Evidence-based Behavioral/Training Interventions

Evidence-based behavioral or training interventions can help children and adolescents with ADHD manage their symptoms of hyperactivity, impulsiveness, and inattention by teaching skills to help control symptoms. Strategies can include reward and consequence systems, self-monitoring, modeling/role playing, self-instruction, generation of alternatives, and reinforcement. Strategies may focus on staying organized and focused; other strategies may focus on reducing disruptive behaviors that can get the child into trouble at school, make it difficult to form friendships, or disrupt family life.

Ongoing adherence to psychosocial treatments is a key contributor to its beneficial effects. Some children and adolescents, especially those with severe ADHD symptoms, benefit from medication along with behavioral or training interventions; the decision about using 1 or both types of therapies, however, depends on acceptability and feasibility to the family. It is important to note that different behavioral/training interventions may be more suitable and effective in some age groups than in others. Also, the presence of comorbid conditions may affect the type of intervention required.

Behavioral therapy can include training for the child, family, or a combination. Teachers can also use behavioral techniques and enlist the help of the school psychologist to provide strategies for reducing problem behaviors in the classroom. Some techniques found to be helpful to parents and teachers include:

• Timeout
• Reward/consequences
• Token economies
• Daily behavior report card
• 1-2-3 Magic Parenting: Positive Parenting

Following is a summary of age-specific treatment recommendations concerning both behavioral/training interventions and medication from the AAP 2019 ADHD Guideline.