Study reinforces Ritalin's value in treating disorder

ANAHEIM, Calif. (AP) -- Children with attention-deficit hyperactivity disorder, or ADHD, who were treated with drugs, including Ritalin, had dramatically improved behavior over children treated only with therapy, a new study says.

The study's early findings should quiet some of the criticism of drugs such as Ritalin and encourage doctors to stop blaming "bad parents" and teachers, said Peter Jensen of the National Institute of Mental Health, one of the authors.

"There's been a lot of blaming the victim," Jensen said. "But looking at these results, we can't say better parenting is the answer for most of these kids."

The authors presented their preliminary results at the American College of Child and Adolescent Psychiatry meeting in Anaheim on Friday. They believe it is the largest study of the disorder.

ADHD affects 3 percent to 9 percent of all children, affecting their ability to focus. It accounts for one-third to one-half of referrals for mental-health services for children.

"Treatment can mean the difference between a kid ending up at Berkeley or ending up in prison. This is a disorder where we can really make a difference," said James Swanson, pediatrics director at University of California, Irvine, and one of the authors.

Critics say doctors are too quick to diagnose ADHD and overprescribe drugs for children.

But Jensen said the problem is that thousands of children aren't treated and more than half of children with the disorder have not been diagnosed.

The 600 children in the study, age 7 to 9, were randomly placed in one of four groups: medication; psychosocial (behavior-modification therapy, social-skills building and summer programs); combination medication and psychosocial; and referral back to the community doctor.

For the children receiving medication, if Ritalin didn't work, other medications were tried until each child was taking the drug and dose that was the most effective for him or her. Clinicians monitored those children and visited with them and their teachers each month.

Intensive psychosocial therapy included training for parents and summer camps that emphasized social skills for the children.

After 14 months of treatment, 12 percent to 15 percent of children on medication or a combination of therapy and medication were diagnosed with ADHD, while 32 percent to 35 percent of children on psychosocial or community-based treatment still had the disorder. For social skills, however, combined treatment was best.

Stephen Hinshaw of UC Berkeley said many questions remain.

What happens to these children years down the road? What treatments work best for children with other disorders?