ADHD

General Interventions

This section provides interventions that may help with the identification of children and teens with ADHD and related problems and help these individuals manage their symptoms.

These general interventions are presented in the context of the child or teen, family, and community.

Child or Adolescent

If the school or family expresses concern about a child’s or teen’s disruptive behavior or inattention, or if screening questions reveal concerns in these areas, further information should be gathered. Symptoms need to be present in several different settings, including home and school. Therefore, obtaining information from the school as well as the child or teen and family is critical. Rating scales, report cards, and written and/or verbal comments from school personnel about a child’s or teen’s presentation and performance provide a fuller picture of his academic and behavioral functioning.

Selected ADHD Assessment Scales

  • Vanderbilt ADHD Diagnostic Parent Rating Scale
  • Vanderbilt ADHD Diagnostic Teacher Rating Scale
  • SNAP-IV
  • ADHD Rating Scale-IV
  • Conners 3rd Edition
  • Obtain a careful social history from the family to identify any ongoing or recent stressors that may also be affecting the child’s or teen’s functioning.1
  • Assess for the following other possible underlying or associated medical or psychosocial concerns:
    • Low birthweight
    • Mental retardation
    • Drug or alcohol exposure in utero
    • Neurotoxin exposure (e.g., lead poisoning)
    • Central nervous system infections
    • Head injury
    • Thyroid dysfunction
    • Child abuse and neglect
    • Foster home placements
  • Assess for mood problems and disorders. Assess for anxiety problems and disorders.
  • Talk with the child or talk in developmentally appropriate language about ADHD and its treatment. Address feelings of failure or low self-esteem.
  • Encourage the child or teen to break difficult tasks up into manageable parts, take short breaks, and write homework assignments in a special notebook.
  • Encourage the child or teen to pursue his talents and interests. Successes will boost his self-esteem and promote positive interactions with adults and peers.

References

  1. American Academy of Pediatrics, Committee on Quality Improvement, Subcommittee on Attention-Deficit/Hyperactivity Disorder. (2000). Clinical practice guideline: Diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics , 105 (5), 1158-1170.

Family

  • Explain to parents that they are not to blame for their child’s or teen’s behavior problems by highlighting the child's strengths and needs.
  • Discuss with parents any concerns they have about ADHD and about handling their child’s or teen’s behavior. Express the importance of giving positive feedback, communicating realistic and clear expectations, and setting consistent and appropriate limits.
  • Encourage parents to establish routines for their child or teen to help her learn organizational skills. Charting the routines may be helpful.
  • Ask about a family history of ADHD, learning disorders, depression, and anxiety.
  • Talk with parents about the role of medication in treating ADHD. Explain that children and teens with ADHD benefit most from a combination of efforts by their family, their school, and health professionals.
  • Help family members identify the child’s or adolescent’s talents, stressing the importance of building self-esteem. Physical activities can help channel high energy levels in children and teens with hyperactivity or impulsivity, and structured group activities can promote social skills. Remind families that safety gear is especially important for those with ADHD.
  • Assess the quality of the relationship between each parent and the child or teen, and encourage parents to spend regular time with their child or teen. Many male children and adolescents with ADHD will benefit from time spent with their father or another positive male role model.
  • Educate family members about ADHD and connect them with supportive resources, such as Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD).

Community or School

  • After obtaining appropriate permission, involve teachers, guidance counselors, and school-based health and mental health professionals in assessing the child’s or
    teen’s functioning and implementing a treatment plan.
  • Assess for any possible learning disabilities or special education needs.1 Public schools are obligated to assess children whose school performance may be impaired by ADHD or a learning disability. In addition:
    • Be aware that children and teens with ADHD may be eligible for special education services under the “other health impaired” disability category. These services include the development of an Individualized Education Program (IEP).
    • Consider assisting parents with contacting the school and/or participating in school conferences or IEP planning meetings for the child or teen.
    • Ensure that parents know that their child or teen may also qualify for services under Section 504 of the Rehabilitation Act.
  • Work with the school to develop a plan to reduce distracting stimuli for the child or teen (such as rearranging seating or providing extra support at transition times) and to ensure that expectations are reinforced clearly and consistently.
  • Encourage teacher-parent communication, and suggest that the child or adolescent work on improving organizational skills by keeping a “homework notebook” in which she records assignments and in which parents and teachers record ideas, observations, and praise pertaining to her successes.
  • Break up homework time into 10- to 30-minute chunks with short intervals of play or rest in between.
  • For a child or adolescent who is taking medication for ADHD symptoms, maintain contact with teachers and/or other school personnel to obtain information about possible changes in the child’s or teen’s classroom behavior and academic performance.
  • For children under age 5, intervention services may be available through IDEA (see below). The local school district or the state department of education can provide specific information about available resources.

Resources to Help Families Learn About Eligibility and Services

References

  1. DuPaul, G. J., & Stoner, G. D. (2003). ADHD in the Schools, Second Edition: Assessment and Intervention Strategies. New York, NY: The Guilford Press.
Additional Resources