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First-line Behavioral Health Treatment Prior to Stimulant or Alpha-2 Agonist Use for Preschoolers on Kentucky

Deborah Winders Davis1,2, Kahir Jawad2, William David Lohr3,4,5

  • 1University of Louisville School of Medicine, KY, USA.

Journal of Attention Disorders
|January 13, 2023
PubMed

Insights

More than half of preschoolers with ADHD did not receive recommended behavioral therapy before starting medication. This highlights a gap in adhering to clinical guidelines for ADHD treatment in young children.

Area of Science:

  • Pediatric medicine
  • Neurodevelopmental disorders
  • Clinical guideline adherence

Background:

  • Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in preschoolers.
  • The American Academy of Pediatrics (AAP) provides clinical guidelines for ADHD management, emphasizing behavioral interventions.
  • Adherence to these guidelines is crucial for optimal treatment outcomes.

Purpose of the Study:

  • To evaluate the extent to which AAP clinical guidelines were followed in treating preschoolers with ADHD.
  • To assess the utilization of first-line behavioral therapy (BH) before initiating medication.

Main Methods:

  • Retrospective analysis of Medicaid claims for children aged 4-5 years who initiated stimulant or alpha-2 agonist medication in 2017.
  • Determined the proportion of children who received BH prior to medication initiation.
  • Examined demographic and diagnostic predictors of BH receipt.

Main Results:

  • Over 50% of the study sample did not receive recommended first-line BH prior to medication.
  • Demographic factors did not significantly influence BH receipt.
  • Children receiving BH before medication had a higher likelihood of an ADHD diagnosis.

Conclusions:

  • A significant proportion of preschoolers with ADHD are not receiving guideline-recommended behavioral interventions before medication.
  • This suggests a gap in the implementation of AAP clinical guidelines for ADHD in early childhood.
  • Further research is needed to identify barriers and develop targeted interventions to improve guideline adherence.
Abstract

Keywords:
attention deficit/hyperactivity disorderchildrenlow-incomepsychotropic medication

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