ADHD: What Works Beyond Meds

Attention Deficit Hyperactivity Disorder is one of the most commonly diagnosed conditions of childhood.

Recent data from the Centers for Disease Control show that 12% of adolescents at some point in their lives have been diagnosed with ADHD.

While some may debate whether we should label 12% of our kids as “disordered,” clearly many children struggle with weaknesses in attention.

Some children need medication to treat these difficulties, but others may respond well to behavioral supports alone.

Even for children who require medication, behavioral supports should be an important part of their treatment plan.

At home, parents should provide a supportive but structured environment that provides opportunities for playfulness but also has clear rules that are consistently enforced.

Parents need to mean what they say and avoid threats of punishment that they do not plan to enforce.

Parents should remain calm when administering correction and avoid getting drawn into arguments with their children.

Certainly, “the stern parent voice” will be needed, but parental screaming generally only results in increased child screaming.

Homework time can be the source of many battles.

Parents should provide a quiet, non-distracting place for homework to be completed such as a desk away from televisions and high-traffic areas of the house.

That space should be equipped with all the materials a child needs to complete his homework.

Many children with attention difficulties need breaks during homework time.

Use of a timer can help a child know when to take a break and when to return.

Breaks should consist of physical activity (e.g., running, shooting a basketball, playing outside), not watching television or playing video games.

Physical activity helps expend excess energy and is more likely to result in children returning to homework with improved focus.

Adequate sleep is also important. A consistent bedtime routine (along with a consistent bedtime) can help provide cues to the body that the time has come to go to sleep.

Most children also benefit from limiting access to electronics (anything with an On/Off switch) during the final hour before bedtime.

Avoiding caffeine-containing beverages and food (chocolate) in the evening hours can also benefit sleep.

For children with more significant behavioral difficulties, parents may want to work with a professional familiar with ADHD to develop strategies for addressing problematic behaviors.

One such intervention is a token program, which consists of a child receiving chips (or some other tangible item) immediately for appropriate behavior.

These chips can then be redeemed later for a motivating item or activity.

In summary, behavioral interventions by themselves can be quite helpful for children with attention difficulties and are an important part of the treatment of ADHD, whether or not a child is on medication.

Dr. Blake is board-certified in both developmental-behavioral pediatrics and general pediatrics. A native of Lexington, he recently returned to his hometown to join Commonwealth Pediatrics.