How Can Behavior Therapy Help My ADHD Kid?

Since frequent tantrums, protests and tuning you out may already be part and parcel of your life as a parent of a child with ADHD, creating a behavior therapy plan can be a live-saving tool. As Caroline Miller, the editorial director of the Child Mind Institute, says in her article, Behavioral Treatments for Kids with ADHD, “one important reason for kids to participate in behavioral therapy (whether or not they also take medication) is that ADHD medications stop working when you stop taking them, while behavioral therapy can teach children skills that will continue to benefit them as they grow up.”

A behavioral plan should have three basic pillars: focus on the essentials, documenting what happens and acknowledging and rewarding improvement. This means structuring your child’s time, creating routines that are predictable and simple to follow, and providing lots of positive praise and attention.

Be prepared for the success of your plan to go up and down. Just because he brushes his teeth, gets his pajamas on and is ready to read a book by 8:00 p.m. one night, doesn’t mean that he’ll be able to get all of those steps done the next night. But, if he can do it three nights out of seven, give him high-fives for that, rather than dwell on the four nights he couldn’t manage. Miller points out that “young children with ADHD often find themselves scolded or punished much more than they are praised, so a clear way to earn positive attention from the most important people in their lives can be a big motivator” and can mean drastic improvement.

Behavior therapy works differently than medication because while a pill can reduce symptoms, such as impulsivity or distractibility, it doesn’t change your child’s behavior. Even though it takes time and commitment to implement and stick with a plan, since you’re changing the way you interact with your child on a day-to-day basis the impact is long-lasting.

In order for your kid to buy in to the behavior therapy plan though, she has to see a good reason for it. Dr. Matthew Cruger, Director of the Child Mind Institute’s Learning and Development Center puts it this way: “Kids with attention problems, in particular, are very pragmatic in a way about how much effort to put into things…they expect a return, and if they don’t see the return, it’s doubly frustrating.” He calls this approach “neuroeconomics”- ADHD kids try to save their energy and attention for things they are confident will pay off.

Apply your plan to a time of day when the two of you frequently struggle: getting ready for school in the morning, bedtime routines, after-school homework time. Here are some guidelines for creating an effective behavior therapy routine:

• Make visual checklists that define tasks step-by-step
• Establish a time limit for each step, particularly when it’s a longer-term project such as cleaning out her closet or completing a science project
• If your child is older, buy a planner to help him keep track of assignments
• Break down steps for specific skills like studying, memorizing, note-taking, and doing assignments on time
• Ask your child what kinds of rewards they’d like to work towards and then make a reward chart for goals achieved

For more information check out:

• The Centers for Disease Control and Prevention’s website has a wealth of resources devoted to this topic. You can access it here.
• Watch this NBC News segment about parents who implemented behavior therapy with their son.
• CHADD’s website list books and parent behavioral training programs here.