Therapy for ADHD

Is your child overactive or impulsive? Do they have a hard time focusing and listening?

ADHD is one of the most common concerns in childhood, affecting nearly 1 in 10 kids across the country. It can show up in different ways: some kids have a hard time sitting still or waiting their turn, while others seem to be daydreaming or missing important details. Many kids show signs of both.

There are three types of ADHD:

Inattentive type, where kids struggle with focus, organization, or following through on tasks
Hyperactive/Impulsive type, where they may talk nonstop, interrupt others, or act without thinking
Combined type, which includes challenges in both areas

To be diagnosed, these behaviors need to show up in more than one setting (like both home and school) and cause real difficulty in day-to-day life.

Like most psychological disorders, it is a combination of genetics and environment. Children are typically born with personality traits or temperament, and some of these traits put them at risk for developing ADHD (e.g., desire for stimulation, base activity level, preference for new things or sensations, etc.).
Typically, a clinical psychologist or a medical doctor (e.g., pediatrician, psychiatrist or neurologist) will diagnose ADHD, and the diagnostic process usually involves 1) questionnaires for teachers and parents and 2) testing of some kind for the child. Because ADHD can look like so many other things, it is important to have a thorough assessment with multiple perspectives and methods of assessing so that you can be sure that it is actually ADHD. Some providers may rush the process, leading to confusion and issues finding the right treatment match.
By definition, symptoms of ADHD must manifest in more than one setting (e.g., home and school), so it is very rare for me to see it diagnosed before the age of 5 for practical reasons. In my experience, 5- and 6-year-olds are so full of energy and new to schooling that it is very difficult to tell ADHD apart from normal variation in personality, or other more common issues. I personally have the easiest time spotting it around age 7+, which is close to official estimates for average age of onset.
ADHD is thought to be a neurodevelopmental disorder, meaning that it is thought to be more “brain-based” than other disorders. You only get one brain for life, so features of ADHD often persist into adulthood. However, many of the problems related to ADHD (e.g., school issues, listening to directions, peer conflict) can be treated effectively. In other words, some of the “quirks” of ADHD may stick around, but does not have to be a life sentence of procrastination and distraction.

How is ADHD treated?

Many parents think that they have to medicate their child with ADHD, but medication is not the only option. In fact, behavior therapy is often the preferred method for treatment at first, particularly for younger children. I am not opposed to medication, but my training is focused on therapy rather than medicine, so you will get a pill-free approach with me. However, I think parents should have an open and honest conversation with their medical provider about the pros and cons of medication, particularly as new research comes out about long-term side effects. I cannot give medical advice, but I can speak about the clinical trial data for ADHD treatments and make general observations and recommendations. Feel free to ask me!

Behavior therapy for ADHD is often very parent-focused, and teaches parents techniques for supporting their child’s organizational skills, listening, staying on task, and paying attention. This is not because ADHD is the parent’s fault. Instead, it is because parents have tremendous power and influence in structuring their child’s day so that motivation and focus can grow. Attention and self-control are skills, just like most things, and parents and teachers can do quite a bit to nurture these skills. One-on-one therapy for ADHD is usually not recommended, though there are some exceptions (e.g., social skills training). There are also other approaches that have questionable scientific support (e.g., neurofeedback, chiropractic medicine, diet/supplements).

I would be happy to discuss treatment options with you some time; click the button below to contact me.

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