A large new study has found that young children in the United States are often prescribed ADHD medication far sooner than recommended by medical guidelines. Current advice for children aged four and five who are newly diagnosed with attention-deficit/hyperactivity disorder (ADHD) is to undergo six months of behavioural therapy before starting medication.
The analysis, published in JAMA Network Open and involving more than 9,700 children, revealed that 42.2% of young patients were prescribed medication within one month of their diagnosis, while only 14.1% began treatment after the recommended six-month period. Lead author Dr Yair Bannett, an assistant professor of paediatrics at Stanford University, said this trend is “concerning,” as starting with behavioural therapy has significant benefits for both children and their families.
ADHD affects an estimated 11.4% of children aged three to 17 in the US, causing symptoms such as distraction, high energy, restlessness, and forgetfulness. Experts stress that early intervention is critical to prevent long-term impacts on academic performance and development.
Treatment typically includes behavioural therapy to develop daily functioning skills, and medication such as Ritalin or Concerta to manage hyperactivity and inattentiveness. While most children benefit from a combination of both, guidelines emphasise starting with therapy alone for the youngest patients.
Researchers noted that limited access to behavioural treatment may contribute to the early reliance on medication. Although the drugs are generally considered safe for four- and five-year-olds, side effects such as irritability and aggression sometimes lead parents to discontinue use.
The study also highlights differences between regions, as children in North America are much more likely to receive ADHD medication compared with their peers in Europe.
