ADHD treatment gap

Recommended behavior management training isn’t usually the first option doctors give parents

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Though parent training in behavior management is the recommended starting point for treating 4- or 5-year-old children with ADHD, few pediatricians start there, research published in October 2021 in JAMA Pediatrics shows.

Lead study author Yair Bannett, MD, a developmental and behavioral pediatrician at Stanford Children’s Health, said the behavioral therapy acknowledges the challenges of parenting ADHD children and provides helpful tools — such as teaching parents to reward their children’s good behavior, set appropriate limits and consequences, and develop predictable daily routines.

Studying 22,714 charts of 4- and 5-year-old children, researchers identified 192 with attention-deficit/hyperactivity disorder symptoms or a diagnosis, finding that behavior therapy was recommended for only 11% of those children.

Medication was prescribed in 17% of the cases, which Bannett said is rarely appropriate for children that age.

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Erin Digitale

Erin Digitale is the pediatrics senior science writer in the Office of Communications. Email her at

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