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a.d.h.d. experts re-evaluate study’s zeal for drugs - nytimes.com

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Solved a.d.h.d. experts re-evaluate study’s zeal for drugs - nytimes.com

Post by skpheilanw Tue 7 Jan - 12:54

  Twenty years ago, more than a dozen leaders in child psychiatry received $11 million from the The widely publicized result was not only that medication like Ritalin or Adderall trounced behavioral therapy, but also that combining the two did little beyond what medication could do alone. The finding has become a pillar of pharmaceutical companies’ campaigns to market A.D.H.D. drugs, and is used by insurance companies and school systems to argue against therapies that are usually more expensive than pills. But in retrospect, even some authors of the study — widely considered the most influential study ever on A.D.H.mini dv camcorder for saleD.sony mini dv camcorder — worry that the results oversold the benefits of drugs, discouraging important home- and school-focused therapy and ultimately distorting the debate over the most effective (and cost-effective) treatments. The study was structured to emphasize the reduction of impulsivity and inattention symptoms, for which medication is designed to deliver quick results, several of the researchers said in recent interviews. Less emphasis was placed on improving children’s longer-term academic and social skills, which behavioral therapy addresses by teaching children, parents and teachers to create less distracting and more organized learning environments. Recent papers have also cast doubt on whether medication’s benefits last as long as those from therapy. “There was lost opportunity to give kids the advantage of both and develop more resources in schools to support the child — that value was dismissed,” said Another co-author, A.D.H.D. narrowly trails asthma as the most frequent long-term medical diagnosis in children. Comprehensive behavioral (also called psychosocial) therapy is used far less often to treat children with the disorder largely because it is more time-consuming and expensive. Cost-conscious schools have few aides to help teachers assist the expanding population of children with the diagnosis, which in some communities reaches 20 percent of students. Many insurance plans inadequately cover private or group therapy for families, which can cost $1,000 a year or more. “Medication helps a person be receptive to learning new skills and behaviors,” said Ruth Hughes, a psychologist and the chief executive of the advocacy group Accepting no support from the pharmaceutical industry — “to keep it clean,” Dr. Arnold said — the National Institute of Mental Health gathered more than a dozen top experts on A.D.H.D. in the mid-1990s to try to identify the best approach. Over 14 months, almost 600 children with the disorder ages 7 to 9 across the United States and Canada received one of four treatments: medication alone, behavioral therapy alone, the combination, or nothing beyond whatever treatments they were already receiving. In what became a simple horse race, medication was ushered into the winner’s circle. “Behavioral therapy alone is not as effective as drugs,” ABC’s “World News Now” reported. One medical publication said, “Psychosocial interventions of no benefit even when used with medication.” Looking back, some study researchers say several factors in the study’s design and presentation to the public disguised the performance of psychosocial therapy, which has allowed many doctors, drug companies and schools to discourage its use.<br>
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