NON-PHARMACOLOGIC MANAGEMENT OF ADHD
Children with ADHD and related disorders often have profoundly disrupted interactions with peers, adults, and the environment. Pharmacologic management is generally very helpful, but a multimodal approach addressing several key areas of dysfunction is usually most therapeutic.
The notion that ADHD is entirely due to poor parenting still survives despite being patently untrue. Nevertheless, children with ADHD are notoriously challenging to their parents. Parents can be helped to better understand ADHD, to develop strategies for managing ADHD symptoms, and to effectively interact with their children's schools.
The school performance of a child with ADHD should be carefully reviewed at each visit. Each advancing grade level requires an increase in attention to detail and organization. Many children with ADHD need educational interventions (a crisis point is often reached around the 3rd grade), such as modified workload, tutoring, classroom modifications and.or alternative settings for instruction or testing. .
Students with ADHD may be eligible for accommodations and/or modifications under eligibility criteria outlined in two federal laws.
1. Under Special Education law (Individuals with Disabilities Education Act- IDEA), a student with ADHD may qualify as a student with a Health Impairment (with physician attestation). Students eligible under any category then receive an Individualized Educational Plan (IEP).
2. Under Section 504 of the Rehabilitation Act of 1975, a student with ADHD or mood disorder may be eligible for accommodations or modifications. Section 504 educational interventions are typically less intensive than Special Education services and with less expense to the school, but are often more flexible, less cumbersome, and easier to implement.
Roles for the pediatrician include:
- informing the family about these options and coaching them about how to ask for services
- providing documentation of the child's disorder
working collaboratively with the school staff to monitor progress.
Social Skills Training
Impulsive, hyperactive children disturb and bother other children just as they do adults. Many children with ADHD have very poor social skills and peer interactions. Social skills can be improved through individual counseling or through group counseling services.