How to Evaluate the Effectiveness of an ADHD Treatment
In my previous post I talked about how to assess your child’s behaviors by using an ABC record keeping system. In this post we will continue discussing ways to observe and record data for behaviors you wish to change. In order to enact change or treat a condition such as ADHD, you have to be able to look at the symptoms in an objective way. Record keeping will allow you to see patterns and trends which can give you some very important information to share with the doctors, therapists, teachers, or anyone who is working with your child.
One way such data can be useful is in deciding whether or not a particular treatment is effective or not. There are two primary methods for treating the symptoms of ADHD and they include behavior management techniques and ADHD medications. Alternative methods for treating ADHD may include a change in diet or using a sensory integration approach. You may decide to try one treatment approach or a combination of several methods.
Regardless of your choice of treatment, you will want to devise some system for telling you whether or not this treatment is working or not. Here are some easy ways you can take a look at your child’s symptoms and behaviors in order to gage the success of your chosen ADHD treatment:
1. Recording the frequency of a behavior: The way that you do this is to first define the behavior you wish to examine. Let’s say that your child’s teacher has just started a behavioral program to deal with your child’s behavior of talking out of turn. She may define this behavior objectively as: Shouting out answers without raising hand first, talking during stated quiet times, and interrupting when others are already talking. In order to evaluate whether or not the behavioral program is effective she may choose time periods to mark down how often your child engages in the talking out of turn behavior.
For example between the hour of 10 am to 11 am she may keep a simply tally sheet of the number of times your child talks out of turn. If the behavioral program is working, of course you expect to see those tally marks decrease over time.
You can find a frequency/behavior count form from the Kansas Institute for Positive Behavioral support web site.
2. Recording the duration of a behavior: Let’s say that you have a child who has meltdowns or outbursts of crying and who needs time to regroup before regaining enough composure to resume an activity. In this case you may want to record how long the meltdown lasts from start to finish before the child is calm again. You will want to have this data before using any new treatments so that you have a baseline comparison of how long these meltdowns last without treatment. After implementing treatment (let’s say your child is placed on a medication to help regulate mood) you will again record the duration of any meltdowns. Hopefully, if the particular treatment is effective, you will see a reduction in the amount of time these meltdowns last. If the duration of the outbursts remain the same over weeks and months or increases, then you know that you have to make a change in your child’s treatment plan.
3. Time sampling record: Perhaps you want to get an overall picture of how your child is behaving throughout the day. A time sampling record or what is sometimes called an interval recording can help. Basically you want to divide up your child’s day into times when you will look to see if the child is engaging in a particular behavior or not. There are two ways you can do this. One is to have set times during the day when you and/or your child’s teachers would check on your child and note whether he or she is engaged in a target behavior. For example you may take a look at what is going on every hour or at some set time during every class period. The advantage of this type of data recording is that you are not going crazy trying to observe behaviors all day long but you may also be missing time periods when your child is engaged in those target behaviors.
A second way to do a time sampling record is to choose intervals of time to observe behavior. For example let’s say you wish to assess whether or not your child’s new medication is having any effect upon decreasing aggressive behaviors. You create a data sheet divided up into regular time intervals such as 8 am-9, 9-10, 10-11 and so forth. You can then use a code to denote the occurrence of any target behaviors. For example if you are targeting aggression you can use the letter "A" to write in the box for the time interval when and if you observe this behavior. What this is going to tell you is when the medication is most and least effective. If you begin to see patterns of break through behaviors at certain times, such as when medication is wearing off then this is something you can discuss with your child’s doctor.
There are many blank time sampling observation forms to be found on the Internet. Here is a time sampling record form from the Special Connections website. Depending on your situation you may just want to create your own form.
It may seem like a lot of trouble to record data like this but it can absolutely give you some very valuable information so that you are able to make wise decisions about your child’s treatment. Collecting data can also encourage you to hang in there because you might see a gradual trend towards improvements in behavior that you might not otherwise notice.
If you have found an effective way to evaluate your child’s progress please let us know. As a community we all learn from each other. Thank you for being a member of ADHD Central.