For ADHD, It's Better to Teach Skills Than Prescribe Pills, Meta-Analysis Shows

Apr 07, 2009
An analysis of ADHD studies conducted by Gregory Fabiano has shown that behavioral treatment works as well as drugs for children with the condition.

(PhysOrg.com) -- Behavior treatment works as well as drugs for children with ADHD and bypasses the risk of medication's side effects, a meta-analysis of 174 studies on ADHD treatment conducted at the University at Buffalo, has shown.

The results, published in the March issue of Clinical Psychology Review, found that teaching parents and teachers how to respond when do things the right way -- as well as when they display harmful or -- is effective, and in some cases more effective, than medication for .

"This review shows that behavioral treatments work, and in general work well," said Gregory A. Fabiano, Ph.D., assistant professor in the Department of Counseling, School and Educational Psychology in UB's Graduate School of Education, and first author on the paper.

"For the past couple of decades, there has been considerable professional controversy about the role and adequacy of behavior modification treatments in the care of children with ADHD. The next step is to figure out how to make them work for individual families over the long run, because we now know that ADHD is a lifelong condition."

Through use of behavior modification, children could bypass the risk of side effects from ADHD drugs and achieve the same or better results as drug treatments, Fabiano noted.

William Pelham, Jr., Ph.D., UB Distinguished Professor of Psychology, Pediatrics and Psychiatry, is co-author on the study.

Fabiano noted that ADHD is one of the most common mental health disorders among children. "Prevalence rates place at least one child with ADHD in every classroom in America, highlighting the need for effective interventions.

"Our results suggest that efforts should be redirected from debating the effectiveness of behavioral interventions to dissemination, enhancing and improving the use of these programs in community, school and mental health settings."

In the future, Fabiano plans to work with teachers, parents, pediatricians and clinicians in the community to emphasize the effectiveness of behavior modification treatments.

His additional research includes developing strategies to get fathers more involved in the treatment of children with ADHD, and use of driving simulators to help teens with ADHD learn to drive, while also helping parents learn to provide effective driving instruction to their teens.

Provided by University at Buffalo (news : web)

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freethinking
1.9 / 5 (9) Apr 07, 2009
Hmmmm ... remember everyone.... Im the one who coined the term that ADHD should more accurately be called TBS... Typical Boy Syndrom.... treatment is not drugs, but proper teaching and discipline techniques.
TheFronz
2.3 / 5 (6) Apr 08, 2009
Dr. Fabiano; Your article infuriates me! I am a 62 year-old Masters level psychologist who has ADHD Combined Type and I still take Ritalin. My job is with the State of Idaho Department of Health and Welfare, Children's Mental Health. What is wrong with medication AND!!! behavioral techniques. I have known of so many children who are victims of parents reading about the "dangers, the ill-effects" of medication and the result is a severely handicapped child, especially in school. Please do not further this myth that medication is bad for ADHD!!!! PLEASE!!!!!!!!!!!!!!!!

A very disgruntled psychologist
axemaster
2.3 / 5 (6) Apr 08, 2009
"Hmmmm ... remember everyone.... Im the one who coined the term that ADHD should more accurately be called TBS... Typical Boy Syndrom.... treatment is not drugs, but proper teaching and discipline techniques."

I'll be blunt. You sound like, and probably are, a moron.
superhuman
3.7 / 5 (3) Apr 08, 2009
Dr. Fabiano; Your article infuriates me! I am a 62 year-old Masters level psychologist who has ADHD Combined Type and I still take Ritalin. My job is with the State of Idaho Department of Health and Welfare, Children's Mental Health. What is wrong with medication AND!!! behavioral techniques. I have known of so many children who are victims of parents reading about the "dangers, the ill-effects" of medication and the result is a severely handicapped child, especially in school. Please do not further this myth that medication is bad for ADHD!!!! PLEASE!!!!!!!!!!!!!!!!
A very disgruntled psychologist


So just because you don't have side effects you think they are all imaginary? Do you think drug companies add false warnings to their own medication?

There is also another problem with your point of view - you can just as well claim that ALL children and adults are handicapped since everyone's cognitive abilities improve while on ritalin. So maybe it would be best to add it to drinking water?

