Dealing with ADHD in Children and Adolescents

Hello everyone! I realize my log has been a little eclectic; I find it helpful each week to write about subjects that I have have learned something substantial about. I am interning as a substance abuse counselor for adolescents, and thus far it has been a wonderful clinical experience. In dealing with teenagers I have come into issues with trying to decide the best approach when forming treatment plans for teens who are dealing with Attention Deficit Hyperactivity Disorder (ADHD). It has only come up with a handful of my clients, but I have been doing research and discussing ideas with my supervisor, in order to have the best approach to providing the best care possible.

In general the typical symptoms associated with ADHD are: inattentiveness, hyperactivity, and impulsivity. These symptoms contribute to issues with behavioral/grades at school, issues with peers, problems with following rules at home and school, and issues with parental relations. It is though by the Center for Children and Families that three factors shape how a child/adolescent with ADHD will function as an adult:
(1) Effective parenting skills
(2) How the child/adolescent gets along with others their age
(3) School success

The Center for Children and Families advocates behavioral treatments for children/adolescents with ADHD, as opposed to medication. Behavior modification looks at the ABC's: Antecedents (events that occur before the behavior that has influence on the behavior), Behaviors (the things the child/adolescent does that are what parents/teachers want to modify), and Consequences (the events that occur after the behavior).

In a behavioral modification program the agent of change is educated on how to modify the antecedents and the consequences. Modifying the antecedents can help to change/eliminate the behavior. Modifying the consequences can also work to change/eliminate the behavior by removing or adjusting the reinforcers that are holding the problem behavior in place.

Typical Forms of Behavior Modification

Parent Training: In this approach you focus on parenting skills. This includes establishing rules and routines and having them reinforced at home. In treatment this can consist of weekly sessions (8-12 sessions) and then after the treatment has been implemented for the 8-12 weeks there are monthly sessions to continue to evaluate progress.

School Intervention: This focuses on behavior in the classroom, grades, and peer relationships. Teachers are educated in class management skills. On average this training lasts 2-10 hours. The clinician would record a baseline of the problem behaviors and then educate the teacher on how to implement an effective intervention. The clinician would evaluate the effectiveness of the intervention and then decisions would be made from there on how to proceed.

Child Intervention: With this the child/adolescent would be taught academic/social skills. This is aimed towards decreasing aggression, how to build friendships, and how to appropriately monitor themselves. These would typically be weekly sessions, sometimes group sessions in order to facilitate practice in social skills. This part of treatment is intertwined with the school and parental treatments.

ADHD treatment goes into much more detail, of course. These are just the basic overview of approaches.

Sources:
http://ccf.buffalo.edu