Behavior modification is an integral part of ADHD treatment. It is the most commonly used nonpharmacological approach for treating ADHD, according to a report published in 2015.
Effective behavior modification programs teach both the child and parent skills for managing ADHD symptoms. Programs can be tailored to work on different areas, such as making good choices, decreasing or redirecting hyperactivity, improving organizational skills, cutting down on disruptive behaviors, or staying focused. The flexibility of creating a program specific to your child’s unique needs makes behavior modification a tailored approach to managing ADHD symptoms.
Many children with ADHD respond positively to behavior strategies, including parent training. A report published in 2015 indicated that children with moderate ADHD symptoms, those without comorbid defiance or oppositional disorders, and those without anxiety benefited the most from behavior strategies.
Traditional treatment is a combination of behavior modification and medication. Experts agree that combination is the right choice for school age and older children; but for those under six, experts recommend behavior therapy first, according to the U.S. Centers for Disease Control and Prevention.
This most often involves parent training. This helps parents deal with tantrums and defiance, provides them with effective ways to give instructions, and teaches techniques to decrease negative interactions and increase positive interactions between parents and children. This type of training is generally done by specialized psychologists and can reduce outbursts and other problem behaviors, according to ChildMind.org. It teaches parents how to use praise, positive reinforcement, and consistent consequences.
According to CHADD, behavioral parenting sessions usually run for eight to 12 weeks. In between sessions, parents use and practice the skills they learned. At the next session, they can talk about their successes and whether certain strategies need to be adjusted. Then, they can learn a new skill.
These organizations offer parent training:
CHADD-Parent to Parent Family Training on ADHD
Incredible Years Parenting Program
Parent-Child Interaction Therapy
Triple P (Positive Parenting Program)
How do I start a behavior modification program at home?
The basic premise behind behavior modification is to increase desired behaviors and decrease undesired behaviors. It uses rewards, anything from praise to a monetary reward, as a way to increase positive behaviors, and consequences as a way to decrease inappropriate behaviors.
Chances are, you already use some form of behavior modification in your home. For example, you might give your children an allowance for completing chores or you might give your child a treat on the weekend if he handed in his homework all week. Starting a behavior modification program at home takes these same concepts and adds structure and predictability.
When first starting, choose one area to improve. Asking your child, especially one who has ADHD, to improve in several areas at once can be overwhelming. There might be a number of different behaviors you want to work on, but choose only one as the main focus. For example, you might want your child to stop hitting other children, or to hand in homework each day. Focus on one thing that is causing the most disruption to your family’s and your child’s life.
Once you pick a behavior, decide the best approach. For example:
Checklists: These can list tasks to get ready for school or ready for bed, daily chores, a list of tasks to complete homework, etc. Provides routine and outlines steps needed to complete the task. You can set a time limit and use a timer for each step.
Daily or weekly planner: Children with ADHD often struggle with working memory. A planner can help with scheduling homework assignments, breaking down tasks, studying for tests, remembering appointments, or organizing their time.
Rewards charts: These are often beneficial for younger children. This provides positive reinforcement for one area. Many parents use stars or stickers on a daily chart: for example, you might put up a star for each day your child is ready for school on time. A certain number of stars would equal a reward, such as going to the movies, choosing what is for dinner or extra screen time.
You might want to talk to your child’s teacher about instituting behavior programs during the school day. A daily report card works well, according to ChildMind.org. This pinpoints specific goals for behavior, gives kids feedback on how they are doing, and rewards them for meeting goals. Goals can include finishing tasks, positive interaction with peers, adherence to classroom rules, or following instructions. Teacher rates performance each day on ONE goal. Student gets a star or check and if the pre-decided number of stars or checks are earned, the child gets a reward.
Should I work with a behavioral therapist?
It is possible to set up a behavior modification in your home without the help of a therapist. There are many books and online resources to help you create and tailor a program to fit your needs. Some parents, however, struggle with finding the right strategies or need help implementing them. A trained therapist can help parents determine when and what types of responses are appropriate for their child, according to CHADD. When working with a therapist or attending parent training programs, parents learn specific skills and strategies that work best for children with ADHD and are appropriate for the age and maturity level of the child.
Many training programs are set up for you to learn a new skill, then practice that skill at home in between sessions. Besides working on specific behavioral issues, a therapist can also train parents.
See more helpful articles:
What Does Behavior Modification Consist of for Adults with ADD
Tips for Using Behavior Charts to Shape Your Child's Behavior
7 Ways to Modify Your Behavior to Treat ADHD
Using Token Economies to Help Manage Behavior
Sample Behavior Charts