The best treatment for attention deficit/hyperactivity disorder in young kids is therapy — for the parents — federal health experts said Tuesday.
It may sound strange, but helping parents help their children can avert or delay the need to use drugs, which can have side-effects, the Centers for Disease Control and Prevention says.
"It's similarly effective as medication but it doesn't have the longer-term side effects," Dr. Anne Schuchat, the CDC's principal deputy director, told NBC News.
A check of millions of medical records showed that about a third of the 6 million U.S. kids with ADHD were diagnosed before they were 6, the CDC said.
And while the American Academy of Pediatrics recommends that parents be advised to try training in behavioral therapy before resorting to drugs, about 75 percent of kids under 5 were being given drugs and only have received any form of psychological services, including behavioral therapy.
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"Parents of young children with ADHD may need support, and behavior therapy is an important first step," Schuchat said.
"CDC is calling on doctors, nurses, and allied health professionals who treat young children with ADHD to support parents by explaining the benefits of behavior therapy and referring parents for training in behavior therapy,' the agency said.
"Behavioral therapy may not be familiar," Schuchat added.
For the youngest children, parents are trained in the best ways to encourage positive behavior, discourage negative behaviors, improve communication, and strengthen their relationship with their child. "When applied, these skills can help the child at school, at home, and in relationships by improving behavior, self-control, and self-esteem," the CDC said.
Schuchat said it's not that parents are somehow causing the ADHD. The treatment helps them help their children. "We want to make sure the message isn't 'blame parents'. Parents are not to blame for the child having ADHD," she stressed.
Schuchat said one barrier is a lack of professionals who can provide the services. Another is difficulty in getting health insurance to pay for it.
"This is a really tough issue for parents," she said. And it's time-consuming. "It is a big time commitment for parents to make. We think that it is worth the time if parents can work it in their schedule," Schuchat said. "We would like increase the availability for services and the reimbursement for services and the referral for services."
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CDC cannot order anything, but can advise state health departments.
"We are trying to work with the health professional organizations," Schuchat said.
"I know in some areas they are helping set up referral networks. It's not just a psychologist that can deliver this treatment. We think social workers can also," she added.
"We also think it doesn't have to be individual treatment. Groups are also effective. We have been exploring development of web materials that ideally would provide that training. This is a work in progress."
A team at Florida International University reported in February that even older kids, aged 5-12, with ADHD fared much better when their first treatment was behavioral therapy rather than medication.
Some studies have found that when kids do go on medication, they often can take lower doses if they are getting therapy, also.
"We also know that even with behavioral therapy, some children will also need medicine," Schuchat said.