The authors declare no conflict of interests.
Stimulant medication in pre-school children in New South Wales
Version of Record online: 9 JUN 2011
© 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 47, Issue 12, pages 870–874, December 2011
How to Cite
Eysbouts, Y., Poulton, A. and Salmelainen, P. (2011), Stimulant medication in pre-school children in New South Wales. Journal of Paediatrics and Child Health, 47: 870–874. doi: 10.1111/j.1440-1754.2011.02107.x
- Issue online: 15 DEC 2011
- Version of Record online: 9 JUN 2011
- Accepted for publication 7 February 2011.
- attention-deficit/hyperactivity disorder;
- pre-school children;
- stimulant medication
Aims: The aims of this study were: (i) to examine the annual treatment rate of children under 4 years from 1997 to 2006; (ii) to compare their treatment rate and attrition with that of children starting treatment at the modal age; (iii) to describe the clinical characteristics of children aged less than 4 years and their response to stimulant medication for the treatment of attention-deficit hyperactivity disorder.
Methods: Retrospective study of electronic prescription and authority records of the New South Wales Department of Health and a review of clinical reports.
Results: The annual treatment initiation rate for children under 4 years showed a progressive decline over the decade. In 2001, 13.6% of the children starting treatment were aged 7 years (modal age); those aged <4 years represented 1.1% of the total. There was no significant difference in attrition rate between these two groups. For those aged <4 years with clinical reports available (n= 235), oppositional behaviour and developmental problems were reported frequently (78 and 43%, respectively). Non-pharmacological interventions were implemented in 77% and non-stimulant medications were prescribed in 50%. For 76% of children, an improvement in behaviour was reported after stimulant therapy.
Conclusions: Children treated with stimulant medication aged <4 years were a small subgroup with a high rate of co-morbidity. The majority were perceived to have a favourable response to stimulant medication. However, there was a disturbingly high rate of prescribing of other psychotropic medications of known toxicity and unproven efficacy.