The therapy of ADHD should always be individually tailored to the deficits of the child and, if possible, should take a holistic approach. Holistic means that therapist, parents and school work together to achieve the best possible results through cooperation. Furthermore, the social-emotional area should be addressed as well as the psychomotor and cognitive areas.
The pedagogical work should be based on the learning level, the learning conditions and the working possibilities of each child. It must be made clear to all persons involved in the upbringing of the child that an ADHD child should not be treated with insults. This primarily requires self-discipline and self-control from these persons, because often the behaviour makes one “upset”.
Clear rules and agreements and especially consistent behaviour of adults are the starting point. Step by step, together with the child, it is then necessary to work on the observance of agreed rules. If… then – consequences must be explained calmly and made understandable, but also observed.
In doing so, they must make sure that the consequences of breaking the rules are always the same. Avoid however absolutely too hard punishments. Even if this suppresses negative behaviour, it will reappear in another place – perhaps even more severely – due to feelings of revenge or the like.
In addition, the principle of positive reinforcement has proven itself. This means: Every success, every adherence to rules etc. should be praised.
But make sure that it comes from the heart. Children, especially ADHS – children notice the difference. Please note the following: Consistent educational intervention and all the above-mentioned support will not help you to cure ADHD.
They only help you to reduce the child’s tensions and fears and to save your own energy. Cries, house arrest or even beatings always cause a defiant reaction in the child. If you feel unjustly treated – and this is the same for almost all people – you will not achieve any change in behaviour and will destroy any will to make an effort and follow rules.
The educational measures also include fine motor exercises, which become necessary because hyperactive children in particular have difficulties in the range of movement. Fine motor exercises can be carried out at any time and anywhere. Examples are: Kneading, cutting, coloring, braiding, beading, beading… .
In principle, all “common” exercises for training hand and finger dexterity are positive. However, any pressure to perform and any form of evaluation should be avoided. As already mentioned several times, there is not THE one therapy that can cure and remedy ADHD.
It must be started at different points. This means that first of all, all areas in which the child’s education is carried out must be addressed. Besides the parental home, this is first of all the kindergarten or school.
But also all other contact persons must be taught the basic aspects of a therapy. Counterproductive work, for example by the grandparents, should be avoided. As a rule, this starts with informing the parents about ADHD, its symptoms and therapeutic options.
It is important to make it clear to the parents that dealing with their own child will require more effort, energy and nerves than would be the case in the “normal case”. As a rule, this also has the consequence of breaking away from old, possibly even cherished rules and behaviour patterns. The establishment or restoration of a positive basis for education must be the main focus.
Psychological counselling should and in many cases cannot take place once and is not limited to the clarification and development of the illness. In many cases, the support during a therapy is just as important, possibly more important, as it demands a lot from the parents in terms of hardness and consistency. As already mentioned, the parents form a unit together with all other children involved in the upbringing of the child and as such should also have generally valid and consistently observed rules.
Everyone should pull “together”. In addition to educating the parents, it is therefore also important that all other groups are informed about the disease. In addition to the passing on of information, the therapy of ADHD is just as important: only if everyone pays attention to the observance of established rules can the therapy claim a chance of success for itself.
In summary, it can be said that the child’s therapy must be tailor-made. This means that there is no specific ADHD therapy that is equally applicable and feasible for every child. As individual as the child is, as individual any therapy must be considered.
This means that the age and the development of the symptoms must be taken into account as well as the accompanying symptoms and the living environment of the child. Special consideration should be given to the child’s environment (see above), so that (therapeutic/psychological) counselling and support for parents and other caregivers may be just as important as the therapy of the child itself. Accordingly, a therapy should usually include and comprise various measures, which should all complement each other in some way.
These are listed again briefly below. Since certain preconditions must first be created in order to be able to carry out a therapy in an appropriate and necessary way, it seems natural that not all measures are started and carried out at the same time. For this purpose, an individual therapy plan is usually drawn up.
In general, therapy is started at those points where problems occur. Since the behaviour then always triggers actio and reactio, it quickly becomes clear at which points further work and therapy should be carried out. – Counselling and support for parents
- Cooperation between all adults involved in education (therapists – school/kindergarten and parents’ home)
- If necessary, educational counselling (clear rules and structures (rituals))
- Appropriate diagnostics in the run-up to the therapy
- Behavioural Therapy
- If necessary, drug therapy
- If necessary (and at the appropriate time: therapy of the accompanying problems (arithmetic difficulties, dyslexia, dyscalculia, dyslexia…)
Once an ADHD has been diagnosed, it must be considered whether to start a non-drug treatment or to resort to some well-researched and currently used drugs for the disease.
Today the active substance methylphenidate is used in both child psychiatry and adult psychiatry. This active ingredient is available under the trade name Ritalin®. It is administered in tablet form and increases the ability to concentrate.
Ritalin® is a drug from the group of so-called stimulants. Why a stimulant has the opposite effect, especially in ADHD patients, and leads to an increase in concentration, is still not known. Ritalin is used in children at a dose of 2.5- 5 mg a day and is generally well tolerated.
Treatment should initially be given over several months. If the symptoms under Ritalin® are significantly reduced or even disappear, an attempt to discontinue it can be made. As a rule, however, and especially in children and adolescents, the drug is first given for at least one year after diagnosis to prevent a recurrence of symptoms.
In addition to the now older Ritalin®, a newer drug containing the active ingredient atomoxetine has also been available for some time. The trade name is Strattera®. In addition to improving concentration, the drug also reduces mood swings and impulsiveness.
No addictive behavior has been observed with this drug to date. The well-being of the child and the prognosis of their attention deficit disorder depends enormously on how the parents can cope with ADHD. Training of affected parents is therefore an elementary component of ADHD therapy.
It creates a basic understanding of the disease in order to better understand the child’s behaviour. ADHD makes normal learning difficult and influences social behaviour. If these children are treated like all others, they experience rejection in early childhood and suffer from fear of failure, which disrupts the child’s development and can lead to problems later in life.
In addition, the parents’ behaviour also influences the child’s image of himself, his illness and his abilities. Dealing correctly with ADHD is not easy. Affected children are often considered to be difficult to raise and the parents have difficulty in getting through to them.
They have to be consistent, but at the same time emotional and empathetic, although they cannot always understand the child’s behaviour. Praise instead of punishment, working in a solution-oriented way, being patient are challenges for the parents, but they are the most effective way to educate children with ADHD.