With the recent call for stronger FDA warnings be placed on some common ADHD medications, many parents are turning to other kinds of treatments to supplement or replace drugs as the primary choice of treatment. It’s not clear that this is a growing trend, or just a blip on the treatment radar. But combined therapies — medications plus certain types of behavioral treatments — usually offer the best course of treatment (best outcomes combined with the quickest result). The Washington Post highlights this growing trend in an article today:
“There’s so much lip service paid to [combined] treatments, but a lot of people just rely on medication alone,” said William L. Coleman, a developmental pediatrician at the University of North Carolina who is chairman of the American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health. “We are a quick-fix society and we want results. There’s a lot of time pressure on parents and on teachers.”
Many Americans want and expect a “quick fix” to their problems. While people often pay lip service to self-improvement, all too often the demands of the real world take precedence over the desires of our ideal selves. Competing priorities often complicate the picture — “Sure, I’d love to take little Jimmy into therapy once a week, but then he wouldn’t have time for his soccer practice!” Parents feel badly when their children can’t do everything that want to do, so it’s easier to purchase the medications than to tell little Jimmy that therapy is important too (even if little Jimmy can’t understand that at his age).
Parents need to play the role of parents, not their child’s best friend. That sometimes means saying “No” when you want to say “Yes,” and sometimes it means explaining to your children why they can’t always do everything they want to do (and have to do some things they’d rather not do).
Common Behavioral Techniques for ADHD Treatment
Like most psychotherapy techniques, behavioral treatments are best tried in the context of an ongoing psychotherapeutic relationship with a child therapist or child psychologist. While you can purchase a self-help book that will help walk you through these in greater detail, an experienced therapist will be more than a teacher or resource, they will be an important aid in helping you find examples that will work best for your situation.
Positive reinforcement
Providing rewards or privileges contingent on the child’s performance.
Example: Child completes an assignment and is permitted to play on the computer.
Time-out
Removing access to positive reinforcement contingent on performance of unwanted or problem behavior.
Example: Child hits sibling impulsively and is required to sit for 5 minutes in the corner of the room.
Response cost
Withdrawing rewards or privileges contingent on the performance of unwanted or problem behavior.
Example: Child loses free time privileges for not completing homework.
Token economy
Combining positive reinforcement and response cost. The child earns rewards and privileges contingent on performing desired behaviors and loses the rewards and privileges based on undesirable behavior.
Example: Child earns stars for completing assignments and loses stars for getting out of seat. The child cashes in the sum of stars at the end of the week for a prize.
Taking an active role in your child’s well-being and development means taking care of their health and mental health concerns as well. This is not always easy, and sometimes the confusing array of choices available to parents makes the task seem overwhelming. When some doctors act more as paternal authoritarians rather than helpful guides in your child’s care, it doesn’t help any. Find a doctor who will listen and help you find a therapist that can be a part of the treatment team for your child. Because it doesn’t just take a village to raise a child, it also takes an invested parent and experienced professionals, all of whom are looking out for the child’s best interests.
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5 Comments to
“Alternative Treatments for ADHD”
The pendulum needs to swing back to more time on the playground, recess, and active activities. The focus on education can only go so far when the body doesn’t get stimulation to enable the mind to focus. The new term for ADD with new technologies: Chronic Partial Attention.
Cheers.
I think that parents need to pay closer attention to what they are feeding their chldren.
A lot of behaviors would go away with proper nutrition and avoidance of certain food groups.
With the way our food is today and the SAD diet (standard american diet) of junk, processed food and sugars parents and doctors need to stop looking for the magic pill and start paying attention to what their kids eat. Supplementation is a must, Omega 3’s are necessary, OPC#3, ORAC and B vitamins have worked for many clients who suffer from childhood and adult add/adhd.
Not only do parents need to pay attention to the foods their children eat, they also need to evaulate themselves and their parenting styles. Children learn from a very young age how their parents will respond to different behaviors. Even the slightest response (eg, laughing at or praising inappropriate behaviors because they are perceived as being “cute”in young children) can result in significant behavioral problems as the child develops. Parents don’t cause ADHD, but their behavior may certainly be a significant factor in treating ADHD.
For boys, you need to closely scrutinize whether sitting in a classroom
for 6 hours, being a “good quiet little boy” is a reasonable expectancy.
After struggling with strong ADD for my entire life and not understanding
what I had, I only realized in my late 20’s that my entire schooling was
off-base and ill-suited for people like me— male and with ADD.
The cruel comments made by many of my teachers were because
they thought I had to conform to a mold that I was not created to conform
to.
I do not understand what causes ADD, nobody does. I haven’t found a
sufficient treatment, either. But I have learned that I learn in a hands-on
environment due to being male and having ADD. Public School is NOT a
hands-on, mentor-to-apprentice type environment. Rather, it is a mass
manufacturing industry designed to jam all kids of all types through one
rather insufficient and ill-suited mold.
You can’t use a hammer the same way you use a pencil, and you can’t use
garlic the same way you use vanilla. Kids come in different flavors,
you need to realize you and your child are BOTH individuals of different
flavors and have different tools in your toolbox. Individuate your
child’s environment to set them up for success and don’t exasperate them
with unreasonable expectations. Help them along, don’t nag the death out
of them!
Well, my son sleeps 10-12 hours a night….goes to bed at 7, wakes up at 7. I have had him on the Feingold diet for 3 months. I have been supplementing his diet with fish oils for over a year. I just don’t know how else to help him. He is extremely active, fidegty, impulsive, inattentive. He has had services since 2, now age 6. Gets speech, OT, social skills group, special bus with matron, Karate, swimming. I am exhausted and feel like giving up. I do not want to medicate in fear of harming him. School, so far, one incident (day 4) Behaviorally, not great, academically, ok.
Any other alternative things I can add before meds?
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Last reviewed: By John M. Grohol, Psy.D. on 2 May 2006
