If your child has been diagnosed with ADHD, chances are medication has been recommended as treatment by your medical provider.
But has your medical provider mentioned the other first-line treatment recommended for ADHD?
According to research, you've probably never even heard that behavior training for parents is recommended treatment for children.
Behavioral interventions are recommended treatment for children with ADHD and related challenges like ODD, anxiety, and other conditions that have challenges with Executive Function. In fact, a combination of behavioral interventions and medication is shown to improve the effectiveness of medication for ADHD.
The research is quite clear -- and compelling.* This NPR story captures it well -- in just 4 minutes.
But here's the surprising (and often confusing) piece: the treatment involves training for parents and teachers, not the kids.
What is Behavior Therapy?
- Also known as “behavior management training” or “parent management training.”
- A first-line recommended treatment, according to the American Academy of Pediatrics and all other major medical associations.*
- Focuses on teaching parents (or teachers) to improve outcomes for kids.
- Involves teaching adults how to modify and support behaviors at the "point of performance."
The Point of Performance is where a child’s problematic behavior actually takes place. When parents and teachers learn to modify behaviors when and where they are happening, children and teens begin to improve self-management. According to research, correcting a child’s behaviors in a therapist’s office is unlikely to have lasting results.
"Parent training helps parents better understand their child’s behavioral issues and learn parenting skills specific to these problems,” states the CDC. The American Academy of Pediatrics explains further, “Although Behavior Therapy shares a set of principles, individual programs introduce different techniques and strategies to achieve the same ends.” For example, Behavior Therapy at ImpactADHD® applies techniques from the evidence-based modality of coaching.
In young children, it has been shown to delay the start of medication, as well as the amount needed in the future.
Even in the medical community, there is a lot of confusion about what behavior therapy is (or is not), and where to find it...
Behavior therapy is NOT...
- a particular kind of therapy for kids
- provided only by licensed therapists
- something that takes place in a medical office
It is a set of principles taught to parents and teachers so that they can help kids learn self-understanding and self-control.
Confused? You're Not Alone!
In 2015, we were hired to do some work as a parenting consultant for the American Academy of Pediatrics’ Quality Improvement Initiative on ADHD. We learned that while Behavior Therapy is a first line recommended treatment (that can also improve the effectiveness of medication) for ADHD, fewer than 10% of pediatricians were regularly recommending it to their patients.
And yet, in a 2017 ADDitude magazine survey, behavior therapy/parent training classes was identified as the 3rd highest rated option for treatments considered as extremely or very effective (after exercise and prescription medication).
So why don’t providers regularly make referrals? And why don’t parents follow through on those recommendations when they get them?
The reasons cited in the ADDitude survey include:
- Affordability – these services are not regularly covered by insurance, and the costs for local providers may be prohibitive for many families
- Accessibility – providers do not know where to refer parents in local communities, or local resources may not be available
- Awareness – providers are not educated about the nuances of parent training and may not know that it is one of two treatment approaches recommended by the AAP
In fact, we developed SANITY SCHOOL®** with those concerns in mind.
ACCESS TO BEHAVIOR MANAGEMENT FOR ALL!
Find out how we offer behavioral training on our Programs & Offerings page.
We are firmly committed to make these resources be available to all! If you would like to get support but find that our low-cost programs are still difficult for you to afford, please ask for the help you need and inquire about our scholarship program.
Every parent should benefit from the coach-approach to behavior management!
* American Academy of Pediatrics Guidelines for Treatment of ADHD: “In 2001, the American Academy of Pediatrics (AAP) published clinical practice guidelines for the treatment of school-aged children with ADHD. The AAP recommended the following: (1) primary care clinicians should establish a treatment program that recognizes ADHD as a chronic condition; (2) appropriate target outcomes designed in collaboration with the clinician, parents, child and school personnel should guide management; (3) stimulant medication and/or behavior therapy as appropriate should be used in the treatment; (4) if a child has not met the targeted outcomes, clinicians should evaluate the original diagnosis, use all appropriate treatments and consider co-existing conditions; and (5) periodic, systematic follow-up for the child should be done with monitoring directed to target outcomes and adverse effects. Information for monitoring should be gathered from parents, teachers and the child.”
** ImpactADHD® conducted an independent research study on our Behavior Management Training program in the summer/fall of 2016, in collaboration with Mindprint Learning. Since research on the efficacy of coaching and parent training is conclusive, this research focused on collecting evidence to 1) assure the efficacy of the coach-approach as a methodology for effective behavior management, and 2) improve parent engagement and compliance. A research poster was presented at the International Conference on ADHD in November, 2016.