Children with severe ADHD should have priority for behavioural therapy

Some children with ADHD benefit more from behavioural therapy than others, researcher Annabeth Groenman discovered. ‘It’s important these children don’t end up on a wait list.’ 

Children with ADHD are often treated with Ritalin or similar medication. Behavioural therapy can also help with symptoms and behavioural problems, but it turns out that not all children benefit from this. It’s therefore important to find out which children benefit from this type of therapy, and which ones don’t, says Annabeth Groenman. 

Groenman works as a researcher at Accare, the UMCG centre for childhood and youth psychiatry. This spring, she spearheaded a large study into the effects of behavioural therapy which combined data from thirty-three international studies.

A single database

‘We looked at all the studies into behavioural treatment for ADHD’, says Groenman. She emailed the people in charge of the studies, asking for their data. But almost every researcher used a different set of questions. ‘I spent approximately two years processing data until it all fit into a single database.’

Interestingly enough, Groenman did not perform a meta-analysis of these previous studies. In a meta-analysis, researchers study the measurement results, averages, and deviations that these earlier papers mention and draw their own conclusions. ‘This sometimes shows that people who are on medication benefit more from behavioural therapy’, says Groenman. ‘From that, you might conclude that behavioural therapy works better for people who are on medication.’

However, this method is not without its issues. ‘It’s possible these people are given medication when they’re showing more symptoms. In that case, it wouldn’t mean the medication leads to better therapy efficacy. Instead, the therapy works better for people who show more symptoms.’

2,200 kids

That is why Groenman didn’t use the processed data, but rather the original results, combining all of those. ‘Our study includes all the details you miss doing a meta-analysis. That’s where this method’s strength lies’, says Groenman. 

It was an interesting experience, Groenman says. ‘Four of us formed a core group, making decisions and writing the paper. Everyone else had the opportunity to give feedback, which led to a lot more work. People always have a lot of opinions, so it’s like getting feedback from thirty-three different lecturers.’  

However, the end results were worth it. While other studies base their finding on sixty to seventy children, Groenman’s database consists of 2,200 kids. That made analysing the data a lot easier. 


It clearly showed, for instance, that children who suffered from a behavioural disorder or a more severe form of ADHD clearly got worse when they didn’t receive behavioural therapy. The same went for children who were raised by a single parent. Therapy helped their stabilise and stay that way. 

This is an important conclusion, says Groenman. These two groups should be given priority for these treatments rather than end up on a wait list. ‘If these children don’t get treatment fast, there’s a good chance their situation will only get worse’, says Groenman.


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