If ADHD wouldn't behavioral intervention be first course, not meds?

Not always. Adhd is a medical disorder, not a behavioral problem. Individual with adhd are often impulsive and it is the impulsivity that gets them into trouble. Their impulsive acts often occur prior to conscious thought. For behavioral interventions to work, you must think before you act, which many adhd individual can't do. The best option is medication with behavioral interventions.
Yes. We work diligently with our patient families to optimize parenting- & customize it to the child's specific needs. That may prove sufficient. But if not, effective & expertly prescribed psycho-active medication should be considered.
Nope . Behavioral intervention means learning. Untreated adhd kids cannot learn because of the inherent nature of problem. Many studies have demonstrated uselessness of behavioral therapy if the adhd person is not treated with stimulants.The amer acad of peds has set the standard of care to use stimulants in adhd since they are extremely safe, remarkably effective & necessary for other therapy 2 work.
Good point. While medications are very effective at treating adhd, it is good to see if behavioral techniques help the symptoms. More importantly, therapy can rule out any other reasons for the symptoms. A proper diagnosis will lead to proper treatment.