Upfront

Most health-care professionals have misinterpreted the research on attention-deficit hyperactivity disorder: They believe stimulant-based drugs are the most effective treatment for the disorder in children. But, according to research conducted by William Pelham, PhD, of the State University of New York at Buffalo, and others, when children, teachers and parents are taught behavioral modifications, medication doesn't need to be the central component of treatment.

"Medication should not play nearly as large a role as it does currently in treatment of ADHD," said Pelham at APA's Annual Convention.

That's particularly important since researchers still don't know if medications have long-term side effects. So far, research indicates that children who ingest a large amount of drugs, particularly in higher doses over years of treatment, may be as much as two inches shorter than the height they would have been expected to reach. Children prescribed smaller doses for less time did not show a height deficit, he said.

In addition, although these medications can address such ADHD symptoms as restlessness, fidgeting or impulsiveness in a classroom, they don't directly address ADHD's impairments, said Greg Fabiano, PhD, also of SUNY Buffalo. Such problems often include a lack of successful interactions with peers, deficits in reading and math skills, and difficult relations with parents and family members.

Another speaker, George DuPaul, PhD, of Lehigh University, discussed his work on Project PASS, which studied an intervention for children in first through fourth grade. He and colleagues have tested a variety of classroom strategies with the students, such as a peer-tutoring intervention and a self-paced computer math program. The results showed that the students improved their math and reading performance, with an interesting side benefit, DuPaul said: For some students, behavior improved as well.

-C. Munsey