Behavioral Treatment for ADHD

Despite the well documented benefits of stimulant medication for treating ADHD, medication is no panacea and some children with ADHD should not receive it. There are several reasons for this. First, although medication helps the majority of children with ADHD, as many as 20% derive no real benefit from medication. Second, some children experience side effects that prevent them from receiving medication on an extended basis. Third, many children who benefit from medication still have difficulties with primary ADHD symptoms or associated problems which must be targeted via other means. Fourth, some children with ADHD can have their symptoms managed effectively without medication (this is most likely to be true, however, when symptoms are relatively mild.) In addition to these reasons, some children have extremely strong objections to taking medication - this may be more likely to occur with teenagers. In these circumstances, trying to force medication on a child can create more problems than it solves. F or all these reasons, other treatments are often necessary - some would say always necessary - to effectively treat ADHD.

An important non-medical approach used in treating children with ADHD is known as behavior therapy or behavior management. Behavior therapy is based on several simple and sensible notions about what leads children to behave in socially appropriate ways. One reason is that children generally want to please their parents and feel good about themselves when their parent is proud of them. When the relationship between parent and child is basically positive, this is a very important source of motivation. A second reason that children behave appropriately is to obtain positive consequences for doing so (i.e. privileges or rewards). Finally, children will behave appropriately to avoid the negative consequences that follow inappropriate behavior.

The goal of behavior therapy, therefore, is to increase the frequency of desirable behavior by increasing the child's interest in pleasing parents and by providing positive consequences when the child behaves. Inappropriate behavior is reduced by consistently providing negative consequences when such behavior occurs. This is a simplified, but not unreasonable view, of what behavior therapy is all about.

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