Treatment for Children with ADHD

What are your ADHD treatment options?

Treatment for attention deficit hyperactivity disorder (ADHD or ADD) isn’t just about taking medication. There are many other effective treatments that can help kids with ADHD improve their ability to pay attention, control impulsive behavior, and curb hyperactivity.

Nutritious meals, play and exercise, learning new coping skills, and improving social skills are all part of a balanced treatment plan that can improve your child’s performance at school, bolster their relationships with others, and decrease stress and frustration—for them and for your whole family.

ADHD medication

Stimulants such as Ritalin and Adderall are often prescribed for ADHD, but they might not be the best option for your child—and they're certainly not the only treatment.

Medications for ADHD may help your child concentrate better or sit still, at least in the short term. But to date, there is little evidence that they improve school achievement, relationships, or behavioral issues over the long term. And even in the short term, medication won't solve all problems or completely eliminate the symptoms of ADHD.

Furthermore, there are concerns about the effects these powerful drugs may have on a child's developing brain. And the side effects—such as irritability, loss of appetite, and insomnia—can also be problematic.

The bottom line: medication is a tool, not a cure.

Everyone responds differently to ADHD medication. Some children experience dramatic improvement while others experience little to no relief. The side effects also differ from child to child and, for some, they far outweigh the benefits. Because everyone responds differently, finding the right medication and dose takes time.

Medication for ADHD is more effective when combined with other treatments. Your child will get much more out of your medication if they are also taking advantage of other treatments that teach new coping skills.

ADHD medication should always be closely monitored. Medication treatment for ADHD involves more than just taking a pill and forgetting about it. Your child’s doctor will need to monitor side effects, keep tabs on how your child is feeling, and adjust the dosage accordingly. When medication for ADHD is not carefully monitored, it is less effective and more risky.

If you choose to put your child on medication, that doesn’t mean they have to stay on it forever. Although it isn’t safe to bounce off and on any drug repeatedly, you can safely decide to stop treating your child’s ADHD with medication if things aren’t going well. If you want your child to stop taking medication, be sure to let your doctor know your plans and work with them to taper off the drugs slowly.

ADHD treatment starts at home

As a parent, you have a huge influence over your child's treatment. Evidence shows that eating a healthy diet, getting plenty of exercise, and making other smart daily choices can help your child manage the symptoms of ADHD. That means your child can begin treatment for ADHD today—at home.

The power of exercise in the treatment of ADHD

Exercising is one of the easiest and most effective ways to reduce the symptoms of ADHD. Physical activity immediately boosts the brain's dopamine, norepinephrine, and serotonin levels—all of which affect focus and attention. In this way, exercise and medications for ADHD such as Ritalin and Adderall work similarly. But unlike ADHD medication, exercise doesn't require a prescription and it's free of side effects.

Activities that require close attention to body movements, such as dance, gymnastics, martial arts, and skateboarding, are particularly good for kids with ADHD. Team sports are also a good choice. The social element keeps them interesting.

The benefits of “green time”

Studies show that spending time in nature can reduce the symptoms of ADHD in children. Encourage your child to play outside for at least 30 minutes each day, if possible.

The importance of sleep in ADHD treatment

Regular quality sleep can lead to vast improvement in the symptoms of ADHD. However, many kids with ADHD have problems getting to sleep at night. Sometimes, these sleep difficulties are due to stimulant medications, and decreasing the dose or stopping the medication entirely will solve the problem.

However, a large percentage of children with ADHD who are not taking stimulants also have sleep difficulties. If your child is one of them, the following tips can help.

• Set a regular bedtime (and enforce it).
• If background noise keeps your child up, try a sound machine or a fan.
• Turn off all electronics (TV, computer, video games, iPhone) at least an hour before bed.
• Limit physical activity in the evening.

Good nutrition can help reduce ADHD symptoms

Studies show that what, and when, you eat makes a difference when it comes to managing ADHD.

Schedule regular meals or snacks no more than three hours apart. This will help keep your child's blood sugar steady, minimizing irritability and supporting concentration and focus.

Try to include a little protein and complex carbohydrates at each meal or snack. These foods will help your child feel more alert while decreasing hyperactivity.

Check your child's zinc, iron, and magnesium levels. Many children with ADHD are low in these important minerals. Boosting their levels may help control ADHD symptoms. Increasing iron may be particularly helpful. One study found that an iron supplement improved symptoms almost as much as taking stimulant medication.

Add more omega-3 fatty acids to your child's diet. Studies show that omega-3s reduce hyperactivity and impulsivity and enhance concentration in kids (and adults) with ADHD. Omega-3s are found in salmon, tuna, sardines, and some fortified eggs and milk products. However, the easiest way to boost your child's intake is through fish oil supplements.

