Treating Kids' ADHD Without Meds

The best-known treatment for childhood ADHD (attention deficit hyperactivity disorder) is medication. Lately, however, non-drug treatments have been gaining ground. Research suggests that they may work just as well as meds over the long haul—and without the same risk of side effects.

7 Signs of ADHD

Which Work Better: Drug or Non-Drug Treatments?

An article in this month’s Monitor on Psychology traces the bias toward treating ADHD with drugs back to a large study published in 1999. In that study, children ages 7 to 9 with ADHD received medication, intensive behavioral treatment, a combination of both, or standard community care. The original study, which lasted for 14 months, showed that medication worked best. Yet when researchers followed up with the same group of kids a few years later, they found that the advantage of taking medication had faded over time.

A mountain of evidence has piled up since then. Overall, these studies show that kids with ADHD who get appropriate treatment do better than those who don’t. That’s true whether you look at their later school success, driving record, social life, work history, drug use, or self-esteem. But it seems that the type of treatment—drug or non-drug—may not make as much difference in the long run.

When to See a Mental Health Professional

The American Academy of Pediatrics’ guidelines recommend behavioral treatment as the first choice for treating ADHD in preschoolers (ages 4-5). For elementary school kids (ages 6-11), the guidelines recommend medication or behavioral treatment—preferably both. For adolescents (ages 12-18), they recommend medication if the teenager agrees, ideally combined with behavioral treatment.

Behavioral Approaches that Work

Studies show that several behavioral approaches may be helpful for children with ADHD:

• Behavior therapy. This approach focuses on helping kids change problem behaviors. Clear rules, chore lists, or structured schedules help children understand what’s expected. There may be a reward system for positive behavior or timeouts for behavior that’s out of control. Ultimately, children learn to monitor their own behavior and praise themselves for good decisions.
• Teacher training. Teachers learn strategies to help their students manage ADHD in the classroom and succeed at school. As an example, the teacher might spell out a goal, such as bringing homework to class every day for a week, as well as a reward for meeting the goal. Then the student’s progress might be tracked with a daily report card or star on a chart.
• Parent education. Parents learn strategies to help their children cope with ADHD, become more organized, and succeed at home and away. In group classes, they may also have a chance to connect with other parents who face the same challenges they do. An example is CHADD’s Parent to Parent program.
• Preschool programs. Some programs are geared to parents of preschoolers with ADHD symptoms or disruptive behavior in general. A report by the Agency for Health Care Research and Quality found that such programs can be effective. The more training sessions parents attended, the more their children’s behavior improved. The improvements lasted up to two years in some studies.
• Exercise. Research by Matthew Pontifex, PhD, an assistant professor of kinesiology at Michigan State University, suggests that regular exercise might be a helpful addition to any ADHD treatment. A 2012 study led by Pontifex looked at the benefits of 20 minutes on a treadmill, compared to reading quietly. After walking on the treadmill, kids with ADHD were better able to slow down when they made an error on a computer game, which helped them avoid repeating the same mistake—often a challenge for students with ADHD. In addition, both kids with ADHD and those without did better on math and reading tests after exercising.

12 Signs of Adult ADHD

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