Symptoms of attention-deficit hyperactivity disorder (ADHD) usually first appear during the early elementary school years. Many children, however, show signs of ADHD in preschool. Although there are many different treatments for ADHD, including behavioral, training, and cognitive, one of the most common approaches is pharmacological. But for preschool-aged children, the side effects and negative outcomes often outweigh the benefits of medication. Addressing the symptoms and behavior associated with ADHD as early as possible can have many benefits for the child and family. Therefore, it is imperative that effective non-pharmacological approaches be identified.
Estrella Rajway of the Department of Psychology at the University of New York attempted to do just that in a recent study. Rajway reviewed 29 separate studies on various treatments for ADHD in preschoolers, including teacher training, parent training, child training, diet manipulation, acupuncture, supplemental diet aids, and multimodal approaches. She found that the least effective and least studied approaches were acupuncture, diet manipulation, and nutritional supplements. Although there were some modest improvements in the behavior of the children studied, these methods did not address parent and teacher outcomes. There was also very little evidence supporting their effectiveness.
Behavioral parent training (BPT) emerged as the most effective approach for treating ADHD in preschoolers. This strategy teaches parents how to change their reactions to behavior and how to set rewards and punishments. The results of this analysis showed that BPT improved child aggression, noncompliance, and parental mental health. The children also exhibited less hyperactivity and impulsivity. More importantly, these effects were maintained over the course of a year.
Rajway believes clinicians, teachers, and especially parents should focus on issues that impair daily functioning in children with ADHD, specifically peer and family relations, academic performance, and behavior problems. “As such, focusing on improving impairment, rather than just ADHD symptoms per se, should result in a greater likelihood of altering the often poor trajectories of youth with ADHD,” she said. Other methods of treatment, including multimodal approaches and child training, appear to be somewhat promising, but more research needs to be done. Overall, the results of this study clearly show that medication is not the only form of effective treatment available for young children with ADHD and that many alternative approaches exist that can drastically improve the quality of life for these children and their families.
Rajwan, Estrella, Anil Chacko, and Moshe Moeller. Nonpharmacological interventions for preschool ADHD: State of the evidence and implications for practice. Professional Psychology: Research & Practice 43.5 (2012): 520-26. Print.
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