Professional treatment for ADHD

Although there are many ways you can help a child with ADHD at home, you may want to seek professional help along the way. ADHD specialists can help you develop an effective treatment plan for your child. Since ADHD responds best to a combination of treatments and strategies, consulting several specialists is advisable.

To find ADHD treatment providers, you may want to contact your primary care physician, your child's pediatrician, local hospitals, or clinics. Other sources for provider references include your insurance company, officials at your child's school, or a local parent support group.

Child and adolescent psychiatrists:

• Diagnose ADHD and prescribe medications

Psychologists:

• Diagnose ADHD and provide talk therapy
• Help people with ADHD explore their feelings

Cognitive-behavioral therapists:

• Set up behavioral modification programs at school, work, and home
• Establish concrete goals for behavior and achievement
• Help families and teachers maintain rewards and consequences

Educational specialists:

• Teach techniques for succeeding in school
• Help children obtain accomodations from school
• Advise families about assistive technology

Behavioral therapy for ADHD

Behavioral therapy, also known as behavior modification, has been shown to be a very successful treatment for children with ADHD. It is especially beneficial as a co-treatment for children who take stimulant medications and may even allow you to reduce the dosage of the medication.

Behavior therapy involves reinforcing desired behaviors through rewards and praise and decreasing problem behaviors by setting limits and consequences. For example, one intervention might be that a teacher rewards a child who has ADHD for taking small steps toward raising a hand before talking in class, even if the child still blurts out a comment. The theory is that rewarding the struggle toward change encourages the full new behavior.

Behavior therapy for ADHD in children

According to the American Academy of Pediatrics, there are three basic principles to any behavior therapy approach:

1. Set specific goals. Set clear goals for your child such as staying focused on homework for a certain time or sharing toys with friends.
2. Provide rewards and consequences. Give your child a specified reward (positive reinforcement) when he or she shows the desired behavior. Give your child a consequence (unwanted result or punishment) when he or she fails to meet a goal.
3. Keep using the rewards and consequences. Using the rewards and consequences consistently for a long time will shape your child's behavior in a positive way.

As parents, you can set up a customized behavioral modification program for your child who has ADHD with the help of a behavioral specialist such as a cognitive-behavioral therapist. A cognitive-behavioral therapist focuses on practical solutions to everyday issues. This kind of therapist can set up a behavioral modification program of rewards and consequences for your child at home and at school and support you in shaping your child's behavior.

Patience is key with behavioral therapy, since people with ADHD are notoriously variable in their symptoms. One day, your child may behave beautifully, and the next, fall back into old patterns. Sometimes it may seem as if the training is not working. However, over time, behavioral treatment does improve the symptoms of ADHD.

Social skills training

Because kids with attention deficit disorder often have difficulty with simple social interactions and struggle with low self-esteem, another type of treatment that can help is social skills training. Normally conducted in a group setting, social skills training is led by a therapist who demonstrates appropriate behaviors and then has the children practice repeating them. A social skills group teaches children how to “read” others' reactions and how to behave more acceptably. The social skills group should also work on transferring these new skills to the real world.

For a social skills group near you, ask for a referral from your school psychologist or a local mental health clinic.

Tips for supporting your child's ADHD treatment

Children with ADHD often have trouble translating what they've learned from one setting to another. For instance, they may have learned how to control impulsive outbursts at school, but impatiently interrupt others at home.

In order to encourage positive change in all settings, children with ADHD need consistency. It is important that parents of children with ADHD learn how to apply behavioral therapy techniques at home. Children with ADHD are more likely to succeed in completing tasks when the tasks occur in predictable patterns and in predictable places, so that they know what to expect and what they are supposed to do.

Follow a routine. It is important to set a time and a place for everything to help a child with ADHD understand and meet expectations. Establish simple and predictable rituals for meals, homework, play, and bed.

Use clocks and timers. Consider placing clocks throughout the house, with a big one in your child's bedroom. Allow plenty of time for what your child needs to do, such as homework or getting ready in the morning.

Simplify your child's schedule. Avoiding idle time is a good idea, but a child with ADHD may become even more distracted and “wound up” if there are too many after-school activities.

Create a quiet place. Make sure your child has a quiet, private space of his or her own. A porch or bedroom can work well—as long as it's not the same place as the child goes for a time-out.

Set an example for good organization. Set up your home in an organized way. Make sure your child knows that everything has its place. Role-model neatness and organization as much as possible.

The importance of praise

As you establish a consistent structure and routine, keep in mind that children with ADHD often receive criticism. Be on the lookout for good behavior—and praise it. Praise is especially important for children who have ADHD because they typically get so little of it. A smile, positive comment, or other reward from you can improve your child's attention, concentration, and impulse control. Do your best to focus on giving positive praise for appropriate behavior and task completion, while giving as few negative responses as possible to inappropriate behavior or poor task performance. Reward your child for small achievements—these will lead to bigger successes down the road.