What Are Medical Guidelines for ADHD Treatment?

According to the American Association of Pediatrics, the American Psychiatric Association, and other professional medical institutions, best practice treatment plans recommend support and training for parents of young children, including parent training for kids of all ages. This 2019 NPR story covers recommended guidelines quite succinctly.

According to the CDC, “Behavior therapy, given by parents and with the support of healthcare providers, teaches children to better control their own behavior, leading to improved functioning at school, home and in relationships.” The CDC explains that when parents learn and practice behavior therapy, it “requires time and effort, but it has lasting benefits for the child.”

Specific treatment guidelines for healthcare providers like pediatricians and family physicians, published by the American Academy of Pediatrics (AAP), are summarized based on the age of the child or teen (CDC.org):

Under Age 6

• Behavior Therapy (parent and/or teacher administered) as the first line of treatment. Medication to treat ADHD may be provided if the Behavior Therapy does not provide significant improvement.
• “Behavior therapy is effective treatment for attention-deficit/hyperactivity disorder (ADHD) that can improve a child’s behavior, self-control, and self-esteem. It is most effective in young children when it is delivered by parents. Experts recommend that doctors refer parents of children under 6 years old for training in behavior therapy before prescribing ADHD medicine. When parents become trained in behavior therapy, they learn skills and strategies to help their child with ADHD succeed at school, at home, and in relationships.

Age 6 – 11

Medication and/or Behavior Therapy (parent and/or teacher administered), although preferably both medication and Behavior Therapy should be used together. In addition, the school environment, program, or placement (which includes school-based accommodations and modifications) is a part of any treatment plan.

Age 12 – 18

Medication for ADHD with the assent of the adolescent, and Behavior Therapy, although preferably both medication and Behavior Therapy should be used together.

What is The Purpose of Behavior Therapy?

No matter how you define “Behavior Therapy,” its purpose is clear: to create environments in a child’s life so that the child can “learn or strengthen positive behaviors and eliminate unwanted or problem behaviors.” (CDC). Since children with ADHD struggle with the ability to pay attention, and their disruptive behaviors often cause challenges in relationships, training in Behavior Therapy teaches parents and teachers methods for improving challenging or disruptive behaviors.

According to HealthyChildren.org, “Behavior therapy recognizes the limits that having ADHD puts on a child. It focuses on how the important people and places in the child’s life can adapt to encourage good behavior and discourage unwanted behavior. It is different from play therapy or other therapies that focus mainly on the child and his emotions.”

Whether done in classes, groups or private sessions, parent training in Behavior Therapy should help parents learn how to adapt, to “better understand their child’s behavioral issues and learn parenting skills specific to these problems” (CDC), including:

• How their child’s challenges manifest in reality
• Positive communication skills
• Ways to strengthen their child’s positive behaviors
• Strategies for minimizing unwanted or problem behaviors
• Skills and strategies to develop effective structures
• Positive ways to interact with their child
• How to set realistic expectations for their child
• Strategies to help their kids improve control of their behavior
• Specific activities they can practice with their child
• How to use rewards and consequences appropriately
• A format for adjusting strategies as needed

Practical Example: Homework

According to Brittany Merrill, a researcher at the Center for Children and Families at Florida International University in Miami, “Behavioral interventions are more effective than long-acting stimulant medications in improving homework performance among children with ADHD.” She continues, “stimulant medication did not add to the effectiveness of the behavioral intervention.”

A Reuters article titled “ADHD Drugs No Help with Homework” states of Merrill’s research, “Medication had no significant effects on homework completion or accuracy, compared with a placebo, researchers report in the Journal of Consulting and Clinical Psychology. But with behavioral treatment, children got 10 percent to 13 percent more homework problems finished and completed 8 percent more problems accurately than they did without the treatment.”

Who Delivers Behavior Therapy?

Who can a parent turn to for reality-based support, especially when their doctors often do not know how or where to direct parents?

The answer varies depending on the community. A wide range of professionals can offer behavior therapy, as long as it fulfills certain criteria. Most professionals provide training for parents, though some are specifically trained to provide behavior therapy directly to children, as well.

At Impact, we provide online behavior therapy training for parents and teachers, and we have trained and certified dozens of professionals – including coaches, therapists, psychologists, nurses, teachers, organizers, special educators and more — to deliver our training program in local communities around the world.

How is Behavior Therapy Provided?

A growing need for qualified providers, coupled with advances in technology and the evidence of coaching as an effective treatment for ADHD, has led to innovations and expansion in service delivery.

Recent research has confirmed that independently developed programs are every bit as effective as university-based programs, as long as they include the following basic criteria.

• Well-trained providers should guide parents in at least the following most basic requirements of Behavior Therapy (although most providers offer significantly more) (CDC):
  • Strengthen the relationship with their child through positive communication
  • Reinforce good behavior
  • Create structure and provide consistent discipline

At ImpactParents we offer behavior therapy classes for parents either online or in person. Not only are they recommended treatment for ADHD, but they are effective for kids with a wide range of challenges, including anxiety and LD. For more information, visit Sanity School.