While there is no known cure for attention deficit hyperactivity disorder (ADHD), there are a number of options that can help those with the condition effectively manage their symptoms. Treatments range from behavioral intervention to prescription medication. While research has found that medication alone is an effective therapy for ADHD, a large-scale study conducted by the National Institutes of Mental Health found that a combination approach to therapy—using medications and behavioral treatment together—was most useful in helping patients manage the condition.
According to the large-scale National Survey of Children's Health taken in 2003, around 2.5 million youth four to 17 years old (56 percent of those diagnosed) were receiving medication treatment for ADHD. Medication use is highest among children with ADHD who are 9 to 12 years old. Medication is often an important and difficult reality for parents of children with ADHD. To found out which medications are safe and right for you or your child, be sure to research and discuss information with your doctor and/or healthcare professional.
Central Nervous System Stimulants
Central nervous system (CNS) stimulants are the most commonly prescribed class of ADHD drug. Although scientists are not sure precisely how these drugs work, it is believed that CNS stimulants balance the levels of certain neurotransmitters (brain chemicals) such as dopamine that may be unstable in ADHD patients. CNS stimulants come in a range of forms including pill, capsule, liquid, and skin patch, and they may also come in short-acting, long-acting, or extended-release varieties. Long-acting or extended-release forms often allow a child to take the medication just once a day before school, so they don't have to make a daily trip to the school nurse for an afternoon dose. Parents and doctors should decide together which medication is best for the child and whether the child needs medication during school hours only or on evenings and weekends as well.
Common CNS stimulants include:
- Amphetamine-based stimulants (Adderall, Dexedrine, Dextrostat)
- Dextromethamphetamine (Desoxyn)
- Dextromethylphenidate (Focalin)
- Methylphenidate (Concerta, Daytrana, Metadate, Ritalin)
Nonstimulant medications are often considered when stimulants haven't worked or have caused intolerable side effects. Nonstimulant medications used to treat ADHD include:
- Atomoxetine (Strattera)
- Blood Pressure Medication (such as guanfacine; brand name Intuniv)
- Atypical antipsychotics
Therapeutic ADHD Treatments
Psychotherapy can be useful, especially with slightly older children, in getting a child to open up about his or her feelings of coping with ADHD. ADHD might cause problems with authority figures and peers; psychotherapy can help children handle these relationships appropriately. In psychotherapy, a child may also be able to explore his or her behavioral patterns and learn how to make the right choices moving forward.Family therapy can be a great venue for figuring out how best to work through disruptive behaviors.
Behavior therapy (BT) attempts to teach a child how to better monitor his or her behaviors and then modify those behaviors appropriately. Often, the child and the child's parents and/or teacher(s) will work together to develop strategies for dealing with certain situations and resulting behaviors. This frequently involves some sort of direct feedback so that the child learns appropriate behaviors; for example, a token reward system could be devised to reinforce positive behaviors.
Social Skills Training
Social skills training can sometimes be useful if a child shows significant issues functioning in social environments. Like BT, social skills training attempts to teach new and more appropriate behaviors—specifically those that can help a child with ADHD play and work better with others. For example, a therapist may try to teach behaviors such as waiting in turn, sharing toys, asking for help, or dealing with teasing.
Support groups are great for helping parents connect to others who may share similar experiences, concerns, and successes with ADHD children. Ideally, support groups will meet regularly so relationships and support networks can be built. Knowing you're not alone in dealing with ADHD can be a huge mental fortification. Support groups can also be a great resource for specialist recommendations and practical strategies, especially if you are a parent of a child newly diagnosed with ADHD.
Parenting Skills Training
This training gives parents tools and techniques for understanding and managing their child's behaviors. Some techniques may include:
- A point system or other means of immediately rewarding good behavior or work
- How to utilize a time-out when the child becomes too unruly or out of control. For some children, being pulled out of a stressful or overstimulating situation can help him or her learn how to react appropriately the next time it comes up.
- Finding time every week to share a pleasurable or relaxing activity. During this time together, a parent should look for opportunities to point out what the child does well and praise his or her strengths and abilities.
- Structuring situations in a way that allows the child to find success. For example, allowing only one or two playmates at a time, so that the child doesn't get overstimulated.
- Stress management methods such as meditation, relaxation techniques, and exercise
Behavioral Interventions for Home and School
One of the biggest concerns for parents of children with ADHD is their child's success in school, a lot of which hinges on organization—a skill with which many children with ADHD struggle. Simple interventions such as the ones listed below can be an immense help.
- Schedule. Set the same routine every day, from waking up to bedtime, including homework and playtime. Post the schedule in a visible place; if a change must be made, make it as far in advance as possible.
- Organize everyday items. Clothing, backpacks, school supplies, and play items all should have a designated, clearly marked space.
- Use homework and notebook organizers. Stress the importance of writing down assignments and bringing home anything needed to complete homework.
- Ask about using a computer in class. For some children with ADHD, handwriting is another stumbling block on the road to success. See if his or her teacher will allow for computer use in the classroom.
Children with ADHD often receive, and then start to expect, criticism from authority figures. If they get only negative feedback without ever hearing nice things about themselves, they'll start to think of themselves as "bad." If rules are followed and behavior is good—even in seemingly inconsequential situations—give small rewards and praise to boost your child's self-esteem and reinforce good behavior significantly.
Children with ADHD often do very well with activities such as art class, music or dance lessons, or martial arts classes because energy can be channeled creatively and productively. These activities can be a source of positive reward for children with ADHD and can also foster mental discipline. Find out what your child is interested in, but remember not to force them into anything.