Published: Dec. 5, 2013
In our previous article, ADHD Treatment, we considered a number of points with regards to the sometimes complex and always challenging goal to treat ADHD.
First, we noted the huge importance of a proper diagnosis. Many difficulties can sometimes seem to be ADD/ADHD, but are in fact other forms of learning disabilities, cognitive difficulties or even other diagnoses altogether.
The opposite is also true – many times what can seem to be something else such as memory problems, clumsiness or emotional difficulties are actually secondary symptoms of attention disorders.
So while it can often involve quite a bit of bureaucracy, professional diagnosis is well worth the effort when faced with difficulties that do not ease over time or seem to have no specific starting point or trigger.
Then, we looked at the two main treatment approaches – medical treatment to increase and balance certain neurochemicals in the brain; and behavioral approaches which work to shape and guide problematic behaviors.
These have both been proven effective to a certain extent. Medication – when it works – works immediately, but has a short-term effect. Behavioral therapy works with the child to develop his self-control over time, but can take a great deal of time and sustained effort. The question then becomes – Are there alternatives?
A Closer Look at Medical and Behavioral Treatments
An important study looking at the relative efficacy of these two main treatments – medical therapy and behavior modification (entitled ‘The Multimodal Treatment Study of Children with ADHD’) found that medication on its own, or combined with behavioral therapy are both helpful. But also found was that behavioral therapy generally enabled children to take lower doses of medication. Another important finding was that many children did well without medication, using only behavioral therapy. In any case, it is clear that every child is unique, and it is worth considering and testing a number of approaches to see what will work best for each child and family.
An additional recent study of long-term effects of stimulant medication points to a significant limitation. While there were clear positive affects in the short-term – for example in the lower grades and during the first or second year of treatment – these did not hold over the long term, and by the third year of treatment, any advantage in academics or social adjustment had completely disappeared.
Are There Alternatives?
It’s surprising that only relatively recently have attention disorders been linked to cognitive deficiencies. An important trend in research and treatment is looking closer at how skills called ‘Executive Functions’ are related to ADD/ADHD. In fact, they are considered to be so important that some leading researchers such as Prof. Barkley even claim that the disorder should be renamed as Executive Function Deficiency…
Regardless of whether the core symptoms are neurological, cognitive or behavioral, strengthening cognitive skills are clearly effective and helpful for children with ADD/ADHD. So even while taking medication or behavioral therapy – it is crucial not to neglect strengthening children’s cognitive abilities – working memory, attention, concentration, focus, response speed and more.
Cognitive training is becoming an important tool for a variety of cognitive difficulties – including ADD/ADHD. Cognitive training enables us to treat the core symptoms from the root – guiding the child to train the way his mind focuses, to process details, to follow instructions, to make decisions and to control impulsivity and distractibility.
Clinical research shows that when these training exercises are properly designed, they in turn stimulate the frontal lobe of the brain, resulting in greater levels of dopamine receptivity as well as balanced brain activity. This in fact changes the brain in a long-term and even permanent way. In this way, it proves an excellent tool to boost children’s ability to overcome the effects of their ADD/ADHD – on its own, or together with other treatment methods.