ADHD Treatment Options 101

pills-copyWe’ve all heard the horror stories…someone who knows someone put their child with ADHD on medication and the child turned into a zombie. Or maybe they cut gluten out of the child’s diet and the ADHD was “cured.” Between the tales we hear first/second/third-hand and the information pushed by Big Pharma, it’s hard to know how to go about helping your child with ADHD. As a learning specialist who is in the trenches with children with ADHD, I can share the basics of ADHD treatment broken into two main categories: non-mediation and medication.

  • Non-medication
    • Behavioral Therapy – Aside from medication, behavioral therapy is the most commonly-used approach for helping children with ADHD. The goal of behavioral therapy is to help the child identify and change their behavior that causes problems at school, with peers/friends, and at home with family members. Together with a therapist, the child learns strategies for solving specific problems; this type of therapy has both a social and a psychological angle. Behavioral therapy providers include psychologists, social workers and family therapists who specialize in treating children with ADHD.
    • Occupational Therapy – An occupational therapist who specializes in working with children with ADHD can help a child develop strategies for self-awareness, organization, regulating energy level, taking appropriate movement breaks and developing routines for everyday tasks.
    • Speech Therapy – While speech therapy often focuses on articulation issues, children with ADHD can benefit from working with a Speech Language Pathologist by focusing on pragmatic, or social, language. In other words, children can learn how to more effectively communicate with adults and peers. How is this helpful for children with ADHD? Many children with ADHD experience problems with friendships and getting along with their classmates. Working on pragmatic skills with a SLP can help a child slow down, understand what others are saying and respond appropriately and thoughtfully.
    • Academic Therapy – Many children find it helpful to work with a learning specialist or educational therapist in order to introduce, reinforce and review the academic skills and strategies taught in school. A tutor can also help a child learn strategies for studying efficiently, staying organized and managing long-term projects. Like the other forms of therapy, academic support ultimately aims at helping the child understand himself and develop the skills needed to eventually help himself independently.
  • Medication

Medication can be a controversial issue! While medication can help many children with ADHD, the dramatic increase in its use — and misuse — have been discussed widely in recent years. Also, in my opinion, many children are started on a prescription and dosage and then not monitored appropriately. Finding the most appropriate medication and dosage is an art and a science. Finding a clinical psychologist who specializes in ADHD is your best bet if you wish to go this route. I have seen dozens of students over the years who have been given a prescription by a pediatrician/family/general doctor and the dosage is haphazardly prescribed and monitored.

Yikes, y’all. No wonder ADHD meds have such a bad reputation! This careless approach can lead to more harm than good. Medication and dosage should be explored systematically, and with constant feedback from parents, caregivers and teachers.

Medications fall into two categories:

  • Stimulants – Stimulant medications, such as Adderall , have been found to be effective in treating the symptoms of ADHD in many children. Prescribing a stimulant to an energetic child seems counter-intuitive, right? Many people wonder children with excess energy are given stimulants to treat ADHD. Basically, children and adults react differently to stimulants. When the optimal dosage is found, stimulant medications can stimulate a child’s brain in ways that promote their ability to inhibit impulses and focus. Stimulants can be short-acting (lasting 4-6 hours), intermediate-acting (6-8 hours) or long-acting (10-12 hours.)
  • Non-stimulants – Strattera is currently the most-used non-stimulant medication approved for use in children with ADHD. Like other medications in its class (nonepinephrine reuptake inhibitor), Strattera increases norepinephrine activity in the brain. Non-stimulants are long-acting medications.

With all of these choices, how do you decide what is best for your child?

Medications may have side-effects for children; use of ADHD medications can be a complex, personal decision to be explored with a specialist. Research supports the use of multiple types of treatment, such as using therapies and medication coordinated by a physician who specializes in treating children with ADHD. Each mode of treatment should work in conjunction with the other(s) in order to best help the child. As with many parenting challenges, helping your child with ADHD requires multiple, coordinated efforts and a flexible mindset in order to try several approach over time in order to find the combination of treatment that works best for your child. As parents, we often have “gut feelings” about issues related to our child. We also are very attuned to our child’s subtle cues, like facial expressions and body language. Our parental intuition often provides fantastic guidance. Your child’s happiness and quality of life will provide much of the feedback regarding what is working.

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