Which ones have scientific evidence of being effective?
Attention Deficit Hyperactivity Disorder (ADHD) is a disorder of known neurobiological origin with onset in childhood. Characterized by a level of impulsivity, activity and/or attention inappropriate to the maturity or developmental age of the sufferer, untreated ADHD can cause a significant imbalance not only at a cognitive-behavioral level, but also at an adaptive and emotional level.
Our current conception of ADHD as a disorder of a dimensional nature encompasses not only merely clinical or diagnostic aspects, but also, and no less important, therapeutic aspects. In this understanding, although pharmacological treatment has been shown to be highly effective as a therapeutic tool, it does not solve the doubts and fears of parents about certain behaviors of these children, nor does it solve all the aspects involved in the executive dysfunction of ADHD (difficulties in organization, planning, search for strategies, cognitive flexibility, etc.).
Pharmacological treatment is, therefore, a fundamental pillar on which the rest of the therapeutic interventions are based and articulated, and as such should be individualized and reviewed in each particular case by a professional with training and experience in the field.
Psychological treatment of ADHD in children and adolescents
As far as psychological interventions are concerned, there are a number of treatments that have proven to be especially helpful in treating children with ADHD, optimizing and enhancing in many cases, pharmacological treatment. These are detailed below:
- Psychoeducation to parents and, depending on the age, to the children themselves, in which they are taught what ADHD is and what can be done to improve it.
- Training of parents in behavior modification skills and contingency management.
- Individualized educational intervention program at school, which includes academic, social and behavioral aspects, and which integrates and involves the teaching staff.
- Social skills training.
- Individual cognitive-behavioral intervention with the child (only in case of comorbidity due to mood or anxiety disorders).
It should be borne in mind that all the aspects mentioned above (and which have demonstrated some degree of efficacy in the treatment of ADHD), revolve in one way or another around the general principles of cognitive-behavioral therapy (CBT). In other words, they basically stem from the functional analysis of behavior, the identification of the factors that promote inappropriate behavior, the recording of behaviors that can be changed and the implementation of a series of interventions aimed at changing such behavior. It is therefore a program that not only provides information on the underlying pathology that causes the symptoms, but also integrates parents and teachers from the in-depth knowledge of ADHD, and trains them in behavior modification techniques, thus increasing their competence in this field.
Psycho-pedagogical intervention in ADHD in children and adolescents.
By integrating multimodal treatment into the school setting, school-based programs range from a series of general psycho-pedagogical adaptations to training teachers in behavior modification techniques and other ADHD management strategies in the classroom.
Or also, intervention at a more individual level, which teaches academic skills to children with ADHD and helps them to achieve school success through the mastery of certain study, organization and task management techniques, enhancing in parallel a series of behaviors considered appropriate to carry them out (working in silence, raising the hand, asking permission, persisting in tasks, etc.).
Once again, the concept of mutimodal treatment takes on a special hierarchy here, providing a dimensionality to the treatment that encompasses different scenarios that are part of the life of children and adolescents with ADHD.
In short, the treatment of ADHD in children and adolescents should be individualized and based on each patient and his or her family. The combination of pharmacological and psychological treatment has the potential to exert immediate effects on the core symptoms of ADHD (through the use of medication), as well as longer lasting effects (through the development of cognitive and behavioral strategies and skills provided by psychological treatment).