Nonpharmacologic Treatments for Attention-Deficit/Hyperactivity Disorder: A Systematic Review

Area of Science:

• Pediatric neurology and psychiatry
• Behavioral science
• Evidence-based medicine

Background:

• Nonpharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD) are widely used, encompassing behavioral interventions and complementary medicines.
• Assessing the comparative effectiveness of these diverse ADHD treatments is crucial for clinical practice.

Purpose of the Study:

• To evaluate the comparative effectiveness of various nonpharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD) in individuals aged 17 years and younger.

Main Methods:

• A systematic review and meta-analysis of English-language studies published between 2009 and 2016.
• Searched PubMed, Embase, PsycINFO, and Cochrane Database of Systematic Reviews.
• Included studies comparing nonpharmacologic ADHD treatments with placebo, pharmacologic treatments, or other nonpharmacologic strategies.

Main Results:

• Identified 54 studies on treatments including neurofeedback, cognitive training, behavioral therapy, parent training, and omega fatty acid supplementation.
• Pooled analysis of omega fatty acids showed no significant effect on parent- or teacher-rated ADHD symptoms.
• No new guidance on comparative effectiveness was identified.

Conclusions:

• Significant gaps in knowledge exist regarding the effectiveness of nonpharmacologic ADHD treatments.
• Many studies had limitations, including short follow-up, small sample sizes, and inconsistent reporting.
• Further research is needed to establish evidence-based nonpharmacologic ADHD interventions.