ADD/ADHD TECHNIQUES
Although there is no cure for ADHD, treatment can help control symptoms. There are several types of treatments available. Stimulant medications have been used to successfully treat ADHD symptoms for many years. Stimulants are used to treat both moderate and severe ADHD in adults and children over age six. Stimulants used to treat ADHD include:
- Adderall and Adderall XR
- Concerta
- Cyclert
- Dexedrine, Dexedrine Spansules Capsules
- Focalin
- Metadate CD, Metadate ER
- Methylin
- Ritalin, Ritalin LA
- Strattera is the first nonstimulant treatment for ADHD. It is the first treatment approved to control ADHD symptoms in children, adolescents and adults.
Several types of antidepressant medications can be used to treat ADHD. Antidepressant therapy for ADHD is sometimes used as the initial treatment in children or adults who also suffer from significant depression. Antidepressants, however, are generally not as effective as stimulants or the newer nonstimulant treatments at improving attention span and concentration. It also may take two to four weeks for the full benefits of antidepressants to appear. Antidepressant medications may increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Two other medications, Catapres and guanfacine, normally taken to treat high blood pressure, have been shown to be of some benefit for ADHD when used alone or in combination with stimulant drugs. The drugs can improve mental functioning as well as behavior in ADHD.
Learning behavior management techniques is considered to be an essential part of any successful ADHD treatment program. Most experts agree that combining medication treatments with extended behavior management is the most effective way to manage ADHD in children and adolescents. A multi-modality approach to treatment of the disorder aimed at assisting the child medically, psychologically, educationally and behaviorally is often most effective. This requires the coordinated efforts of a team of health care professionals, educators and parents who work together to identify treatment goals, design and implement interventions, and evaluate the results of their efforts.
Ideally, treatment should also include consideration of the individual's psychological adjustment targeting problems involving self-esteem, anxiety, and difficulties with family and peer interaction. Frequently family therapy is useful along with behavioral and cognitive interventions to improve behavior, attention span, and social skills. Educational interventions such as accommodations made within the regular education classroom, compensatory educational instruction, or placement in special education may be required depending upon the particular child's needs.
Students with ADHD may have more difficulty with spelling. They may not pay attention to detail when writing or may be careless. This can cause spelling errors. Some students may have weaknesses in auditory or visual memory which can also contribute to problems with spelling. Teach a phonetic approach to word analysis. Although many words are not spelled as they sound, a good understanding of phonics can be a powerful aid to weak spellers.
Students with ADHD often have difficulty with fine-motor control. This can affect their handwriting. For some, written work becomes so laborious they avoid it. Writing assignments that may take other students a few minutes, may take the student with fine-motor problems hours to complete. Encourage the student to use a sharp pencil and have an eraser available. Teach appropriate posture and how to position the paper correctly. Experiment with pencil grip, special papers, etc. Allow student to use laminated handwriting cards, containing samples of properly formed letters.
Over half of children with ADHD present challenging behavior which must be managed by parents or teachers. Behavior modification principles involving systematic delivery of reinforcements and punishments work pretty well. Parents and teachers who are structured, consistent, provide close supervision and feedback about behavior to children and teens with ADHD get the best results. Instruction in such strategies can be obtained through parent training groups offered in school districts or community clinics or practices. The following suggestions apply to parents and teachers:
- Post house/school rules in a conspicuous place. Clearly communicated rules are helpful in maintaining proper behavior. Children with ADHD may need such rules to be reviewed daily. When possible, consequences for rule violations should be specified.
- Be alert to early warning signs of a problem. Anticipate trouble brewing. Intervene quickly before a situation becomes problematic.
- Provide concrete, visual examples of appropriate and inappropriate behavior. Use role-playing to illustrate these behaviors giving students clear guidelines as to teacher expectations.
- Establish routines for regular family or classroom activities (i.e. at home; cleaning room, doing homework, morning and bedtime tasks; at school; handing out and collecting papers in class, entering and leaving the room, taking attendance, answering questions, etc.)
- Use proximity controlĀ to manage problem behavior. Stay near the child who is acting out so you can provide immediate, frequent praise for appropriate behavior and quickly intervene when/if negative behavior occurs.
- Redirect the acting out child to more appropriate behavior when you notice inappropriate behavior (i.e., a student who is talking to another student could be redirected to get on task).
- Praise positive behavior often Positive reinforcement is an effective way to motivate children to behave appropriately. Use of verbal praise can be extremely effective.
Seven Principles for Parents of ADHD Children and Teens
- Provide unconditional love and positive regard.
- Spend enjoyable time with your child. Become an AD/HD expert.
- Model good values.
- Provide structure at home with clear and consistent rules.
- Monitor compliance with rules and check behavior regularly.
- Inspire confidence as a parent-coach.