A condition which affects 5% of the population and does not have any adverse health effects is not really a disorder any more then an IQ 80 is.
rhuarch
not rated yet Apr 08, 2009
Dr. Fabiano; Your article infuriates me! I am a 62 year-old Masters level psychologist who has ADHD Combined Type and I still take Ritalin. My job is with the State of Idaho Department of Health and Welfare, Children's Mental Health. What is wrong with medication AND!!! behavioral techniques. I have known of so many children who are victims of parents reading about the "dangers, the ill-effects" of medication and the result is a severely handicapped child, especially in school. Please do not further this myth that medication is bad for ADHD!!!! PLEASE!!!!!!!!!!!!!!!!

A very disgruntled psychologist




So just because you don't have side effects you think they are all imaginary? Do you think drug companies add false warnings to their own medication?



There is also another problem with your point of view - you can just as well claim that ALL children and adults are handicapped since everyone's cognitive abilities improve while on ritalin. So maybe it would be best to add it to drinking water?



A condition which affects 5% of the population and does not have any adverse health effects is not really a disorder any more then an IQ 80 is.


I think you are missing the point of his post. He wasn't claiming that there aren't really any side effects, but rather for children and adults whose lives are adversely affected by ADHD the benefits outweigh the risks. Also your statement that everyone's cognitive ability improves on ritalin is wrong as well. Several studies have shown that stimulants do not improve IQ at all. They simply allow a person to focus long enough for their natural intelligence to be useful.

Finally, he was not advocating the use of medication instead of behavioral therapy. He was advocating the continued use of both which is what almost every expert in the field recommends. This meta study isn't actually news. Researchers have known for a long time that behavioral therapy can be very effective for people with ADHD; they have also known for quite a while that most people benefit even more from a combined approach which this study doesn't seem to address. In my experience which is purely anecdotal medication should only be introduced after puberty. Before puberty parents should rely on training and therapy.
freethinking
2 / 5 (4) Apr 08, 2009
"Hmmmm ... remember everyone.... Im the one who coined the term that ADHD should more accurately be called TBS... Typical Boy Syndrom.... treatment is not drugs, but proper teaching and discipline techniques."







I'll be blunt. You sound like, and probably are, a moron.




Why would you call me a moron, It is you who needs education. I have dealt with kids for a long time, simply put, normal kids are put on these drugs because parents and teachers dont want to put in the time or effort it takes to effectively teach and discipline these kids. I have seen a study which shows that if teachers are told that kids that they think are ADHD are placed on drugs, even though they werent, that the teachers perception of the kids behavior changes. These drugs are mind altering and therefore need to be used very carefully if at all for kids.

My guess is that you have a child and you feel guilty about giving your son (just a guess) the drugs. Some other guesses about you and your family:

Both you and the mother work,
The family situation is unstable,
You are a liberal,
You have are or have taken legal or illigal mind altering drugs.
Your kid is in public school,

If you want to give your kid drugs, you have every right to do so, as I feel every parent has the right to destroy their kids. You even have the right to call me a moron. But you are the one who is wrong. Statistically speaking and from my experience and observation kids from difficult home environments are the ones diagnosed with ADHD more often. Yet everyone denies that home environment has anything to do with ADHD.

Dr. Fabiano; Your article infuriates me! I am a 62 year-old Masters level psychologist who has ADHD Combined Type and I still take Ritalin. My job is with the State of Idaho Department of Health and Welfare, Children's Mental Health. What is wrong with medication AND!!! behavioral techniques. I have known of so many children who are victims of parents reading about the "dangers, the ill-effects" of medication and the result is a severely handicapped child, especially in school. Please do not further this myth that medication is bad for ADHD!!!! PLEASE!!!!!!!!!!!!!!!!



A very disgruntled psychologist


I have seen a kid who had disciple problems put on these drugs. What happened is that the kid still had discipine problems, but now was doped up, and the life zapped out of him.



If you really are a Doctor, you are one that I would stay away from. All the years you have been on Ritalin has damaged your thinking skills. Very few kids need these drugs, most kids need teachers who are willing to adapt to the childs needs not drugging a child to meet the teachers needs.

The risk to the child in using these drugs is that these are mind altering drugs given to kids whos brain is developing. Is it not better to have teachers and parents adapt to their kids, and then teach the kids how to use their personalities in the best possible way?

MikeB
5 / 5 (1) Apr 08, 2009
Disgruntled thefronz,
Maybe if you got off the drugs you wouldn't be so angry. The kickbacks from drug companies are the hardest thing to quit cold turkey...
I've had ADHD my whole life and have managed quite well without Ritalin. There's always a three-ring circus going on in my head, but if I turned it off with drugs I wouldn't be me anymore. I would only be what you want me to be. No thanks.

Let the circus continue...

Mike