Initial treatment

Successful treatment of attention deficit hyperactivity disorder (ADHD) begins with an accurate diagnosis and understanding of a child's weaknesses and strengths. Learning about ADHD will help you and your child's siblings better understand how to help your child.

The American Academy of Pediatrics guidelines recommend medicine and/or behavior therapy to treat children with ADHD. This recommendation is based on numerous studies, including the landmark Multimodal Treatment Study of Children with ADHD (MTA), funded by the U.S. National Institute of Mental Health (NIMH). In this large study, researchers found that school-age children with ADHD who received stimulant medicine had a significant decrease in core ADHD symptoms (inattention, impulsivity, and hyperactivity).⁶

Your child's doctor may recommend that your child take a stimulant medicine, such as amphetamine (for example, Dexedrine, Adderall) or methylphenidate (for example, Ritalin, Concerta, Metadate CD). These medicines improve symptoms in about 70% of children who have the condition.⁷

Although it may seem contradictory, stimulants usually decrease hyperactivity and impulsivity and improve focus. Some parents worry about their children becoming addicted to stimulants. Research has shown that these medicines, when taken correctly, do not cause dependence. But parents should closely supervise the use of ADHD medicines, because abuse by siblings, classmates, and adults has been reported.

Parents are also often concerned about medicine side effects, including loss of appetite, nervousness, tics or twitches, and problems sleeping. Children should be closely monitored after they start medicines, to assess whether they are receiving the correct dose. These side effects usually decrease after a few weeks on the medicines, or the dosage can be lowered to offset side effects. For more information, see:

Should my child take medicines for ADHD?

Atomoxetine (Strattera) is a nonstimulant medicine that may be prescribed if stimulant medicines are not effective or have bothersome side effects. Strattera is not a controlled drug, which means refills on prescriptions and telephone prescriptions are allowed.

The AAP guidelines also encourage behavior therapy. Through behavior therapy, parents learn strategies, such as positive reinforcement, to improve a child's behaviors. Children learn to develop problem solving, communication, and self-advocacy skills. Behavior therapy is more helpful when used with medicine than it is when used by itself.

Counseling may help children and adults with ADHD recognize problem behaviors and learn ways to deal with them. For both parents and children, counseling can be a place to air frustrations and deal with stress.

Some children with ADHD also have other conditions, such as anxiety or oppositional defiant disorder. Behavioral therapy can help treat some of these conditions.⁷

Elementary school teachers are often the first to recognize ADHD symptoms because in the classroom more demands are placed on children to sit still, pay attention, listen, and follow class rules. Many times teachers recommend to parents that a child be tested or see a health professional.