Post by akafred on Jan 17, 2017 7:06:46 GMT -5
m.additudemag.com/?url=http%3A%2F%2Fwww.additudemag.com%2Fadhdblogs%2F28%2F11969.html&utm_referrer=http%3A%2F%2Fm.facebook.com#2880
Opinion piece from Russel Barkley in ADDitude mag.
Highlight:
You would think from the article in Mental Health Weekly , based on a report from and interviews with CDC officials, that behavioral parent training (BPT) was as effective as medication for management of young children with ADHD. Alas, sadly, this is not true. It is yet another example of the CDC speaking to the press about their findings and implications without doing more careful scholarship or talking with those of us who do know the science on ADHD and its management.
First, understand that BPT was designed for, and is most effective with, helping parents manage oppositional, defiant, and noncompliant behavior. It was not designed for, and is not very effective in managing the symptoms of ADHD specifically (inattention, impulsivity, hyperactivity, and executive function deficits). Every meta-analysis of BPT for ADHD has found this to be the case, including the one in 2013 by Ed Sonuga-Barke and colleagues. But no major researcher working in ADHD, including myself, ever claimed it did in the last few decades.
We have known since the 1980s that BPT is not very helpful for ADHD symptom management. BPT is based on social learning theory and the idea that much of child misbehavior is the result of faulty learning and disrupted parenting. It targets compliance and cooperation, not inattention and impulsivity.
So to require that all young children undergo BPT first before getting medication is to require a less effective therapy that is not widely available be initiated before a more effective therapy. It is also to believe that BPT is widely available in the U.S. when it is not. No wonder that physicians are treating more young children with ADHD with medication than are getting BPT as the CDC found. They are leading with their most effective therapies first.
Opinion piece from Russel Barkley in ADDitude mag.
Highlight:
You would think from the article in Mental Health Weekly , based on a report from and interviews with CDC officials, that behavioral parent training (BPT) was as effective as medication for management of young children with ADHD. Alas, sadly, this is not true. It is yet another example of the CDC speaking to the press about their findings and implications without doing more careful scholarship or talking with those of us who do know the science on ADHD and its management.
First, understand that BPT was designed for, and is most effective with, helping parents manage oppositional, defiant, and noncompliant behavior. It was not designed for, and is not very effective in managing the symptoms of ADHD specifically (inattention, impulsivity, hyperactivity, and executive function deficits). Every meta-analysis of BPT for ADHD has found this to be the case, including the one in 2013 by Ed Sonuga-Barke and colleagues. But no major researcher working in ADHD, including myself, ever claimed it did in the last few decades.
We have known since the 1980s that BPT is not very helpful for ADHD symptom management. BPT is based on social learning theory and the idea that much of child misbehavior is the result of faulty learning and disrupted parenting. It targets compliance and cooperation, not inattention and impulsivity.
So to require that all young children undergo BPT first before getting medication is to require a less effective therapy that is not widely available be initiated before a more effective therapy. It is also to believe that BPT is widely available in the U.S. when it is not. No wonder that physicians are treating more young children with ADHD with medication than are getting BPT as the CDC found. They are leading with their most effective therapies first.