Health Day - ONLINE EDITION
Posted: 09/2/2013 9:00 AM | Comments: 0
MONDAY, Sept. 2 (HealthDay News) -- Parents' goals for treating their child's attention-deficit hyperactivity disorder (ADHD) tend to steer the treatment in a distinct direction, new research shows.
When parents' main concern was their child's academic performance, they often chose medications as the treatment of choice, but if parents were more worried about their child's behavior they tended to opt for behavioral therapy as an initial treatment.
"If clinicians can bring evidence to parents, and parents can share their values and goals with their child's doctor, the decision-making process can be easier and it's likely to yield better outcomes," said the study's author, Dr. Alexander Fiks, an assistant professor of pediatrics at Children's Hospital of Philadelphia and the University of Pennsylvania.
Still, Fiks said he was surprised that the treatment choices were so distinctly divided. "I don't know that I expected the choices to be so clear-cut," he said.
Results of the study were published online Sept. 2 and in the October print issue of the journal Pediatrics.
ADHD is a common brain disorder, according to the U.S. National Institute of Mental Health (NIMH). Symptoms include an inability to pay attention or focus, being easily distracted, frequent daydreaming, trouble concentrating, difficulty completing schoolwork, talking all the time and an inability to sit still for long periods, according to the NIMH.
Treatment for ADHD may include medications, behavioral therapy or both, according to the NIMH.
"Both medication and behavior therapy are considered first-line treatments for children between the ages of 6 to 12, and many people will suggest a multi-modal treatment. But, families often start out with one treatment or the other. If you don't do well with the first-line treatment, you should try the other," explained Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park.
For his study, Fiks and his colleagues recruited 148 parents or guardians of children between the ages of 6 and 12 who had been diagnosed with ADHD. Fiks said that they accepted parents of children who were already receiving treatments, as well as those just choosing a treatment for the first time. However, they did exclude parents of children who were already receiving a combination of medications and behavioral therapy.
The researchers developed and validated the ADHD Preference and Goal Instrument, a tool to measure the preferences and goals of parents of children with ADHD.
If parents were most concerned about their child's performance at school, they were more than twice as likely to choose medications as their child's first treatment. If, on the other hand, a parent was most concerned with the behavioral problems associated with ADHD, that parent was 60 percent more likely to choose behavioral therapy for their child.
After six months, the parents of the children who had initiated their treatment of choice had lower academic and behavioral goals. "If the goals are a little less strong, those parents may be more likely to have met their goals," said Fiks.
"Our findings highlight the importance of talking about goals. If people feel like they've been heard and valued, they feel like the treatment is working toward something they care about," noted Fiks.
"This approach could help with conditions like asthma, where there are multiple treatments. Starting with a family's goals could really be a big innovation in care," said Fiks.
Like Fiks, Adesman said he was "surprised to see such a distinct delineation with treatment choices."
He said he was particularly surprised that parents of children with behavior issues were more likely to choose behavioral therapy. While behavior therapy is effective, he said, it requires multiple appointments and can take a little bit longer to bring about a change in behavior.
"These are often the parents I find more receptive to medication," he added.
Fiks thought that parents might see behavior problems as distinct from medical problems. "When parents think about behavior problems as non-medical, then non-medical treatments might seem more acceptable," he noted.
Both experts thought that involving the parents in the decision-making would likely lead to more parent participation in the chosen treatment, which could improve treatment outcomes.
"This study drives home the importance of soliciting family preferences around treatment options, and pediatricians would be well-advised to engage parents and try to elicit any treatment preferences and biases they may have," said Adesman.
Learn more about available ADHD treatment options from the U.S. Centers for Disease Control and Prevention.
Have you found an error, or know of something we’ve missed in one of our stories? Please use the form below and let us know.
Having problems with the form?Contact Us Directly
If you want to hit your stride, trail running impoves technique
Virus drugmaker fights pediatricians' new advice
Wives' Higher Education May Not Affect Divorce Rate
Health Highlights: July 27, 2014
Don't Let Kids Drink Pool Water
Recipe for race-day endurance
Training basket: Caelin White
195 mistakes in Saskatchewan health settings
Survey: Teens experimenting with HGH on the rise
Distractions Seem More Troublesome With Age
Human Brain Has Coping Mechanism for Dehydration
IRS Caps Fines on Uninsured Americans at $12K for Family of 5
Rhymes Reveal Evidence of Learning in the Womb
Ottawa seeks to improve opioid prescribing
Most Adults Are Members of 'Clean Plate Club'
Anal, Throat Cancers on the Rise Among Young Adults, Study Finds
Genes May Be Key to Language Delay in Kids
Health Highlights: July 25, 2014
The 'Hobby Lobby Ruling' and What It Means for U.S. Health Care
Diet Changes Can Alter Gut Bacteria, Study Says
Lift U.S. Ban on Blood Donations by Gay Men, Experts Say
Health Tip: Pack Safety Essentials for a Long Hike
Health Tip: Easing Headache Pain
Study Links Shift Work to Risk for Type 2 Diabetes
Health council member resigns after CBC report
Female Triathletes May Face Health Problems Such as Incontinence
Is Coffee Aggravating Your Hot Flashes?
Could Canadian-style medicare find a US home?
Too Few Teens Receive HPV Shot, CDC Says
Farmers' Market Vouchers May Help Poorer Families Eat Healthier
Bacteria in Semen May Affect HIV Transmission, Levels: Study
FDA Approves Hard-to-Abuse Narcotic Painkiller
Teenage Boys Want Intimacy, Not Just Sex, Survey Finds
Tough-to-Abuse Formulation of Oxycodone Approved
Health Highlights: July 24, 2014
More Than 10 Million People Gained Coverage Under Obamacare, Study Finds
Many Kids With Medicaid Use ER as Doctor's Office: CDC
Parents of Obese Kids Often View Them as Healthy
Young Readers, Tomorrow's Leaders?