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    Classes for Parents May Help Tots at Risk for ADHD

    Programs try to promote positive relationship between parent and child

    WebMD News from HealthDay

    By Serena Gordon

    HealthDay Reporter

    MONDAY, April 1 (HealthDay News) -- Parent behavior training is an effective and well-studied intervention for preschoolers at risk of developing attention-deficit/hyperactivity disorder (ADHD), a new review shows.

    Such programs seek to promote a positive relationship between the parent and child, and to teach effective discipline strategies that rely on rewards and non-punitive consequences.

    "When we looked at studies with children with a cluster of disruptive behaviors, parent behavior training is a good strong intervention for behaviors like hyperactivity, impulsivity, temper tantrums and oppositional behavior," said review author Dr. Alice Charach, head of the neuropsychiatry team at the Hospital for Sick Children in Toronto.

    The drug methylphenidate (Ritalin, Methylin) may also be effective in this age group, although there was only one study that met the review's standards, and American Academy of Pediatrics (AAP) guidelines don't recommend medication for ADHD in preschool-age youngsters.

    Results of the review were published online April 1 and in the May print issue of Pediatrics.

    Diagnosing ADHD in preschool-aged children is possible, but it can be difficult, according to study background information. "Kids that age can be very busy and inattentive and distractible. It's sometimes hard to have them do what they're supposed to do," Charach said. Parents may initially ask their doctor to evaluate their child because the kids have more disruptive, oppositional behaviors, she noted.

    Once kids are diagnosed or found to be at high risk of developing ADHD, the most effective intervention hasn't been clear.

    To get a better idea of what might work best in these young children, the researchers reviewed the medical literature for studies on interventions for children younger than 6 who had behavior disruptive enough to be referred to treatment, or a diagnosis of ADHD, oppositional defiant disorder or a conduct disorder.

    They found 55 studies that matched their initial criteria, and then they further reviewed the studies to assess factors such as sample size and study design. They found eight good studies on parent behavior training, and one study they considered good on medication.

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