What is the best treatment for AD/HD?

The best way of helping a child who has this condition, requires a serious multidisciplinary approach. This must include:

1. Proper diagnosis, especially with the non-hyperactive, difficult to diagnose children. (See diagnosis section.)

2. Setting up goals for treatment results, before starting with the treatment. The goals must be high but realistic and as the situation improves, these must be readjusted. When the IQ score is very high, yet the school performance is very poor, goals may be set higher than expected. When the difference between an expected high performance due to a high IQ score (that may enable one to be an A student), and the actual school performance is very significant, the difference may be attributed to the AD/HD difficulties. In such cases the improvement with stimulant medications may be remarkable. Some children may in fact become A students (from failing), within a short period of time.

   My experience has shown that some children who were considered "mentally deficient" in special education, with proper management, including stimulant medications, have become A students in a mainstream education program. Hoping to become an A student is the goal I like to see families wish for. This goal may be very realistic in many situations, more than most parents believe.

3. Changing the mind set, resetting the priorities of the child's lifestyle and activities may enable him to achieve the set goals. For example, changing recreational and sport activities if they interrupt the after school learning session, accommodating the activities in a way most helpful to the academic needs. Habits believed to disturb learning should be eliminated or adjusted (tv time, Nintendo, etc.)

4. Structured learning. (See specific section on Contracted, Structured and Rewarded Learning.) This is the program that helps exercise the brain to overcome the cognitive dysfunctions of AD/HD.

5. School involvement. Accommodations may be made as needed. I usually advise parents not to overdo it with extra help that may be an unnecessary "crutch" for the child. Helping too much may lead to a possibility that the child will take advantage of the help, becoming lazier than needed. Some extra help at school may require specific labeling by the board of education. This may be avoided by proper medication and supportive management. If possible, special education and resource room should be avoided, so that the child will not lose the challenge in school.

   Once accommodations are needed, the 504 laws may be activated. This indicates that all the children with difficulties must get equal opportunity. Special requests must be made in regards to this law. These may include increased time or a quiet environment for testing, or even a one on one assistance from a paraprofessional, who will redirect the child's attention to the class work. Board of education "labeling" permitting these accommodations may include, most commonly, "learning disabled," "emotionally disturbed," or a more gentle one, "other health impaired." Accommodations, including special educational services, require an IEP (Individual Educational Program). This is a specific academic plan for the child's goals at school. An IEP is a "legal document" and must include an IQ test.

6. Psychologists. Help from a psychologist or counselor may be important. Some kids may need help with self esteem difficulties, social skills, controlling their rage, improving their insight with regards to how their behavior impacts themselves and others, or dealing with an oppositional and deficient behavior.

   Psychological help is an important supportive treatment for the right individual, but does not result in a cure. Children who have hyperactive behavior or inattention due to a chemical imbalance will be unable to correct this situation as a result of "psychological treatment."