8 behavioral treatment ideas for your child with ADHD
Try these options before jumping to medication
If you haven’t ready my post on diagnosing ADHD, you can find it here:
Your child is showing signs of or has been diagnosed with ADHD. What do you do next?
The first line of treatment for children with ADHD are behavioral options. I never ask (or let) a family jump first to medication if they haven't first tried some of the techniques I’m going to describe below.
What are the goals of treatment?
1. Improved interaction with parents, teacher, classmates and siblings
2. Improved grades
In my opinion, the goals are simple and should be taken in that order. It is important to consider these goals and re-evaluate them frequently during the treatment course. Perfection should not be the goal.
I recommend these behavioral techniques before medication for all children, especially those who are young or who have milder ADHD:
1. Make a schedule daily. All kids have difficulty and waste time with transitions. Children with ADHD do this to the 1000th degree. If these transitions are scheduled and the child knows what comes next it might speed up the transition. Things that should be included on the schedule are homework time, daily chores and self-care items (shower, brushing teeth, etc).
2. Make separate areas in the house for necessary tasks. Keep toys and video games out of the space where homework needs to be completed. This helps limit the child’s distractions so that they can finish the task at hand.
3. Set small goals that are attainable. Don’t ask the child who is failing to make the A honor roll in the next six weeks. Start with turning all assignments in and that they are complete, then slight increases in grades, etc.
4. Use charts and checklists. Children with ADHD are often very visual and concrete. If you can put a list in front of them that can be checked off, they are much more likely to complete what needs to be done. I find this to be helpful for me as well ...
5. Keep choices to a minimum. Don’t tell them to go to the closet in the morning and pick out something to wear. This is a sure way to start a huge fight as they stand in front of the closet for hours while you are trying to wrestle them out the door. Pick out two options ahead of time for them to choose from.
6. Don’t discipline them impulsively. Remember that one of their biggest problems is that they don’t stop to think about consequences before they act. If your discipline follows the same pattern, how can we expect them to learn to act differently? Plan out your discipline plan in advance and be consistent. As tempting as it may be, corporal punishment is rarely effective. I’m not going to get into a spank your child or not debate here, but timeouts and restriction of privileges seem to be more effective for children with ADHD.
7. Help your child with organizational skills. Developing a system that helps them keep track of all the papers is a way to keep them from getting thrown away, having them sit in the floorboard of the car or (more infamously) avoiding having the dog eat them. If you need some help establishing this system, check out this amazing book called That Crumpled Paper Was Due Last Week.
8. Get help. Raising a child with ADHD can be very frustrating and quite exhausting. There will be lots of times when you will feel like there is nothing left to do to help. If your child continues to struggle, talk with your pediatrician about options for treatment, including medication options. Find a family counselor that can work with your child but, maybe even more importantly, that can help you develop a plan for your child and help you cope with the struggles you will face.
I hope that you find these tips helpful as you begin to think about how you can help your child with ADHD.
As you walk through the process keep in mind that your goal should be function, not perfection.
About the author
Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.