Last week, the CDC Vital Signs report encouraged health care providers to discuss the benefits of behavior therapy as the first step in treatment with parents of young children diagnosed with ADHD.

Parents look to their child’s healthcare providers for guidance. This conversation between parents and providers is a critical one when it comes to getting children between 2 and 6 years old the proper treatment for ADHD. Parents often have questions about what treatment involves and difficulty finding support.

“Parents may feel overwhelmed with decisions about their child’s treatment for ADHD, but healthcare providers, therapists, and families can all work together to help the child thrive,” said Anne Schuchat, MD (RADM, USPHS), the Principal Deputy Director of the CDC. “Parents of young children with ADHD may need support, and behavior therapy is an important first step.”

Behavior therapy for young children involves licensed therapists training parents in skills to guide their child’s behavior, such as the following:

• Positive communication: When parents give children their full attention and reflect their words back to them, they know the parents are listening and care about what they have to say.
• Positive reinforcement: Praise the child when she does something right. The more parents praise a behavior, the more likely it is the child will behave the same way again.
• Structure and discipline: Children do better when their world is predictable. Set up routines and daily schedules to help the child know what to expect each day. Respond to the child’s behavior the same way every time to help her learn more quickly.

If you have a young child who has been diagnosed with ADHD, your child’s health care provider should talk with you about behavior therapy and offer you a referral to a therapist. Health care providers, or members of their medical practices or offices, should look in their communities for evidence-based behavior therapy and parent-training programs to suggest in their referrals. Since it can be difficult to find therapists who train parents in behavior therapy in some areas of the country, providers and parents can find resources by visiting Parent Training in Behavior Management for ADHD.

To help the families of their young patients, healthcare providers need to be familiar with the guidelines for identifying ADHD in children from the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry. These guidelines recommend that preschool-age children receive behavior therapy as the first-line treatment for ADHD. Some children who do not respond to the behavior treatment or do not respond strongly enough may need to have medication added to their treatment.

“Behavior therapy may require more time, energy, and resources than medicine,” Dr. Schuchat said. “But the effects of behavior therapy can be longer lasting. We know that, unfortunately, behavior therapy may not be available in every community. We know there’s work to be done to increase availability. State and local governments, healthcare professional organizations, and insurers can work together to increase these options for families.”

Once a family begins working with a behavior therapist, health care providers are encouraged to continue to follow up with the family periodically to make sure the treatments are working and determine if adjustments to the treatment plan need to be made.

Additionally, Vital Signs notes that health professional organizations can support their members and other health care providers in beginning and continuing this conversation in several ways. They can inform healthcare providers about the reasons for and benefits of parent training in behavior therapy, along with providing training and support to new and existing providers to deliver parent training in behavior therapy to fill service gaps. Organizations can also include content about proven treatments for

ADHD in graduate or professional curricula, training, and certification.

“[The Vital Signs] report suggests we’re missing opportunities for young children with ADHD and their parents to benefit from behavior therapy,” Dr. Schuchat said. “We all can play a role in helping parents get the information and services they need.”