ADHD: Getting the right treatment
Psychological therapy for ADHD may help children, teenagers and adults with ADHD, often in combination with medication.
The approach for therapy may involve counsellors, psychiatrists, psychologists and social workers.
Behavioural techniques for children with ADHD
Learning behaviour-management techniques is an essential part of any successful ADHD treatment programme for children. Most experts agree that combining medication treatments with extended behaviour management is the most effective way to manage ADHD in children and adolescents.
There are three basic categories or levels of ADHD-behavioural training for children:
- Parent training in effective child-behaviour management.
- Classroom behaviour-modification techniques.
- Special educational placement.
Behaviour management is most often used with younger children with ADHD but it can be used with adolescents up to the age of 18, even with adults. In children and adolescents, the two basic principles are:
- Modelling behaviour by encouraging good behaviour with healthy praise or rewards. This works best if the reward or praise immediately follows the positive behaviour.
- Negatively reinforcing bad behaviour by allowing appropriate consequences to occur naturally.
Behaviour-management strategies for children under five
To help younger children with ADHD, try these behaviour-management techniques:
- Provide a consistent routine and structure. Let children know when the routine is changing, such as a visit from a relative, a trip to the shops or a holiday.
- Give your child clear boundaries and expectations. These instructions and guidelines are best given right before the activity or situation.
- Devise an appropriate reward system for good behaviour or for completing a certain number of positive behaviours, such as a merit point or gold-star programme with a specific reward, such as a favourite activity. Avoid using food and especially sweets for rewards.
- Engage your child in constructive and mind-building activities - such as reading, games and puzzles - by participating in the activities yourself.
- Some parents find that using a timer for activities is a good way to build and reinforce structure. For example, setting a reasonable time limit for a bath or playtime helps train the child to expect limitations, even on pleasurable activities. Giving a child a time-limit for chore completion is also useful, especially if a reward is given for finishing on time.
Behaviour-management strategies for children aged six to 12
Behaviour-management strategies for older children with ADHD may include:
- Give clear instructions and explanations for tasks throughout the day. If a task is complex or lengthy, break it down into steps that are more manageable, keeping in mind that as the child learns to manage their behaviour, the steps and tasks can become more complex.
- Reward the child appropriately for good behaviour and tasks completed. Set up a clear system of rewards (point system, gold stars) so the child knows what to expect when they complete a task or refine their behaviour.
- Bear in mind that as your child gets older they will be more sensitive to how they appear to others and may overreact or be unduly ashamed when they are disciplined in front of others. It is important to have a plan for appropriate discipline that does not require carrying it out in public. Setting up a specific consequence for certain behaviour is probably the best method of providing consistency and fairness for your child.
- Communicate regularly with your child’s teachers so behaviour patterns can be dealt with before they become a major problem and before the teachers get overly frustrated with the situation.
- Always set a good example for your child. Children with ADHD need role models for behaviour more than other children - the adults in their lives are very important.