What alternative ADHD treatments work to combat attention deficit disorder?
It's a question more parents are asking doctors after a study, funded by the National Institute of Mental Health , found that the best outcomes — measured by parental satisfaction and some academic standards — were the result of "combination" treatment: ADHD medications that reduce hyperactivity and improve concentration, along with behavior therapy to address some of the more subtle symptoms, such as difficulty with organizational and social skills.
While other non-drug treatments — play therapy, cognitive therapy, psychotherapy, and special ADHD diets — have been regarded as promising, only behavioral treatment has been shown to work.
Although ADHD specialists say they consider behavior therapy a key component of effective ADHD treatment and one that has inspired a recent resurgence of interest, few parents actually invest the necessary time and effort.
“There’s so much lip service paid to (combined) treatments, but a lot of people just rely on medication alone,’’ says William L. Coleman, M.D., a developmental pediatrician at the University of North Carolina, who is chairman of the American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health. “We are a quick-fix society and we want results. There’s a lot of time pressure on parents and on teachers."
How behavior therapy works
A behavior therapy regimen can be developed by a pediatrician or a school psychologist or another mental-health worker. Based on a structured system of rewards and consequences — such as increased or decreased TV privileges — the program also includes changes in a child’s environment to minimize distractions. Parents also receive training in giving commands and reacting when a child obeys or disobeys.
The goal is to incrementally teach children new ways of behaving by rewarding desired behavior, such as following directions, and eliminating undesired actions, such as losing homework , notes Ginny Teer, a spokeswoman for Children and Adults with Attention Deficit/Hyperactivity Disorder (CHAAD), a national advocacy group in Landover, Maryland.
Parents often "have an inappropriate expectation of what medications can do," observed pediatrician Patricia Quinn, M.D., who has specialized in treating AD/HD in Washington, D.C., for more than 25 years. “Drugs don’t improve self-esteem, time management, or organizational skills. But the problem is that most parents don’t have enough time or energy" for behavior therapy or are inconsistent about applying it. Sometimes, Quinn says, they complicate the regimen with too many rules. The trick, Quinn says, is to keep things simple. Experiencing success reinforces the desired behavior.