While medications treat symptoms of ADHD, researchers are always evaluating non-medication strategies, such as psychotherapy, and complementary approaches like meditation. We asked the experts to weigh in on these tools and others.
Is there a downside to taking ADHD meds?
Medication won’t cure ADHD, but it does treat the symptoms, says child and adult ADHD specialist Mark Stein, PhD, a research affiliate at the Center on Human Development and Disability at the University of Washington in Seattle. This is important, he says, because, “people may think that untreated ADHD is benign; but the person may do poorly in school and in their relationships, and it has an impact on their self-esteem and health and well-being.”
Are there effective nondrug strategies for children?
“The only treatment for kids with repeatedly demonstrated efficacy is behavior management, or modification,” says Ronald Brown, PhD, dean of the School of Integrated Health Sciences at the University of Nevada, Las Vegas. “This means giving effective instructions and using reward systems like praise or a point system.” For younger children, for example, timeouts and loss of privileges can be helpful.
“A relatively new and effective treatment for children and young teens is organizational skills training,” says Richard Gallagher, PhD, an associate professor of child and adolescent psychiatry at NYU Langone Health, and director of special projects at the Institute for Attention Deficit Hyperactivity and Behavior Disorders at the Hassenfeld Children’s Hospital in New York City. “This training has led to improvements in functioning at home and at school, and reductions in inattention and activity levels.”
Can parents practice behavior management at home?
“Parents can use behavior modification and organizing skills with their child, but they should go to a trained provider to learn how,” Dr. Brown says. “Some techniques are simple, like doing homework in a special place each day so your child associates this place with studying. If the child doesn’t follow the rules with appropriate behavior, it costs them points or an activity.”
How would a parent know if a child would respond better to medication or a behavior strategy?
“Most children are responsive to behavior management, and about 90 percent respond to meds,” Dr. Brown says. “But I’m reluctant to treat a child only with medication. If a parent is hesitant to use meds, I suggest starting with behavior management. Meds can be added later.”
What alternatives are there for adults who don’t want to take ADHD medications?
“It depends,” Dr. Brown says. “If a father has ADHD and can never get organized, you may want the family to have therapy because it’s affecting the whole family, or if an adult is always procrastinating, individual therapy is an option.”
What non-medication therapies are effective for adults and older kids?
“Cognitive behavioral therapy (CBT) can help with inattention and impulsivity by modifying how the person thinks and reacts,” says Lenard Adler, MD, director of the Adult ADHD Program at NYU Langone Health in New York City. “A therapist might work on strategies to overcome procrastination. Sometimes, learning how to use a planner can help a person better manage time and complete tasks.”
“CBT teaches time management, organization, how to set realistic goals, and task completion strategies,” says Dr. Brown. “A person learns that if their flight leaves at 10 am, they can’t get up at 8—unless they live next door to the airport.”
How does diet affect symptoms of ADHD?
“If you are drinking a lot of caffeine while you are on a stimulant, that can cause a higher heart rate, which is not advisable,” says Dr. Adler. “It’s important to make sure you eat, eat well, and stay hydrated. If you are not eating and drinking fluids, it can affect your ability to pay attention.”
“When you have an overabundance of sugar, it can aggravate anything,” including possibly ADHD symptoms, notes Dr. Brown. But he cautions that sugar doesn’t cause ADHD. “It’s something you’re born with that persists over your life.”
Is exercise beneficial in treating ADHD?
“Physical activity helps combat negative habits like excessive screen time and poor sleep,” says Dr. Stein. “It also helps build resilience and improves mood.”