Non-Drug ADHD Treatments Don't Pan Out in Study
Even after learning of the study findings, some people might say it can't hurt to try a particular therapy. But Simonoff warned of potential negative side effects.
"Adverse effects are often associated with pharmacological therapies, but other interventions can have them as well," she said. "For example, does a highly selective diet limit the way a child can play and socialize, making them feel different from their friends? And for parents, if a child doesn't improve under these therapies, does it affect how the parents feel about themselves?"
Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park, agreed: "The danger in saying it won't hurt [to use non-drug therapies] is, where do you draw the line and what's the rationale?"
Attempting other therapies "instead of something that works," he said, results in lost time and money, false hopes, and missed opportunities.
Adesman said, however, that he was surprised that behavioral therapy was not found to be effective. "Unlike neurofeedback, elimination diets or attention training, the American Academy of Pediatrics does recommend behavioral therapy for ADHD in children," he said. "It involves psychologists working with parents to elicit better behavior in their kids, using positive and negative reinforcement, like time-outs."
Even if therapy doesn't improve the core symptoms of ADHD, such as attention span and impulsiveness, it may provide other benefits to the child and family, such as teaching effective communication strategies, Adesman said.
He also encourages parents to be open to the potential benefit drug therapy may provide.
"When I hear parents say they'll consider medicine only as a last resort, that's dangerous," he said. "Parents should confer with their child's pediatrician and discuss a range of treatment approaches and recognize that often the reason a medicine is suggested is not because of a physician's bias but rather because the data is generally stronger than for other treatments."
The European ADHD Guidelines Group received support for the study from Brain Products GMBH and drug makers Janssen-Cilag, Lilly, Medice, Shire and Vifor Pharma.