Preschoolers With ADHD Often Treated Incorrectly

Preschoolers With ADHD Often Treated Incorrectly
Early Morning Buddhist Inspiration - 5/4/2013
A Simple 5-Step Process to Separate Your Actions from Negative Thoughts

Posted: 04 May 2013 01:00 PM PDT

A little boy holds and looks at a bottle of prescription medicine

CREDIT: Child medicine photo via Shutterstock

Doctors usually do not follow guidelines for treating very young children withattention-deficit/hyperactivity disorder (ADHD), a new study suggests.

In the study, about 90 percent of doctors surveyed did not strictly adhere to new guidelines recommended for treating preschoolers with ADHD, such as guidelines that address when to start medications, and which medications to use.

For instance, some doctors started preschoolers on medication too soon — before trying any non-drug treatment, such as counseling parents on how to manage their child's behavior.

The findings are concerning because doctors should recommend behavior treatments first, the researchers said.

"At a time when there are public and professional concerns about over-medication of young children with ADHD, it seems that many medical specialists are recommending medication as part of their initial treatment plan for these children," said study researcher Dr. Jaeah Chung, of Cohen Children's Medical Center in New Hyde Park, N.Y. [See ADHD Medications: 5 Vital Questions and Answers.]

The researchers surveyed 560 doctors who specialize in diagnosing and managing children ages 4 to 6 with ADHD.

Results showed that only 8 percent of doctors followed all guidelines from the American Academy of Pediatrics — the rest either prescribed medications too soon, prescribed medications without first checking to see if behavior therapy was working, or did not use the drug methylphenidate as the first drug treatment.

One in five doctors said they often prescribe medications to preschoolers with ADHD as their initial treatment. The AAP said in 2011 that doctors should attempt to treat ADHD in preschoolers with behavioral therapies before prescribing medications.

In addition, about 40 percent of doctors said that when they did prescribe medications, they initially used a medication other thanthe ADHD drugmethylphenidate(sold under the brand name Ritalin). According to the AAP, methylphenidate should used first in preschoolers because it has been more rigorously studied in young children than other medications such as amphetamines.

About 20 percent of doctors said they expected the number of children they treated with medications would increase in the future.

Study researcher Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's, noted that the AAP guidelines are written for general pediatricians, and it's possible that specialists see children with more severe ADHD (who are more likely to need medications).

Still, "Doctors collectively should recommend their patients pursue behavior therapies first," Adesman said.

There may be obstacles to providing behavior therapy — the treatment is not always covered by insurance, and families may live in an areas without a specialist who provides behavior therapy, Adesman said. If this is the case, the AAP recommends that doctors weigh the risks of starting medication at an early age against the risks of delaying treatment.

Pass it on: In general, preschoolers with ADHD should attempt behavior therapy before they try medications.

Follow Rachael Rettner @RachaelRettner. Follow MyHealthNewsDaily @MyHealth_MHND, Facebook & Google+. Originally published on MyHealthNewsDaily .

What didn't work

Replace a negative thought with a positive thought.

"I can't study for another hour."
"I can study for another hour!"

Five minutes of studying later...

"Nope I can't. I'm too tired."

Textbook closed and I'm looking up the latest NBA Power Rankings.

I also tried focusing cues, reframing, positive imagery and plenty more mental techniques, but nothing seemed to stick.

It just isn't realistic to stop thinking negatively altogether. I eventually realized the issue was not my thoughts; it was my inability to separate my thoughts from my behavior. I needed to become an observer of my thoughts and an active participant in my behaviors.

Thoughts alone achieve nothing. It is the action we take that achieves everything. Thoughts are useful for solving math problems, analyzing scenarios, developing business plans, etc… But it is not until these thoughts are put to action that they become useful.

For example, I am walking down the street and I see someone getting mugged in an alley, and I say to myself, "Run over ther! e and help this person out!" however, I just keep walking and don't do a damn thing despite my "positive thought".

I was thinking positively yet did nothing to help this person in need. My issue was not the content of my thoughts; it was a lack of commitment to my thoughts. This lack of commitment can be problematic in situations like this, and beneficial when the content of our thoughts are self-deprecating.

What are thoughts anyway?

Thoughts are a bunch of letters, grouped together into words, grouped together into sentences, and these letters, words and sentences are given meaning by… us.

If we gave them their meaning, how do certain words, phrases or sentences supposedly affect our behavior? Because we allow them to!

This is the issue.

There are times when we feel sad, think 'negatively' without much control of our own. Our behavior directly affects our lives. So why spend so much time attempting to change our thoughts, when they have zero direct impact on our lives?

Committing to our values consistently is essential to our mental health, and there are times when you will have to push yourself through some negative internal states.

In order to do this, it takes self-awareness of thoughts and commitment to valued action.

The 5 Step Process

Here is my 5-step process to act in a valued direction while experience negative thoughts and/or emotions:

"I can't walk." exercise. Simply walk around wherever you are, and say, "I can't walk". Say it to yourself and then say it out loud while walking. Although this may seem silly, you are actually training your mind to distinguish between thoughts that are helpful and those that are not.
Separate thoughts from behavior in other simple tasks. For the next week or two choose 2 to 3 activities that you know you can do with no problem and say out loud or in your head "I can't ________." This could be "I can�! �t brush ! my teeth for 30 seconds." "I can't get out of this chair". "I can't walk up this stair." It doesn't matter what activity you choose as long as it is easy and you say, "I can't _______" while performing the activity.

Take note of how connected you are to your thoughts. Notice how it was the first time you did this exercise to the next. You will begin to see a difference in your feelings as you practice this activity. However the point is not to eliminate negative thoughts, it is to act how you want in the presence of these negative internal states.
Increase the difficulty. As you notice the impact of your thoughts lessening, increase the difficulty of the activity slightly. VERY SLIGHTLY. If you were brushing your teeth for 30 seconds while saying that you can't, increase it to 40 seconds. Or if you said, "I can't walk for 1 minute straight", try lightly jogging for 1 minute straight while saying you can't.
Observe 'bad moods' and 'negative thoughts.' Simply notice negative content that goes through your head as if you were reading it from a book. Pay attention to your thoughts and recognize that they are not in control of your behavior.
Appreciate your experience. Lastly, appreciate these experiences and let them be a reminder that you're human. Embrace the range of thoughts and emotions that you can experience. Accept them and move in your valued direction.

Use these tips and notice your life improve.

Now over to you.

Have you tried these yourself?

What have you found to be the most effective?

Written on 5/4/2013 by Guido Saltarelli. Guido Saltarelli seeks to help people live their life according to the things they value the most by providing immediately use! ful menta! l tips and techniques. Drawing from his current experiences as a graduate student working full-time in retail, and his past experiences as a student-athlete on Grand Valley State University's Cross Country and Track Teams.

Photo Credit

Have a bucket list? Create yours today with this list of 101 things to do before you die! Grab your free pdf e-book in the next second by signing up for the free newsletter.

Search This Website

Health | Wellness | Yoga