If you have a child with ADHD, you’ve probably heard terms like behavioral therapy and parent training bandied about as suggestions for ADD treatment, especially with younger kids. The value of behavioral treatments can’t be understated. Young children are generally more sensitive to the side effects of the medications used to treat ADHD, making behavioral therapy the first and best course of action in many cases. And even when kids are old enough for medication, a combination of medication and behavioral therapy has found to be the most successful at reducing the symptoms of ADHD.
Here are the main principles of behavioral approaches to ADD treatment.
First and foremost, the most important element in any behavioral ADD treatment is parent training. Traditional therapies don’t work with young children because they’re not old enough to try to change their behavior on their own. What does work is if the adults who interact with them the most (such as their parents) use proven behavioral modification techniques to encourage positive behaviors and discourage negative behaviors?
Learning how to use this approach isn’t going to happen from reading an article, however. It’s important to work with a professional, not only to ensure you are trained properly in the techniques but also to help you stay on course over the long run. Behavioral training takes time for you, the parent to learn, but it also takes time to produce results even when you do everything right. It’s easy to get frustrated, give up, or even just lose track of your original goals. Meeting with a professional on a regular basis will help you keep your goals in sight.
A major element of behavioral therapy is rewarding the behavior you want with positive reinforcement. Simply put, behaviors that are rewarded tend to become more frequent. ADHD children especially have a hard time controlling their behavior, and to complicate matters they become accustomed to getting yelled at a lot. This can destroy confidence, undermine good behavior, and result in spiraling behavioral problems. Taking a renewed approach based on positive reinforcement, on the other hand, helps kids to understand what behaviors are good and desirable, and encourages them to do those things more often.
The flip side of positive reinforcement is, of course, that negative behaviors must be given consequences. For example, time out is an often used consequence for young ADHD children. Consequences should never be delivered out of anger, though. Think of consequences as a way of reminding your child that certain behaviors are not appropriate or welcomed.
One way that many parents of ADHD children have made rewards and consequences into an effective parenting system is by setting up a “token” system. In a token system, the child is given a way to measure his behavior, usually visually. For instance, he might have a sticker chart with gold stars or a jar full of marbles that are given or taken away. At the end of the day, he can see how he did that day. An alternative is to do a point system, such as a daily report card. In general, for younger kids this should be a daily exercise, starting each morning with a clean slate, so to speak.
Another important element of behavioral therapy as an ADD treatment is the use of clear expectations. Clear, consistent rules will help ADHD kids learn appropriate behaviors more quickly. This means that “no jumping on the bed,” for example, must always be the case. Likewise, parent training will help parents learn to be more clear and concise when they ask for certain behavior. Telling a kid to “be good” doesn’t actually tell them what is expected of them, so telling your child exactly what you want them to do is more likely to get a positive result.
Another element of behavioral therapy is that it recognizes progress by the achievement of small goals. For instance, consider everything a kid has to do in order to get ready in the morning. He has to go to the bathroom, brush his teeth, comb his hair, get dressed, and be downstairs by a certain time. And that’s not even counting making his bed or getting his backpack ready! ADHD kids often have a hard time completing a list of things like this, so it’s important to narrow the focus and pick out one or two things that are most important. Focus on achieving those things consistently before adding more to the list.
Last but not least is consistency, one of the most important elements in successful behavioral therapy. This means that a kid knows the same rules apply everywhere and every time, with the same rewards or consequences. Obviously parents are in charge of most of this, but keeping it consistent across the board means educating teachers, babysitters, other family members, and anyone else who interacts with your child on a regular basis on how you handle behavioral issues.
Raising a child with ADHD is a tough job. Approaches like behavioral therapy take time for a parent to learn, but they are effective because you are the parent, and spend far more time with your child than anyone else. With training and guidance from the professionals, you can help your child in turn learn skills that will help him for the rest of his life.