-- Robert Preidt
SATURDAY, May 4 (HealthDay News) -- About 90 percent of
pediatric specialists who diagnose and manage
attention-deficit/hyperactivity disorder (ADHD) in preschool
children do not follow treatment guidelines published recently by
the American Academy of Pediatrics, according to a new study.
Some prescribe medications too soon, while others do not give
the young patients drugs even as a second-line treatment, according
to study author Dr. Andrew Adesman, chief of developmental and
behavioral pediatrics at Cohen Children's Medical Center in New
Hyde Park, N.Y., and colleagues.
The American Academy of Pediatrics (AAP) guidelines recommend
that behavior therapy be the first treatment approach for
preschoolers with ADHD, and that treatment with medication should
be used only when behavior-management counseling is
The researchers also found that more than one in five
specialists who diagnose and manage ADHD in preschoolers recommend
medications as a first-line treatment alone or in conjunction with
The study is scheduled for Saturday presentation at the
Pediatric Academic Societies' annual meeting in Washington, D.C.
Data and conclusions should be viewed as preliminary until
published in a peer-reviewed journal.
"It is unclear why so many physicians who specialize in the management of ADHD -- child neurologists, psychiatrists and developmental pediatricians -- fail to comply with recently published treatment guidelines," Adesman said in a medical center news release.
Some physicians also deviate from guidelines with their choice
of medication. Although methylphenidate (Ritalin) is recommended as
the first drug to try when medications are warranted, many doctors
prescribed other types of drugs.
"With the AAP now extending its diagnosis and treatment guidelines down to preschoolers, it is likely that more young children will be diagnosed with ADHD even before entering kindergarten," Adesman said. "Primary care physicians and pediatric specialists should recommend behavior therapy as the first-line treatment."
Awareness is lacking across specialties, another study author
"Although the AAP's new ADHD guidelines were developed for primary care pediatricians, it is clear that many medical subspecialists who care for young children with ADHD fail to follow recently published guidelines," study principal investigator Dr. Jaeah Chung said in the news release.
"At a time when there are public and professional concerns about overmedication of young children with ADHD, it seems that many medical specialists are recommending medication as part of their initial treatment plan for these children," Chung added.
The U.S. National Institute of Neurological Disorders and Stroke
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