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| |    ADHD Treatment: Overview by Robert Needlman, M.D., F.A.A.P. reviewed by Robert Needlman, M.D., F.A.A.P. Once you've decided that your child really does have ADHD, the question is, what do you do about it? There is no cure, but there are things that can help your child be more successful at school and easier to live with at home. The three main types of treatment are education interventions, behavior therapy, and medication. Most studies show that a combination of these treatments is better than any one alone. Here is some basic information about these different treatments. Educational interventions Children with ADHD do better in smaller classes, with fewer distractions. They thrive with one-on-one attention from an adult. In a larger class, it helps if they can sit in the front, near the teacher. Many teachers work out a secret signal--a touch on the shoulder, for example--that serves as a reminder to the child to get back on task without causing him embarrassment. Effective teachers have the children run errands (to let them get up and move around), help break up the work into smaller blocks, and coach them in study skills and ways to organize their notebooks. Some teachers send home a daily behavior report card so that parents can reward good efforts with special privileges at home. See the handout for teachers, Suggestions for Classroom Teachers, for more details. Behavior therapy Behavior therapy means setting up a system of rewards and mild punishments that can gradually help your child change his usual behaviors. The therapist works with you to make a plan, and once you've carried the plan out, to revise it so that it works better. The plan lays out the specific behaviors you want to change and the exact steps you need to take. For example, you might decide that you want your child to learn how to wait quietly while you are on the telephone. The plan would tell you how to go about rewarding your child for waiting longer and longer periods of time, then gradually removing the rewards so that your child learns to manage without them. Often a behavior therapist will work with a family for just a few sessions. After that, many parents can keep using the techniques on their own. Medications The question of medication for ADHD is difficult. It is hard to think about putting your child on a drug that he might have to take for many years. The press regularly runs stories about how ADHD medication is overprescribed, the risks of side effects or addiction, and the moral questions about medicating to control behavior. But there are risks in leaving ADHD untreated, too. Without treatment, children with ADHD often get so much negative feedback from teachers, parents, and peers that they come to believe that they are bad or stupid. The risk of underachievement or dropping out of school, and all of the negative things that go with that, is very high. Finally, there is a lot of research to show that medication is one of the most powerful tools we have to help children with ADHD. For many children, the other, nonmedical approaches work much better if they are combined with medication. The next article goes more in depth about medications and other treatments for ADHD.
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