For the 6.4 million American children with Attention Deficit Hyperactivity Disorder (ADHD), personalized treatment offers not only relief but the opportunity to live life to its fullest. Symptoms of ADHD often manifest at around age seven and include difficulty focusing, restlessness, disorganization, and irritability. These symptoms may cause children with undiagnosed ADHD to engage in behaviors that earn them the misnomer “troublemakers.” If the condition is left untreated, such habits can continue into adulthood.
Treatment for ADHD generally occurs in two forms: medication therapy and behavioral modification. Medication works to regulate brain irregularities, while behavior therapy aims to replace bad behavioral habits with positive alternatives. Neither is mutually exclusive. In fact, according to a study of multimodal treatment by the National Institute of Mental Health, a combined regimen may be ideal. However, many parents feel uncomfortable medicating their children at a young age. There are also instances where children react poorly to medication or experience harmful side effects.
Whether it is applied in tandem with medication, or as a primary treatment option for children whose parents prefer non-chemical intervention, the benefits of behavioral therapy can be massive. An equally colossal amount of hard work is required, however, for such techniques to actually change children’s lives for the better. Parents must be willing to fundamentally redefine their interactions with children, and remain unwavering over time. Patience is a necessity, as behavioral improvements are often slow to appear, and may not be apparent for weeks or months.
At its core, behavior therapy involves setting clear expectations for children using reinforcement techniques: positive actions are praised, while undesirable actions are discouraged. Because of its inherent simplicity, children who receive maximum benefits from behavioral therapy often begin at a young age. According to William Pelham, Ph.D., director of the Center for Children and Families at the State University of New York, studies show that the average child with untreated ADHD can have as many as half a million negative interactions every year with peers, parents, and teachers. Without correction via behavior therapy, these negative interactions may continue to accumulate, increase the likelihood of mental illnesses such as oppositional defiant disorder, anxiety, and low-self esteem.
James Swanson, Ph.D., pediatrics professor at the University of California, Irvine, states that any effective behavioral therapy involves the following principles:
- A reward system that awards special privileges for good behavior
- Discouraging bad behavior by ignoring it
- Revoking privileges if bad behavior escalates to unignorable levels
- Separating the child from common triggers of bad behavior
Many behavior programs span three areas of focus: parent training, social skills instruction for children, and classroom strategies. Parent training, for example, might concentrate on setting house rules and determining chores and responsibilities, while group activities that involve children working together to solve problems may constitute social skills learning. Classroom training usually incorporates collaboration between a teacher and a behavioral therapist to create effective learning strategies.
Approaches to behavioral therapy vary and are generally tailored to suit individual cases. What unites all behavioral strategies is what they require from parents and children alike: a commitment to maintaining an environment of positive consistency. If behavior therapy is successful, parents have a strong chance of imparting in young children the resilience and self-esteem needed to successfully manage a lifetime of ADHD, even without medication.