Before effective treatment cab be utilized, a comprehensive evaluation should be conducted. Generally, this includes assessments of the following areas:
This evaluation can be completed within the school by psychologists, or externally through clinical psychologists. These individuals often work in conjunction with pediatricians and teachers for a complete understanding of the child's difficulties and potential treatments. Once a diagnosis of ADHD is confirmed, treatment is likely to be initiated. Treatment may involve medication, behavioral modification strategies, classroom accommodations, or a combination of methods. Medication is often the first-line of treatment, as research has found that effective medication treatment provides substantial improvement in behavior and academic functioning for many children. Options often include stimulant (i.e. Adderall, Concerta, Ritalin, Vyvanse, etc.) and non-stimulant (i.e. Straterra, Intuniv, etc.) medications. Medication is often combined with behavior therapy, as research indicates is the combination is more effective than medication or behavior therapy alone.
More About Medication
Stimulant medication is often prescribed by a child's pediatrician for remediation of children's core symptoms of ADHD: inattention, hyperactivity, and impulsivity. These medications (i.e., Concerta, Adderall, Vyvanse, Focalin, etc.) have been demonstrated to be the most effective medications in the treatment of ADHD in children. In fact, treatment with stimulants is highly effective in 75%-90% percent of children with ADHD. In addition to being highly effective, psychostimulants have been found to be safe to use for children with ADHD, and have been FDA approved for such use. Stimulants work by helping a child maintain attention and exhibit greater self control. They also have been shown to provide the greatest improvement in the core symptoms of ADHD (inattention, impulsivity and hyperactivity) of any treatment method. Stimulants take effect in the body quickly and work the same day that they are administered. They may remain in the body for anywhere from 4 hours (for short-acting medications) to 8-12 hours (for extended release medications), but are only effective on days where they are taken. Non-stimulant medication, on the other hand, take longer to take effect and laster longer in one's symptoms.
Therapy for Children with ADHD
A combination of medication and therapy are most likely to bring about improvement in children with ADHD. While ADHD medication is efficacious for improve the core symptoms of ADHD (inattention, hyperactivity/impulsivity) psychological interventions are typically more effective at improving targeted behaviors (i.e., completing school work, keeping hands to him/her self). Behavior management treatments are designed to address the special challenges associated with managing the behavior of a child with ADHD, such as providing skills training to parents to help them better manage their child's behavior. While many treatments are provided on a one-to-one basis ("individual" therapy) some may be provided in group formats to best meet the needs of the family. Treatments often focus on:
The use of structured systems of rewards and consequences, including Contingent rewards programs (i.e., token economy, point systems) and the proper use of "time-out"
Strategic attending and ignoring
Environmental organization at home and school
Treatments may also include strategies to help children improve their academic functioning and behavior at school. They can include techniques such as:
Classroom-based system of rewards and consequences, including:
Daily Report Card
Organizational skills systems, including
Organizational binder to improve homework completion