In 2001, the American Academy of Pediatrics (AAP), in their Clinical Practice Guideline, suggested that when treating target ADHD symptoms, "clinicians should recommend stimulant medication and/or behavior therapy, as appropriate." Several forms of behavioral intervention have been found to show little or no effectiveness in treating ADHD patients. These included individual or play therapy, long-term psychotherapy, psychoanalysis, sensory-integration training, and cognitive behavioral therapy. However, one form of a non-medication approach, behavioral therapy, has been demonstrated to be somewhat effective with ADHD children. The therapy sessions are conducted by a mental-health professional (for example, a psychologist or social worker) and consist of parent and teacher training in child behavior management. The parents and teachers are taught to consider their child's behavior as a function of the disorder, rather than "bad behavior" or the result of failed parenting/teaching skills. The sessions then go on to teach the adults to pay attention to appropriate behavior, ignore minor inappropriate behavior, to give clear and concise directions, and to establish effective incentive programs, such as token or point reward systems. The adults manage misbehavior by applying immediate, specific, and consistent consequences (removal of privileges). Basically, the three principles of behavior therapy are:
- set specific goals
- provide rewards and consequences
- keep using the rewards and consequences for a long time
Parents can help their child's behavior with specific goals such as: (1) maintaining a daily schedule, (2) keeping distractions to a minimum, (3) setting small and reasonable goals, (4) rewarding positive behavior, (5) using charts and checklists to keep a child "on task," and (6) finding activities in which the child will succeed (sports, hobbies).
Many feel that behavior therapy can be an appropriate first-level treatment in several scenarios:
- the milder ADHD patient
- for the preschool-aged child with ADHD-suspicious symptoms
- when the family prefers this approach vs. medication
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