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Wednesday, February 13, 2013

Easing ADHD without meds

Psychologists are using research-backed behavioral interventions that effectively treat children with ADHD.

By Rebecca A. Clay
February 2013, Vol 44, No. 2
Print version: page 44

Because of his attention-deficit/hyperactivity disorder (ADHD), the 10-year-old boy rarely even tried to answer the questions on the math and language arts worksheets his fourth-grade teacher asked students to complete during class. Not only that, he often bothered the students who did.

Then the teacher made an important change to the boy's worksheets: She wrote the correct answers on them with invisible markers so that the boy could reveal the correct answer by coloring over the space as soon as he finished a question. The teacher also randomly inserted stars he could uncover by coloring and told him he would earn a reward for collecting four stars. The strategy paid off: The boy was soon answering every question and getting 84 percent of them correct.

Giving immediate feedback is just one of many simple and effective behavioral approaches to improving children's attention, says psychologist Nancy A. Neef, PhD, who described the invisible marker experiment in a chapter on treating ADHD she co-authored in the 2012 "APA Handbook of Behavior Analysis." With ADHD affecting an estimated 7 percent of American children ages 3 to 17, psychologists are developing behavioral interventions that parents, teachers and others can use to help kids focus and control their impulses. Others are conducting research that demonstrates that more exercise and longer sleep can help.

That's good news for kids, says Neef, who believes that parents, teachers and pediatricians are sometimes too quick to jump to prescribing medication for ADHD.

"Particularly in the case of stimulant medications, which are the most common treatment for ADHD, we don't know an awful lot about the long-term side effects," says Neef, a professor of special education at The Ohio State University.

And medication doesn't address problems related to children's academic performance and relationships with family members, peers and others. "Even though medication can be effective and very helpful, it's not a panacea," Neef says.

Behavioral interventions

Surprisingly, nonpharmacological approaches are also controversial, especially among the medical community.

"If you read the professional guidelines for psychiatrists or sometimes pediatricians, the treatment that is emphasized for kids with ADHD is a pharmacological one," says Gregory A. Fabiano, PhD, an associate professor of counseling, school and educational psychology at the State University of New York at Buffalo.

The entire story is here.

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