Therapeutic intervention for children with ADHD in the school and home environment

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention and/or hyperactivity-impulsivity. The prevalence of the disorder is about 5.29% among children, with a higher prevalence among boys than among girls. Although this disorder is often presented as a childhood disorder, studies have shown that in most cases it continues into adulthood and is associated with lower academic, occupational, social, medical and economic performance and lower overall quality of life.

In the last decade, the amount of knowledge about this disorder and school interventions has greatly expanded. An increasing number of students with ADHD are receiving special education programs or accommodations in general education. Despite this, there is still an urgent need to develop behavioral interventions and provide appropriate guidance and resources for teachers and parents.

An important consideration for improving the effectiveness of school interventions is the connection between school and home. Implementing classroom behavior change programs is no easy task for most teachers. Therefore, it is very important for parents to be actively involved in their child’s educational program and its completion. Such a combination, which includes the triangle: parent-child-teacher, increases the child’s motivation to participate in the program and increases the chances of success of the program.

Here are some principles for behavioral intervention for children with ADHD in the school and home environment:

1. Give children clear and concise instructions that the child can repeat aloud and pronounce for themselves while performing the action. It is recommended to pass the rules through visible signs (stop signs – stop, big eyes – look, big ears – listen).
2. Respond immediately to behavior. Delaying the parent/teacher’s response to the child’s behavior greatly lowers its effectiveness in children with ADHD. The timing of the response must be methodical and is very essential in managing children with ADHD.
3. Give the child feedback frequently. Frequent rewards are helpful in maintaining the rules learned over time, especially in children with ADHD who have difficulty maintaining motivation for an extended period of time.
4. Replace reinforcements frequently. Compared to normal children, children with ADHD get used to outcomes more quickly, especially rewards. This means that although some reinforcement seems effective in the first stage, it is likely to lose its value over time, and therefore should be replaced frequently (every 2-3 weeks).
5. Remind the child repeatedly of the behaviors expected of them. The difficulty in managerial functioning in children with ADHD leads to them having difficulty monitoring and directing their behavior. Providing external cues and repeating the behaviors expected of the child will help them direct their behavior according to the goals you have set together.
6. Adjust and change the program according to the child’s response throughout the intervention. A common scenario is that a child initially responds to the appropriate program, but after a while the effectiveness of the program decreases. This does not necessarily mean that the program is not good, but that it is time to change the program according to the new needs of the child.