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ADHD Symptoms: Using Behavioral Management  

10 Things You Can do to Help Your Child With ADHD.  

 Help for Adult ADD/ADHD- The Fundamentals You Need to Know  

  Help for Adult ADHD Page #2

ADHD Assessment for Your Child?    

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Adhd Symptoms: Using Behavior Management

The application of behavior modification techniques to assist children with ADHD symptoms was founded on the success of the management of behavior problems among mentally retarded children, and upon the purported limitations and potential side effects of stimulant drugs. These stated limitations were a large part of the rationale behind the implementation of behavior modification techniques rather than based upon strictly their own merits. Now at least one of the basic tenets which underlie the use of behavior management has now been found to be based on outdated information concerning the side effects of stimulants, which are believed be much more benign than previously thought to be the case. Currently, behavioral improvements resulting from the use of stimulant medication typically is as great or greater than those resulting from behavior modification techniques, moreover, stimulant use frequently results in greater improvements in academic productivity. Given such information, such medications are usually viewed as first-line treatment for ADHD in place of behavior modification, which is frequently seen as a necessary adjunct to medication to achieve maximum treatment effects. Another convincing justification for using behavior modification techniques in treating ADHD is the argument that since referral for treatment is frequently based upon the social distress of the caregivers involved, interventions to change the interactions between children and their caregivers is often believed to be useful.

 

It was first proposed in 1977 that ADHD may reflect poor stimulus control of behavior by parental commands, resulting from the inconsistent and inadequate use of child management methods by the parents. It was believed that by training parents in more consistent and effective child behavior management, there should be a reduction or elimination of ADHD symptoms. However, such a theory has been dismissed on the grounds that the inconsistent, negative or punitive management techniques of some parents of children with ADHD have been shown to actually be more associated with children with oppositional defiant disorder in conjunction with ADHD, rather than ADHD alone. Further research seems to suggest that the negative and controlling behavior of parents with ADHD children is more of a reaction to than a cause of their children's inappropriate behavior. Also, some parents of ADHD children seem to have exceptional management skills. Parent training does not seem to normalize the ADHD symptoms in children and does not seem to generalized to "no-treatment" settings such as school, where ADHD symptoms may be equally problematic. The evidence seems to be against the concept of "bad parenting" as a primary etiology of ADHD, so this rationale cannot be considered a reasonable justification for undertaking parent training with ADHD children.

A more recent trend seems to be toward viewing ADHD as a potential problem in response inhibition and self-regulation with secondary consequences that may create poor self-motivation to persist at assigned tasks, which may now provide a more persuasive rationale for employing behavioral interventions with ADHD. If ADHD is a developmental delay in self-regulation of behavior through internal means of representing information and motivating goal directed behavior, than interventions may be correctly focused on the nature of the stimuli controlling behaviors, as well as the pattern, timing, and salience of consequences, by socially arranging consequences and structure to focus on symptomatic reduction. The usual procedures for manipulating the antecedent and consequent events are those provided by the behavior therapies. However, extension of this argument holds that such social arrangement will not alter the underlying neurophysiological basis for ADHD. These techniques must be employed across various situations, over extended time intervals. Premature removal of these socially arranged circumstances is believed to eventually precipitate the eventual return to pretreatment levels of the behavior symptoms. Also, the use of behavior treatments in one setting has not been found to generalize to additional settings.

So, in effect, behavior modification techniques have been found to assist in the behaviors associated with ADHD children although they have not been found to be very generalizeability to many or most nontreatement settings.

Information from Treatment of Childhood Disorders by Eric J. Marsh and Russell A. Barkley

By Paul Susic  MA Licensed Psychologist   Ph.D. Candidate  (Health and Geriatric Psychologist)

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