Behavior Therapy First for Young Children with ADHD

October is Attention-Deficit/Hyperactivity Disorder (ADHD) awareness month. Did you know that many children with severe symptoms of ADHD are diagnosed before 6 years of age? Young children with ADHD need the right treatment for ADHD. Learn about using behavior therapy first to help young children with ADHD.

ADHD is one of the most common enduring conditions of childhood and affects many children, including very young children. Those with more severe symptoms are often diagnosed earlier. Read about trends in diagnosis and medication treatment for ADHD.

Being easily distracted, impulsive, and highly active is normal for young children, but when the symptoms are severe and persistent, it can cause problems. Young children with ADHD are more likely than those without ADHD to have difficulties in daycare or school, including problems with peer relationships, learning, and a higher risk of injuries.

My Young Child has been Diagnosed with ADHD, Now What?

For older children, the best treatment is often a combination of behavior therapy and medication. But for children under 6 years of age, experts recommend that ADHD be treated with behavior therapy first, before trying medication. Behavior therapy is the recommended treatment for ADHD in children under 6. The type of behavior therapy that is most effective for this age is parent training in behavior therapy, meaning that therapists work with parents and teach them the skills needed to help their child better manage their ADHD.

Young children with ADHD are more likely than those without ADHD to have difficulties in daycare or school, including problems with peer relationships, learning, and a higher risk of injuries.

How Can Parent Training in Behavior Therapy Help my Child?

Children who have ADHD act in ways that are often challenging for parents. Children may forget things they are told, be overly active, and act before thinking. They might not be able to get positive attention the way that other children can; they tend to misbehave and might be punished more frequently than other children. Even if children with ADHD really try to follow rules, they might not be able to. This can have a negative impact on their self-image, and cause them to give up trying or to act up more often.

A therapist skilled in behavior management can help parents understand how ADHD affects their child. Parent training in behavior therapy is used to help change problem behaviors by building parenting skills, improving the relationship between parents and their child with ADHD, and helping children manage their own behaviors.

Others (daycare providers, preschool teachers, and other caretakers) can also help to manage the behavior of preschoolers who have ADHD by becoming educated about the disorder and by being trained in behavioral techniques.

The Recommended First Choice

Behavior therapy is the recommended ADHD treatment for children under 6 and should be used first, before medications that treat ADHD.

Children under 6 are more likely than older children to experience side effects from ADHD medications, such as increased heart rate and blood pressure, trouble sleeping, loss of appetite, and a loss of energy.
The long-term effects of ADHD medications on children under 6 are not known since ADHD medications have not been well-studied in young children.
Behavior therapy works as well as medication in young children with ADHD in helping to manage symptoms. Studies have shown that families who receive training in behavior therapy notice improvements for several years after treatment.

Parent training in behavior therapy has evidence as an effective treatment. There are several programs that meet the criteria of the Agency for Healthcare Research and Quality for effective treatments. Read more about these behavior therapy training programs for parents of young children here.

What is CDC Doing?

CDC works to help families get the right care, at the right time. The data available so far show that almost half of 4-5 year olds with ADHD did not get behavior therapy in 2009-2010.

CDC is working with states and partner agencies to increase awareness as well as to identify best practices in support of behavior therapy for ADHD.
CDC is using national surveys to understand how many children have ADHD and how they are treated.
CDC is learning more about how children with ADHD are diagnosed.
CDC funds the National Resource Center on ADHD to provide evidence-based information about ADHD to families and professionals.

What You Can Do:

To get the recommended treatment for your young child with ADHD, talk to your doctor about behavioral therapy first. Learn more by visiting theNational Resource Center on ADHD's webpage on preschoolers or by calling 1-800-233-4050.
Share your experience on behavioral therapy with other families.