A new large-scale analysis has found that young children in the US are often prescribed ADHD medication almost immediately after diagnosis, contrary to recommended medical guidelines. Children aged four and five who are newly diagnosed are advised to undergo six months of behavioural therapy before starting medication, but the study shows this is frequently bypassed.
The research, published in JAMA Network Open and involving more than 9,700 children, found that 42.2% of young patients received ADHD medication within one month of diagnosis, while only 14.1% began treatment after the recommended six months. Dr Yair Bannett, lead author and assistant professor of paediatrics at Stanford University, called the trend “concerning,” highlighting the benefits of starting treatment with behavioural therapy for both children and families.
ADHD affects an estimated 11.4% of US children aged three to 17 and can lead to symptoms such as distraction, hyperactivity, restlessness, and difficulties with learning if left untreated. Early intervention is considered crucial, as untreated ADHD can influence academic performance and long-term outcomes.
Treatment generally involves behavioural therapy, where children develop skills to manage daily functioning, and medications like Ritalin or Concerta to reduce hyperactivity and inattention. While most children benefit from a combination of both approaches, guidelines emphasize behavioural therapy first for four- and five-year-olds.
The study noted that limited access to behavioural therapy may contribute to early reliance on medication. While the drugs are considered safe for young children, side effects such as irritability, aggression, and emotional changes sometimes lead parents to discontinue use.
The research also highlights a stark contrast between North America and Europe, where young children are far less likely to receive ADHD medication.
