Documente Academic
Documente Profesional
Documente Cultură
Alex Richardson
Brandman University
Treatment of ADHD 2
disruptive behavior disorders among children and adolescents (Jones 2002). Stimulant
medication and behavioral treatments are both evidence based treatments for children with
ADHD (Pelham et al., 2005). This paper looks at three studies conducted by Pelham et al.,
(2005) Arnold et al., (2004) and Gillberg et al., (1997) who investigate medication and its impact
on ADHD.
better for the management of ADHD in children. Pelham et al (2005) conducted a study looking
at; the use of medication (methylphenidate); behavior modification, and the combination of both,
during a summer treatment program. They were able to study the difference in a child’s behavior
using a point system, a daily report card (DRC) and teacher/counselor ratings.
In their study, Pelham et al., (2005) found that medication alone was able to improve
academic productivity, compliance and rule following in every setting during the summer
treatment program. In addition to this, medicated students also rated themselves as behaving
better on the days they were medicated, even though they did not know if they were medicated or
not. Lastly, parent ratings also indicated that positive behavioral effects continued into the
evening on the days their children were medicated. This shows that medicating ADHD children
Pelham et al., (2005) also looked into the use of behavior modification without
medication and the impact it had on ADHD children. Children were 19 times more likely to
reach their daily point goal with a placebo pill and behavior modification, compared to days
where they had a placebo pill and no behavior modification. This also shows the huge impact
Treatment of ADHD 3
behavior modification can have on ADHD children and argues that medication does not always
need to be the only treatment. This contradicts reviews that concluded that behavioral treatments
Pelham et al., (2005) also looked at the impact of combined treatments. Their biggest
finding was that a much lower dose of medication is needed to help the children, and the
combined treatment helped children the most. Interestingly, many may believe that a higher dose
of medication will have a greater chance of improving ADHD behaviors. However, Pelham et
al., (2005) illustrate that a low dose of medication combined with behavior modification gave
better results than a high dose of medication alone, or behavior modification alone. Therefore, a
combined treatment plan makes more sense. They argue that “if a physician or parent desires to
keep the dose of medication low for a child, they can obtain that result...by instating an in-school
behavior program” (p.123). Therefore, a high dose of medication does not necessarily correlate
with better management of ADHD. In fact, this study argues that the implementation of a
behavior modification plan combined with a low dose of medication is the appropriate treatment
plan.
Similarly to Pelham et al., (2005), Arnold et al., (2004) also looked at stimulant
medication and behavioral treatment for ADHD. However, Arnold et al., (2004) conducted a 14
month study compared with Pelham et al., (2005) whose study was over a course of a summer
treatment program that lasted only 8 weeks. Another difference was that Pelham et al., (2005)
only included 25 children, whereas Arnold et al., (2004) included 579 children. Therefore it can
be argued that Arnold et al., (2004) conducted a more reliable study as they included more
participants and also conducted their study over a longer time frame.
Treatment of ADHD 4
Although there are differences among the two studies, Arnold et al., (2004) also studied
similar treatment strategies. These were medication management; intensive behavioral treatment;
combination of medication and behavioral treatment, and routine community care. They found
through their study that “medication management, whether alone or in combination with
behavioral treatment, was significantly superior to behavioral treatment alone” (p.40). This
finding supports the argument that medication, along with behavioral treatment, is an effective
However, Arnold et al., (2004) also states that their study results found that combination
of treatments does not differ significantly from medication management alone. This finding does
not support Pelham et al., (2005) as their argument states behavioral intervention was an
Moreover, Arnold et al., (2004) recognizes that certain subgroups may have an excellent
response to either medication or behavioral intervention, or may require the combination of both
to have a better impact on them. This shows that treatment of ADHD is a unique experience and
In support of Arnold et al., (2004), Gillberg et al., (1997) studied the stimulant
medication treatment of children with ADHD. 62 children participated and had all been through
some kind of intervention before the study. Gillberg et al., (1997) found that “all 62 children
and teacher ratings” (p.856). Furthermore, they found that those who were receiving medication
had improved behavior rating compared with those who were taking placebo. Additionally, the
medication had a positive effect on the children's learning, as they had a greater increased mean
IQ compared to those who were receiving placebo. Overall this study also demonstrates that a
Treatment of ADHD 5
medication treatment for ADHD proves to be beneficial and can help children in a multitude of
ways.
However, there are some limitations to this study in comparison to Arnold et al., (2004)
and Pelham et al., (2005). Gillberg et al., (1997) did not look at other methods to compare with
the results of those who were taking medication. Therefore this study only compared children on
medication with children on placebo. This does not provide any argument for alternative
treatments to medication. Additionally, this study also points out that only 27% of the original
cohort assigned to placebo completed their treatment through the entire 15 months. Therefore,
the data may not be as valid as not all participants were able to fully complete their treatment
plan. Lastly, this journal was published in 1997. This was over 20 years ago and therefore the
studies on medication and the impact it has on children has developed since then. Therefore it
may be considered outdated and should not be used alone as an argument for the medication
treatment of ADHD.
Overall, all three of the published journals showed that the use of medication can be
extremely beneficial for the treatment of ADHD. Although there are arguments for alternative
treatments, overall, the three studies showed that medication is an effective way to manage
References
Arnold, L. E., Chuang, S., Davies, M., Abikoff, H. B., Conners, C. K., Elliott, G. R., Wigal, T.
39-51. doi:10.1023/b:jacp.0000007579.61289.31
Gillberg, C., Melander, H., Knorring, A., Janols, L., Thernlund, G., Hägglöf, B., Eidevall-
Pelham, W. E., Burrows-Maclean, L., Gnagy, E. M., Fabiano, G. A., Coles, E. K., Tresco, K. E.,
13(2), 111-126.