLearning clinicians use a secure, web-based platform to deliver live therapy sessions based on students’ needs. For districts that need extra support or are unable to hire onsite professionals, teletherapy is a viable option.

To learn more about how behavioral intervention strategies can be implemented using teletherapy, visit our website.

5 responses to “Behavioral Intervention vs. Medication: Which is more effective for children with ADHD?

  1. Interesting study….I currently have two children diagnosed with ADHD and taking medication after attempts to not medicate. We only briefly did counseling as it demonstrated little impact, was costly, and required the kids to be pulled early from school. The school does not offer any support. It would seem there are many theories on how to treat ADHD but the schools and families do not have the funds to even sometimes support medication. The public school system and the medical community need to make big changes which will likely no happen in my lifetime.

  2. My son was diagnosed at the age of 6.75 years with ADHD. It took 5-6 weeks to determine an optimal dosage for him. He took the medication from the period of March to mid June to finish school. I wonder how dosage could be determined so quickly with these 75 students. Our reality was the sudden side effects of loss of appetite, disrupted sleep cycle and nausea as he adjusted to the medication for the first time. To push the medicine too quickly would have backfired in serious refusal. Anyways I also wonder why they did not include a complete placebo only group. Finally the margin of error on the statistics quoted would be helpful to know. A 3-5% error, which can be typical in research, quickly limits the quality of the percent outcomes listed. Food for thought. For us the best outcome is a constantly strict/planned schedule, lots of sport activities (our son is very coordinated, athletic and needs to exercise), strong limits on overarousing electronic games, limits on volume of music (which can also hype him up too much), medication routine with an extended release formula and now also now adding, at 8.75 years old, ADHD coaching. With these learned interventions he is meeting academic standards, has lots of friends, continues to grow and enjoy his sport activities more and is starting to finally show some attempts at behavioral self regulation. It is a life long process to help organize his brain chemistry pattern. That is how I view it, a brain chemistry pattern or type versus a “disordered brain”.

  3. Thank you for sharing your story, Cena. It’s great to hear what is working for your son. I had the same question about the placebo as well.

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