In everyone’s life, there have been situations in which it was necessary to sit still, maintain attention or control oneself, trying to remain calm. However, for some people it is such a pervasive and persistent problem that it interferes with every aspect of their life, both at home and in school, social environment and work.
Attention deficit hyperactivity disorder (ADHD) is a developmental neurological behavioral disorder that occurs on average in 10% of school-aged children. Symptoms persist into adulthood in more than three quarters of cases. ADHD is characterized by inappropriate levels of inattention, impulsivity, and hyperactivity.
People with ADHD can be very successful in life. However, without proper diagnosis and treatment, ADHD can have serious consequences, including learning difficulties, relationship problems, depression, substance abuse, delinquency, accidental injury, and frequent job changes. Early detection and treatment is extremely important.
ADHD in children often requires a comprehensive approach to treatment that includes the following:
- informing about the disorder and its causes, as well as diagnosis and treatment options;
- teaching parents how to manage their child’s behavior;
- drug treatment and regular monitoring of it;
- support of a psychologist at school;
- psychotherapy of a child and family in order to eliminate personal and (or) family problems.
Numerous studies over the past 30 years show that both drug and behavioral therapy are effective in improving ADHD symptoms. Short-term studies comparing the two have found that drug use is more effective in treating ADHD symptoms than behavioral therapy alone.
In a long-term treatment study (14 months), results showed that children who received both medication and behavioral therapy had the greatest improvement in ADHD symptoms. Combination treatments have shown better results in improving ADHD and opposition symptoms and in other areas such as parenting and academic performance. Overall, those who received the closely watched treatment experienced greater improvement in ADHD symptoms than children who received either intensive behavioral treatment without medication or help with less closely monitored medications.
Medical treatment. Medications do not cure ADHD; they relieve symptoms. The most effective ones primarily directly affect certain neurotransmitters, including dopamine and norepinephrine. Both neurotransmitters play key roles in the behavioral symptoms of ADHD.
Psychostimulants are the most widely used class of medications for managing symptoms associated with ADHD. Approximately 70 to 80% of children with ADHD respond positively to treatment and show improvement: an increase in the duration of maintaining attention and concentration, an improvement in the quality and accuracy of school performance, a decrease in the level of hyperactivity, impulsivity, negative behavior in social interactions, and others. These improvements are clearly visible in the short term, however, long-term effectiveness is still being studied by researchers. Antidepressants, antihypertensives, and other medications can reduce impulsivity, hyperactivity, and aggression. However, every family must weigh the pros and cons of taking drugs, they may carry the risk of side effects.
Behavioral therapy. Behavioral therapy plays an important role in the treatment of children and adults with ADHD. In addition, parents need to be trained in certain skills to help them cope with children with ADHD. They, in turn, can also educate their children at home, and thus help them overcome their difficulties. Learning to do this is especially important because ADHD is a chronic condition and these skills will be useful throughout your life.
In short, behavior change occurs as follows. Behavior modification is often expressed in ABC terms:
A (antecedents) – what happens before the behavior,
B (behaviors) – what the child does, what the parents want to change,
C (consequences) – consequences.
Adults learn to change what happens before (for example, how they give directions to children) and the consequences (for example, how they react when the child obeys or disobeys directions) in order to change the child’s behavior (that is, the child’s response). By constantly changing the way they respond to their children’s behavior, parents teach their children new ways of behaving.
The following five points should be included in all three components of behavior modification:
- Start with goals that your child can achieve in small steps.
- Be consistent.
- The consequences must come immediately after the behavior.
- Behavioral therapy is carried out for a long time, from several months or more.
- Learning and mastering new skills takes time, and improvement in children will be gradual.
Cognitive behavioral therapy is the main focus in the work of a psychotherapist with a disorder such as ADHD, but it is always worth paying attention to what symptoms come to the fore and the characteristics of the child, including age. Art therapy, play therapy , gestalt therapy and others can come to the rescue . Such “talking” or “play” therapy improves the emotional state, helps to touch your feelings, teaches you to understand and express your feelings, and helps to increase self-esteem.
Thus, treatment for ADHD requires a multimodal approach, is age dependent, and must be tailored to the unique needs of each individual and family to help control symptoms, manage the disorder, improve overall psychological well-being, and manage social relationships.