Parent Perceptions of Medication Treatment for Preschool Children with ADHD

Hart, Katie; Ros, Rosmary; González, Victoria; Graziano, Paulo A.

doi:10.1007/s10578-017-0737-9

Cited by 11 publications

(9 citation statements)

References 36 publications

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“…Parent preferences and beliefs may also affect the uptake of psychosocial treatment. These beliefs may include perceptions of parental self-confidence and self-efficacy to engage in these treatments, ability and commitment to prioritizing attendance at psychosocial treatment visits (32, 34), varying levels of willingness to have their young child take psychotropic medications (35), and level of motivation to engage in psychosocial treatments after medication treatment has been initiated (13).…”

Section: Discussionmentioning

confidence: 99%

Adherence to Recommended Care Guidelines in the Treatment of Preschool-Age Medicaid-Enrolled Children With a Diagnosis of ADHD

Morán

Serban

Danielson

et al. 2019

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Objective: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder of childhood. Clinical guidelines recommend behavior therapy as the first-line treatment for preschool-age children with ADHD. This study evaluated longitudinal patterns of services received by Medicaid-enrolled children ages 2 to 5 with ADHD in seven southeastern states (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina). Methods: A discrete sequence clustering analysis was used with 2005–2012 Medicaid Analytic eXtract data to profile patient-level utilization for each state, with a focus on receipt of psychological services and medication. The model output was used to assess utilization behaviors longitudinally relative to recommended care guidelines and to characterize sources of variation in utilization patterns by demographic and ecological factors. Results: Five states had a utilization profile with a high probability of receipt of psychological services before medication among children with ADHD, covering 16% of the total study population. Most young children’s ADHD care experience in the seven states (65%) fit utilization profiles characterized by a high probability of receiving any ADHD medication. Black race was significantly associated with higher utilization of psychological services in three states. Conclusions: About 16% of Medicaid-enrolled preschool-age children with ADHD received care during 2005–2012 that appeared to be consistent with 2011 recommended care guidelines. State-level and subpopulation variations in utilization for ADHD-related clinical care were found. The findings indicate that there were major gaps in treatment for ADHD among young children and that the gaps are wider for some states and subpopulations of children.

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Section: Discussionmentioning

confidence: 99%

Adherence to Recommended Care Guidelines in the Treatment of Preschool-Age Medicaid-Enrolled Children With a Diagnosis of ADHD

Morán

Serban

Danielson

et al. 2019

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“…Yet this study found parent-rated disruptive behavior significantly more frequently among the medicated children compared to the unmedicated children. Support of disruptive symptoms affecting parental openness to ADHD medication has been found in a preschool study ( n = 151) of medication-naive children (Hart et al 2018 ). That study found that children of parents who were open to medication tended to have higher levels of parent-reported oppositional behavior and aggression compared to the children of parents who were not open to medication.…”

Section: Discussionmentioning

confidence: 88%

“…That study found that children of parents who were open to medication tended to have higher levels of parent-reported oppositional behavior and aggression compared to the children of parents who were not open to medication. Interestingly, there was no significant difference on parental openness to medication associated with child gender, ADHD symptom severity, or socioeconomic status in the family (Hart et al, 2018 ). A review study has also concluded with high-quality evidence for psychostimulants having a moderate-to-large effect on disruptive behavior in children with ADHD (Pringsheim et al 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Child and Parental Characteristics of Medication Use for Attention-Deficit/Hyperactivity Disorder

Oerbeck

Furu

Aase

et al. 2020

Journal of Child and Adolescent Psychopharmacology

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Objectives: To investigate child and parental characteristics of medication use for attention-deficit/hyperactivity disorder (ADHD). Methods: Participants were part of the prospective population-based Norwegian Mother, Father and Child Cohort study (MoBa) (n = 114,500 children, 95,000 mothers, and 75,000 fathers). This cohort was linked to the Norwegian Prescription Database (NorPD) and the Norwegian Patient Registry (NPR) to compare child and parental characteristics in children medicated and not medicated for ADHD during years 2008-2013. Results: One thousand seven hundred and sixty-four children (74% boys) with ADHD (International Classification of Diseases [ICD-10]: F90 and F98.8) were identified. One thousand three hundred and sixty-two (77%) used medication. Boys and girls did not differ in the use of ADHD medication (both 77%). Mean age at first prescription was 9 years in both boys and girls, and age at ADHD diagnosis was 8 years in medicated and unmedicated children. Significantly more hyperkinetic conduct disorders (F90.1), and significantly fewer with attention-deficit disorder (F98.8) were found among the medicated children compared to the unmedicated children. The medicated children also had a significantly lower global functioning (Child Global Assessment Scale). Child disruptive symptoms reported in the MoBa child age 3 year questionnaire were significantly higher in children who used medication compared to the nonusers (t = 2.2, p = 0.03), and group differences in ADHD symptoms at age 3 years were close to significant (t = 1.8, p = 0.07). Other preschool child and parental characteristics were not significantly different in the two groups. Conclusion: In this large birth cohort study, where a great majority of children with ADHD used medication, only child characteristics were significantly associated with the use of medication. We could not replicate previous findings suggesting that ''environmental factors,'' such as parental education and psychopathology, drive medication use. The small differences between medicated and unmedicated children in this cohort study, where a majority used medication, might be due to strong established clinical practices where medication is offered as a treatment option, particularly for hyperkinetic conduct disorder in an egalitarian high-income society.

