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ADHD—What is Behavioral Therapy?

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There are specific ways you can help your child with attention deficit/hyperactivity disorder (ADHD) succeed. Read on for information from the American Academy of Pediatrics about behavioral therapy for a child with ADHD.

About Behavioral Therapy

Most experts recommend using both behavioral therapy and medication to treat ADHD depending on the age of the child. This is known as a multimodal treatment approach.

There are many forms of behavioral therapy, but all have a common goal—to change the child’s physical and social environments to help him improve his attention and activity.

Behavioral therapy has 3 basic principles.

  • Set specific, doable goals. Set clear and reasonable goals for your child, such as staying focused on homework for a certain amount of time or sharing toys with friends.

  • Provide rewards and consequences. Give your child a specified reward (positive reinforcement) every time he demonstrates the desired behavior. Give your child a consequence (unwanted result or punishment) consistently when he exhibits inappropriate behaviors. Sometimes when you start using a punishment, the behavior may first increase before it starts to decrease and disappear.

  • Keep using the rewards and consequences. Using the rewards and consequences consistently for a long time will shape your child’s behavior in a positive way.

Under this approach, parents, teachers, and other caregivers learn better ways to work with and relate to a child with ADHD. You will learn how to set and enforce rules, help your child understand what he needs to do, use discipline effectively, and encourage desired behavior. Your child will learn better ways to control his behavior as a result. You will learn how to be more consistent.

Table 1 shows specific behavioral therapy techniques that can be effective with children who have ADHD.

Table 1. Behavioral Therapy Techniques

Technique Description Example
Positive reinforcement Complimenting the child and providing rewards or privileges in response to a desired behavior The child completes an assignment and is permitted to play on the computer.
Time-out Removing access to a desired activity because of unwanted behavior The child hits a sibling and, as a result, must sit for 5 minutes in the corner of the room.
Response cost Withdrawing rewards or privileges because of unwanted behavior The child loses free-time privileges for not completing homework.
Token economy Combining reward and consequence. The child earns rewards and privileges when exhibiting desired behaviors. He loses rewards and privileges for unwanted behaviors. The child earns stars or points for completing assignments and loses stars for getting out of his seat. He cashes in the sum of his stars or points at the end of the week for a prize.

Behavioral therapy is designed to help families recognize the limits that having ADHD puts onto a child. It focuses on how the important people and places in the child’s life can adapt to encourage desired behavior and discourage unwanted behavior. It is different from play therapy or other therapies that focus mainly on the child and his emotions.

How can I help my child improve his attention and activity?

As their child’s primary caregivers, parents play a major role in behavioral therapy. Parent training is available to help you learn more about ADHD and specific, positive ways to respond to ADHD-type behaviors. This will help your child improve. In many cases, attending parenting classes with other parents will be sufficient, but with children who have more challenging behaviors, individual work with a counselor or coach may be needed.

Taking care of yourself will also help your child. Being the parent of a child with ADHD can be challenging. It can test the limits of even the best parents. Parent training and support groups made up of other families with children who have ADHD can be a great source of help. Learn stress management techniques to help you respond calmly to your child. Seek counseling if you feel overwhelmed or hopeless.

Ask your child’s doctor to help you find parent training, counseling, and support groups in your community.

What you can do

  • Keep your child on a daily schedule. Try to keep the times that your child wakes up, eats, bathes, leaves for school, and goes to sleep the same each day.

  • Cut down on distractions. Loud music, computer games, and TV can be overstimulating to your child. Make it a rule to keep the TV or music turned off during mealtime and while your child is doing homework. Don’t place a TV into your child’s bedroom. Whenever possible, avoid taking your child to places that may be too stimulating, such as busy shopping malls.

  • Organize your house. If your child has specific and logical places to keep his schoolwork, toys, and clothes, he is less likely to lose them. Save a spot near the front door for his school backpack so that he can grab it on the way out the door.

  • Reward desired behavior. Offer kind words, hugs, or small prizes for reaching goals in a timely manner or for desired behavior. Praise and reward your child’s efforts to pay attention.

  • Set small, reachable goals. Aim for slow progress rather than instant results. Be sure that your child understands that he can take small steps. Help your child stay “on task.” Use charts and checklists to track progress with homework or chores. Keep instructions brief. Offer frequent, friendly reminders.

  • Limit choices. Help your child learn to make good decisions by giving him only 2 or 3 options at a time.

  • Find activities at which your child can succeed. All children need to experience success to feel good about themselves.

  • Use calm discipline. Use consequences such as time-out, removing your child from the situation, or distraction. Sometimes it is best to simply ignore the behavior. Physical punishment, such as spanking or slapping, is not helpful. Discuss your child’s behavior with him when both of you are calm.

  • Reach out to teachers. Develop a good communication system with your child’s teachers so that you can coordinate your efforts and monitor his progress.

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Adapted from the American Academy of Pediatrics patient education booklet, Understanding ADHD: Information for Parents About Attention-Deficit/Hyperactivity Disorder. Information applies to all sexes and genders; however, for easier reading, pronouns such as she are used in this publication. The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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