1. ADHD Symptoms in Children Slideshow Pictures
2. Take the ADHD Quiz
3. Parenting a Child with ADHD Slideshow

Medical Author:

John Mersch, MD, FAAP

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

View Full Profile

Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

View Full Profile

In this Article

• Attention deficit hyperactivity disorder (ADHD) in children facts
• What is attention deficit hyperactivity disorder (ADHD)?
• What is the cause of ADHD?
• What are ADHD symptoms and signs?
• How is ADHD diagnosed?
• Is ADHD inherited?
• Is ADHD on the increase? If so, why?
• Can ADHD be seen in brain scans of children with the disorder?
• What is the role of alternative therapies in ADHD?
• What are behavioral treatments?
• Which educational interventions have been studied and shown to be effective in the treatment of ADHD?
• What medications are currently being used to treat ADHD?
• What is the relationship between ADHD and other disorders, such as learning disabilities, anxiety disorders, bipolar disorder, or depression?
• What is the prognosis for individuals with ADHD?
• What is the history of ADHD? How is it related to ADD?
• What are the future research directions for ADHD?
• ADHD FAQs
• Patient Comments: Attention Deficit Hyperactivity Disorder - Tests and Diagnosis
• Find a local Psychiatrist in your town
• Attention Deficit Hyperactivity Disorder (ADHD) Index

CAM (complementary and alternative medicine) therapies are considered and/or tried in over half of patients with ADHD. Many times, these modalities are used covertly and it is important for the treating physician to inquire about CAM to encourage open communication and review risks vs. benefits of such an approach. CAM treatment modalities incorporating vision training, special diets and megavitamin therapy, herbal and mineral supplements, EEG biofeedback, and applied kinesiology have all been advocated. The benefits of these approaches, however, have not been confirmed in double-blind controlled research studies. Families should be aware that such programs might require a long-term financial commitment that may not have insurance reimbursement as an option. Recent research on the benefits of specific polyunsaturated fatty acid (EPA and DHA) supplementation has demonstrated a therapeutic benefit in several well-designed studies. Further research in this area will hopefully shed light on how these supplements work.

In October 2011, the American Academy of Pediatrics (AAP), in their Clinical Practice Guideline, reaffirmed the 2001 recommendation that when treating target ADHD symptoms, "clinicians should recommend stimulant medication and/or behavior therapy, as appropriate." Several forms of behavioral intervention have been found to show little or no effectiveness in treating ADHD patients. These included individual or play therapy, long-term psychotherapy, psychoanalysis, sensory-integration training, and cognitive behavioral therapy. However, one form of a non-medication approach, behavioral therapy, has been demonstrated to be somewhat effective with ADHD children. The therapy sessions are conducted by a mental health professional (for example, a psychologist or social worker) and consist of parent and teacher training in child behavior management. The parents and teachers are taught to consider their child's behavior as a function of the disorder, rather than "bad behavior" or the result of failed parenting/teaching skills. The sessions then go on to teach the adults to pay attention to appropriate behavior, ignore minor inappropriate behavior, to give clear and concise directions, and to establish effective incentive programs, such as token or point reward systems. The adults manage misbehavior by applying immediate, specific, and consistent consequences (removal of privileges). Basically, the three principles of behavior therapy are

1. set specific goals,
2. provide rewards and consequences,
3. and keep using the rewards and consequences for a long time.

Parents can help their child's behavior with specific goals such as: (1) maintaining a daily schedule, (2) keeping distractions to a minimum, (3) setting small and reasonable goals, (4) rewarding positive behavior, (5) using charts and checklists to keep a child "on task," and (6) finding activities in which the child will succeed (sports, hobbies).

Many feel that behavior therapy can be an appropriate first-level treatment in several scenarios:

1. The milder ADHD patient
2. For the preschool-aged child with ADHD-suspicious symptoms
3. When the family prefers this approach vs. medication