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For ADHD, It’s Better to Teach Skills Than Prescribe Pills

Published April 7, 2009

Behavior treatment works as well as drugs for children with ADHD and bypasses the risk of medication’s side effects, a meta-analysis of 174 studies on ADHD treatment conducted at UB has shown.

The results, published in the March 2009 issue of Clinical Psychology Review, found that teaching parents and teachers how to respond when children do things the right way—as well as when they display harmful or aggressive behavior—is effective, and in some cases more effective, than medication for ADHD.

“This review shows that behavioral treatments work, and in general work well,” said Gregory A. Fabiano, PhD, assistant professor in the Department of Counseling, School and Educational Psychology in UB’s Graduate School of Education, and first author on the paper.

“For the past couple of decades, there has been considerable professional controversy about the role and adequacy of behavior modification treatments in the care of children with ADHD. The next step is to figure out how to make them work for individual families over the long run, because we now know that ADHD is a lifelong condition.”

Through use of behavior modification, children could bypass the risk of side effects from ADHD drugs and achieve the same or better results as drug treatments, Fabiano noted.

William Pelham Jr., PhD, UB Distinguished Professor of Psychology, Pediatrics and Psychiatry, is co-author on the study.

Fabiano noted that ADHD is one of the most common mental health disorders among children. “Prevalence rates place at least one child with ADHD in every classroom in America, highlighting the need for effective interventions.

“Our results suggest that efforts should be redirected from debating the effectiveness of behavioral interventions to dissemination, enhancing and improving the use of these programs in community, school and mental health settings.”

In the future, Fabiano plans to work with teachers, parents, pediatricians and clinicians in the community to emphasize the effectiveness of behavior modification treatments.

His additional research includes developing strategies to get fathers more involved in the treatment of children with ADHD, and use of driving simulators to help teens with ADHD learn to drive, while also helping parents learn to provide effective driving instruction to their teens.

Fabiano is a recent recipient of the White House’s Presidential Early Career Award for Scientists and Engineers, the nation’s highest honor for professionals at the early stages of their independent scientific research careers.