Treatment of attention deficit hyperactivity disorder is multidirectional. It includes pharmacotherapy and psychosocial interventions. Interventions are directed at the young patient, his parents and the school environment. The cooperation of the child, family members and teachers is important for the outcome of the therapy. The accepting attitude of the patient’s relatives and environment also has a significant impact on the treatment process.
Psycho-education consists of providing information about ADHD, ways of coping with the symptoms of the syndrome and methods of treatment. It takes into account the individual needs of the specific child. It can involve the patient, his parents and people from the school environment.
The aim of behavioural interventions is to reduce undesirable behaviours and increase – desirable ones. In patients with poor social skills, social skills training or anger replacement training is implemented.
Studies have also shown the effectiveness in ADHD of family behavioural interventions and parenting skills training. The latter intervention is one of the most important after an ADHD diagnosis. During such meetings, parents learn how to work with the symptoms of the disorder (recognition, use of appropriate strategies), as well as how to deal with undesirable, difficult behaviours that are not the result of attention-deficit hyperactivity disorder.
Psychotherapy in ADHD
Individual and group psychotherapy is used in ADHD. It is undertaken with patients who have additional difficulties – low self-esteem, depression or anxiety disorders. Depending on the problems of the individual child/teenager, the following are suggested:
- internal speech development;
- cognitive behavioural therapy;
- interpersonal therapy;
- systemic family therapy;
- art therapy;
- play therapy;
Facilitation in the learning system
Facilitation in the learning system involves the use of methods adapted to the cognitive and behavioural needs of the child with ADHD. Part of the therapy is contact with the school so that more attentive care is provided to the pupil.
Elements of this include:
- seating the child with ADHD in the first bench, with a calm colleague;
- organising the work area accordingly;
- accepting symptoms that do not disrupt the rest of the class;
- checking the student’s progress during the lesson;
- checking that the child has written down all the necessary information;
- providing breaks for the pupil;
- placing the child in a class with a small number of pupils.
Pharmacotherapy is a method with proven effectiveness in controlling ADHD symptoms. In children, it is usually included if psychotherapeutic interventions are not sufficiently effective. In cases of very severe symptoms or associated disorders (e.g. oppositional defiant disorder, severe conduct disorder or depression), both methods are used simultaneously.
The first-line drugs in attention deficit hyperactivity disorder are psychostimulants (methylphenidate and amphetamines). The non-stimulant drug atomoxetine is also used. Other preparations with proven efficacy in ADHD are:
- tricyclic antidepressants;
During pharmacotherapy, it is important to ensure that the prescribed doses are adhered to, to observe the child and to contact the doctor if there is any doubt.
Source / Bibilography