Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental conditions. The United States Center for Disease Control has recently indicated that approximately ten percent of the school age population has been diagnosed with ADHD (CDC, 2010).
Typical symptoms that are exhibited in a child with ADHD include:
- a lack of attention to details
- difficulty following instructions
- poor impulse control
- issues with regard to self-regulation
Research On ADHD Treatment:
The National Institute of Mental Health (NIMH) conducted the largest on-going research studies (MTA: Multimodal Treatment of Attention Deficit Hyperactivity Study) examining the efficacy of various treatment modalities for ADHD. This study consisted of over six hundred children who were diagnosed with ADHD.
Each child was assigned randomly to one of four treatment groups:
- intensive medication management alone
- intensive behavioral treatment alone
- a combination of both
- or routine community care which served as a control group
Outcomes Of The ADHD Study:
What the study found was that combination behavioral treatment and medication management were significantly superior to behavioral treatment alone in reducing symptoms of ADHD (Dec 1999, Archives of General Psychiatry). The results also highlighted that these improvements in functioning (with combination behavioral and medication therapy) lasted for upwards of 14 months. A final important finding from the study indicated that combination treatment (behavioral therapy and medication) was superior in treating other areas of daily functioning such as anxiety/depression, academic achievement, social skills, and family interactions in comparison to medication or behavior therapy alone.
ADHD treatment Options:
As the above study indicates, pharmacological intervention is oftentimes the first treatment of choice for a child with a diagnosis of ADHD. However, medication alone is not the only solution as was evident in the study. Behavior therapy, which focuses on teaching children appropriate self regulation skills by modifying the environment so that appropriate on-task behaviors are reinforced while negative, off-task behaviors are extinguished, is a vital component of a treatment plan. Many times parents do not want to go with medication as a primary treatment and would rather try behavioral therapy or working with a social worker to help develop socialization skills.
Many children with ADHD exhibit issues with their daily social functioning. It is important to realize that these social deficits are not because of a lack of inherent social skills but because of the impact that issues with attention to the social world and impulsivity have on their daily social interactions. The focus of the intervention then needs to be on how to change the child’s daily environment so that he or she is set up for success. Many times this will include modifications in the classroom setting to help improve on-task behaviors and self regulation. Another intervention that is often needed for a child with a diagnosis of ADHD is parent and teacher education. It is important to work with parents and teachers so that they can have a better grasp as to why they are observing particular behaviors.
In summary, the empirical research has indicated that a combination of pharmacological intervention and behavioral treatment is the number one intervention for a child with a diagnosis of ADHD. However, there are other options that are less invasive such as behavioral therapy in isolation, parent/teacher education, and/or social work support to help improve daily social interactions.