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“…While both American and European guidelines stipulate that evidence-based psychosocial interventions serve as first-line treatments for ADHD in preschoolers, severe symptoms, functional impairment, and psychiatric comorbidity (particularly ODD; Hart et al, 2018) may warrant pharmacological treatment, particularly when BPT has not fully addressed the child's needs. The United States Food and Drug Administration has approved methylphenidate (e.g., Ritalin â , Focalin â and extended release variants) and three nonstimulants [Strattera â (atomoxetine), Intuniv â (guanfacine), and Catapres â /Kapvay â (clonidine)] for the treatment of ADHD in children as young as age 6, while Dexedrine â (dextroamphetamine) and Evekeo â (immediate-release, shortacting amphetamime sulfate) have been approved down to age 3 years (Center for Medicare & Medicaid Services, 2015).…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

“…Psychosocial treatment for preschool ADHD Although pharmacological treatments are considered first-line interventions for school-age children with ADHD (Shier, Reichenbacher, Ghuman, & Ghuman, 2012), several factors constrain their use in preschool populations. First, parents and/or treatment providers frequently express trepidation about psychostimulant use (Hart, Ros, Gonzalez, & Graziano, 2018) due to concerns regarding their impact on neural development (Henderson & Fischer, 1995), perceived over-prescription (Jensen et al, 1999), and both diminished treatment efficacy and increased side effects Wigal et al, 2006). Additionally, behavioral interventions, relative to pharmacological treatments, may differentially impact proximal outcomes, such as parent competence and mental health (Rajwan, Chacko, & Moeller, 2012).…”

Section: Treatmentmentioning

confidence: 99%

Practitioner Review: Assessment and treatment of preschool children with attention‐deficit/hyperactivity disorder

Halperin

Marks

2019

Child Psychology Psychiatry

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Background Attention‐deficit/hyperactivity disorder (ADHD) often emerges during the preschool years and remains impairing throughout the life span. Early identification and intervention may yield lasting benefits that alter the often‐adverse trajectory of the disorder. Methods This Practitioner Review provides up‐to‐date information regarding the evaluation and treatment of ADHD in preschool children. The clinical presentation of ADHD in preschool children, its persistence into later childhood, the applicability of DSM‐5 criteria for preschoolers with ADHD, and early predictors of long‐term trajectories are addressed, as well as current findings from randomized controlled trials of both nonpharmacological and pharmacological interventions. Results Symptoms of hyperactivity/impulsivity extend down to age 3, but several inattention symptoms, as defined by DSM‐V, less accurately differentiate preschoolers with and without ADHD. Most preschool youth with ADHD symptoms continue to manifest symptoms and impairment into school‐age and adolescence. However, few predictors of persistence beyond early severity have been identified. Behavioral interventions constitute a first‐line treatment for preschool ADHD symptoms, with telepsychiatry increasing in prominence to help to mitigate financial, geographic, and/or logistical barriers to care. Pharmacological interventions, particularly psychostimulants, also confer demonstrable benefits, yet efficacy and safety profiles are less desirable relative to findings in school‐age youth. Conclusions Acute treatments have demonstrable efficacy, but do not appear to fundamentally alter underlying mechanisms or long‐term trajectories.

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Parent Perceptions of Medication Treatment for Preschool Children with ADHD

Cited by 11 publications

References 36 publications

Adherence to Recommended Care Guidelines in the Treatment of Preschool-Age Medicaid-Enrolled Children With a Diagnosis of ADHD

Adherence to Recommended Care Guidelines in the Treatment of Preschool-Age Medicaid-Enrolled Children With a Diagnosis of ADHD

Child and Parental Characteristics of Medication Use for Attention-Deficit/Hyperactivity Disorder

Practitioner Review: Assessment and treatment of preschool children with attention‐deficit/hyperactivity disorder

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