Once you, your child, and the treatment team have identified the target outcomes you hope to achieve, it is time to create a treatment plan to address those goals. With the help of the professionals on your treatment team, you will need to educate yourself on the various treatments that are available and what effects and limitations each is likely to have. As you begin to make decisions regarding treatment, keep in mind a central fact about treatment for ADHD: Nothing is written in stone. Because ADHD symptoms tend to change over time, your child may have different target outcomes at different stages of life and require different types of treatment. (What worked well during third grade may not work for fourth grade.) Because individual children respond to different therapies in a variety of ways, it may take several tries before you find a treatment program that works well. For all of these reasons, your child’s treatment plan will consist of an ongoing process of treatment decisions, observation, review and, in most cases, treatment revision.
Choosing One or More Types of Treatment
In the years since ADHD symptoms were first described, a variety of treatment approaches have been tried and tested for their effectiveness. Only 2 of these approaches—use of medication and behavior therapies (a set of systematic, consistent techniques that parents and teachers can use to help a child better manage his behavior)—have been shown in well done studies to have consistent positive effects. The key is to find a balance between medication and behavior therapies—using the medication recommended by your pediatrician, as well as relying on behavioral management techniques that will help address behaviors such as tantrums and oppositional behavior. These approaches are often most effective when used in combination.
Medical professionals and other experts have also studied traditional psychotherapy, special diets, nutritional supplements, biofeedback, allergy treatments, vision training, sensory integration therapy, chiropractic, and many other methods. Most of these approaches have either not been studied adequately enough to be recommended or have been shown to have minimal or no long-term effect. The following table summarizes the most proven treatments for ADHD and accompanying problems
The Evidence Shows
|
ADHD as a chronic condition |
-
Education for parents and treament
-
A team approach among all of the child’s caregivers, including parents and pediatricians (the kind provided in the medical home concept)
-
Empowerment of children and adolescents to "own" and help carry out their own treatment plan
-
Careful setting and monitoring of treatment targets, goals and plans |
|
Core symptoms of ADHD (inattention, impulsivity, hyperactivity) |
-
Stimulant medication (first-line treatment)
-
Proven behavior therapies
-
Atomoxetine, or bupropion (second-line treatment)
-
Individualized Education Program (IEP) based on Section 504 of the Rehabilitation Act or Individuals with Disabilities Education Act legislation |
|
Oppositional and defiant behavior and serious conduct problems |
-
Behavior monification and management techniques
-
Medication management if appropriate
-
IEP based on behavioral needs that cannot be met in the context of a regular classroom |
|
Depression, anxiety, and problems with self-control and anger management |
|
|
Significant difficulties in family functioning |
|
|
Underachievement and learning and language disorders |
|
