ADHD can take quite a toll. It is tough for the individual who must cope with daily frustrations. It is rough on family members whose lives are regularly disrupted by outbursts, temper tantrums or other misbehavior.
It’s normal for parents to feel helpless and confused about the best ways to handle their child in these situations. Because kids with ADHD do not purposely decide to act up or not pay attention, traditional disciplinelike spanking, yelling at, or calmly trying to reason with your son or daughterusually does not work. Fortunately there are treatment options that can help alleviate the symptoms of ADHD and arm families with the tools needed to better handle problem behaviors when they arise.
These interventions include:
- psychosocial interventions
- a combination of these two approaches
Research has shown that medication alone is not always sufficient. For more than two decades, psychosocial interventions such as parent training and behavioral modifications have been used for children with ADHD. A key goal is to teach parents and educators methods that equip them to better handle problems when they arise. In this approach they learn how to reward a child for positive behaviors and how to discourage negative behaviors. This therapy also seeks to teach a child techniques that can be used to control inattention and impulsive behaviors.
Preliminary research has shown that behavior modification is also effective for children with severe oppositional problems. Such an approach may lower the number or severity of oppositional behaviors, although the underlying conditionADHDremains.
MedicationsUsed properly, medicines such as methylphenidate hydrochloride (Ritalin) and other stimulants help suppress and regulate impulsive behavior. They squelch hyperactivity, improve social interactions and help people with ADHD concentrate, enabling them to perform better in school and at work.
These medications also may help children with co-existing disorders control destructive behaviors. When used with proper medical supervision, they are considered generally safe and free of major unwanted side effects. (Some children may experience insomnia, stomachache or headache.) They rarely make children feel high or, on the flip side, overly sleepy or out of it. Although not known to be a significant problem, height and weight should be monitored with long-term use of these medications. These medications are not considered addictive in children. However, they should be carefully monitored in teenagers and adults because they can be misused.
It is important to understand that these medications are not a cure-all, but they can be highly effective when used appropriately in the right dosage for each individual. In fact, as many as nine out of 10 children do better when they are taking one of the most commonly used stimulants. However, in combination with other techniques such as behavior modification or counseling, symptoms may improve even more. Researchers are currently evaluating the effectiveness of medications in combination with these other approaches to determine the best route to take.
Individuals taking any of the medications listed below should see their doctor regularly for a check-up to review the types and timing of ADHD symptoms. The benefits and potential risks of using these medications also should be discussed before the first prescription is filled.
The most commonly used stimulants are:
- methylphenidate hydrochloride (Ritalin)
- dextroamphetamine sulfate (Dexedrine or Dextrostat)
- a dextroamphetamine/amphetamine formulation (Adderall)
When these front-line medications are not effective, physicians sometimes opt to use one of the following:
- buproprion hydrochloride (Wellbutrin)an antidepressant that has been shown to decrease hyperactivity, aggression and conduct problems.
- imipramine (Tofranil) or nortriptyline (Pamelor) these antidepressants can improve hyperactivity and inattentiveness. They can be especially helpful in children experiencing depression or anxiety.
- clonidine hydrochloride (Catapress)used to treat high blood pressure, clonidine also can help manage ADHD and treat conduct disorder, sleep disturbances or a tic disorder. Research has shown it decreases hyperactivity, impulsivity and distractibility, and improves interactions with peers and adults.
- guanfacine (Tenex)this antihypertensive decreases fidgeting and restlessness and increases attention and a child’s ability to tolerate frustration. A study of children who also have Tourette syndrome showed the medication improved vocal and motor tics as well.
- Pemoline (Cylert) is no longer considered a first- or second-line treatment due to concerns about the risk of liver dysfunction.
Some people with ADHD benefit from emotional counseling or psychotherapy. In this approach, counselors help patients deal with their emotions and learn ways to cope with their thoughts and feelings in a more general sense.
Group therapy and parenting education can help many children and their families master valuable skills or new behaviors. The goal is to help parents learn about the particular problems their children with ADHD have, and give them ways to handle those problems when they arise. Likewise, children can be taught social skills and gain exposure to the same techniques the parents are learning, easing the way for those methods to be incorporated at home.
Support groups link families or adults who share similar concerns.
Therapies that have not been scientifically proved to be helpful in the treatment of ADHD include:
- herbal products
- restrictive or supplemental diets
- allergy treatments
- chiropractic adjustment
- perceptual motor training
- medications for inner ear problems
- yeast infection treatments
- pet therapy
- play therapy
- eye training
- colored glasses