Twenty years ago, the National Institute of Mental Health (NIMH) asked more than a dozen experts what the best treatment for ADHD was; they concluded that medication was superior to behavior therapy. The accuracy of those findings are now being questioned.
According to the US Centers for Disease Control and Prevention “about 8 percent of U.S. children are diagnosed with attention-deficit hyperactivity disorder (ADHD) before the age of 18, and more than 2/3 of them are treated with medications.” Children who are diagnosed often display symptoms of restlessness, have trouble concentrating, and can act out impulsively. Drugs can be helpful, but the benefits are not apparent when the drugs wear off or are not taken regularly.
Today, experts including some of the original researchers, believe that the NIMH study was too narrow. The results from the study have shown to be less conclusive as the children were followed into adulthood.
“I hope it didn’t do irreparable damage,” study co-author Dr. Lily Hechtman, of McGill University in Montreal, told the Times. “The people who pay the price in the end [are] the kids. That’s the biggest tragedy in all of this.”
The children’s achievements and social interactions were not ever given consideration in the study, and may therefore have given medication an advantage over the use of therapy.
Insurance companies may have used the findings from the original study to support their denial of coverage for behavior based therapies. According to one news source:
An insured family might pay $200 a year for stimulants, while individual or family therapy can be time-consuming and expensive, reaching $1,000 or more.
The long term benefit of skill-training therapies may have been overlooked in favor of the easier and cheaper use of drugs. This may have resulted in medication being the preferred treatment, instead of therapy or a combination of medications and therapy.
The original study included almost 600 children between the ages of 7 and 9 years old and lasted over a year. Researchers say that the families liked the combined treatments. Dr. Peter Jensen, who oversaw the study, said
“They didn’t not like medicine, but they valued skill training. What doctors’ think are the best outcomes and what families think are the best outcomes aren’t always the same thing.”
This leads to the conclusion that patients and doctors should carefully consider all the choices available before deciding on any course of action. The best treatment may not be the same for every person or family.