No pharmacological Considerations for Managing ADHD

Attention deficit/hyperactivity disorder (ADHD) is one of the most prevalent disorders of childhood. The CDC estimates that between 3% and 7% of school-aged children have ADHD. Characterized by inattention, impulsivity and/or hyperactivity, ADHD impacts many areas of a child’s life. This includes social participation with peers and relationships with adults, academics, executive functioning skills like organization and time management, and more. Pediatricians may recommend medication and/or a variety of non-pharmaceutical interventions.

No pharmacological Interventions

Behavior modification: This intervention involves using behavioral strategies in everyday routines to provide structure, reward positive behavior, and communicate expectations. Examples of behavior modification may include:

·         A token system.

·         Use of a communication app between home and school.

·         The use of a written or visual routine.

These methods effectively improve academic and social performance and are even more impactful when carried over in different environments such as school and home. 

Cognitive Behavioral Therapy: Also known as CBT, cognitive behavioral therapy involves self-management that results in behavior modification. The process involves identifying and challenging problematic thoughts and behaviors and replacing them with practical actions. A child may learn and practice problem-solving, role-playing, and the ability to redirect, instruct and guide themselves. Strategies take into account the child’s strengths and goals.  

Environmental Modifications: Children with ADHD are more likely than their peers to be over responsive to sensory input; thus, the classroom can be more difficult for them to navigate. Modifying the environment to support the child’s nervous system functioning may include:

·   Providing preferential seating, so they are facing away from high-traffic areas such as cubbies or hallways

·         Providing access to noise-canceling headphones

·         Removing distracting classroom decorations

·         Offering a ‘cozy corner’ with decreased visual and auditory stimulation

·         Providing scheduled heavy work motor breaks

 

Sensory Integration: Sensory integration is a specific intervention approach used by occupational therapy. This sensory-rich therapy allows children to process and integrate different kinds of sensory input in a controlled environment. Therapists look for adaptive responses such as decreased impulsivity or the ability to tolerate increased volume without having a meltdown. The ultimate goal is that eventually, changed neurology results in more consistent appropriate responses to sensory stimulation.   

Activity Modifications: For a child with ADHD, a multi-step activity can become overwhelming and result in behaviors or withdrawal. Breaking down large tasks into manageable chunks can allow the child to experience success. Reduce the size of homework or the amount of written material on handouts. Focusing on quality rather than quantity can enable these children to showcase their best work. 

Social Skills Training: Social skills training provide children with ADHD the opportunity to learn and practice social skills. Several professionals use this intervention, and intervention may include education, use of social protocols, modeling, role-playing, practice in the community, and more. 

Team Collaboration: When a child’s disability impacts their participation at school, the child’s team may adopt an IEP or 504 plans. Children benefit from interdisciplinary collaboration, and the team may consist of the parents or caregivers, the child’s physician, special education teacher, regular education teacher, social worker, counselor, or occupational therapist. Since ADHD impacts multiple areas of functioning, each profession can contribute its specialty. For example, the physician can help team members understand side effects, and the occupational therapist can suggest sensory strategies. The child, family, and team all benefit from collaboration.