Family Skills Training Intervention for ADHD: Putting the Child Back into Child Therapy

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) affects over 7% of school-aged children in the US, and it is the most common reason pediatricians refer children for psychosocial treatment. However, the range of effective treatments for ADHD is limited to four interventions (i.e., medication, Behavioral Parent Training (BPT), behavioral classroom modifications, intensive summer programs). Notably, current behavioral interventions indirectly treat disruptive behaviors associated with ADHD through parental participation and often don't reduce core ADHD symptoms of inattention and hyperactivity/impulsivity. While multiple dimensions of attention problems are associated with ADHD, our understanding of these functional impairments has yet to guide new approaches to intervention. The purpose of this paper is to introduce a model for innovative, child-focused approaches to ADHD intervention. First, we discuss the multidimensional impairments of attention that are associated with ADHD (e.g., behavioral activation, inhibition, and adjustment problems) in order to guide the development of specific operational targets and intervention strategies for child-focused behavioral intervention. Next, we exemplify these novel methods within complementary child-focused therapy that can be delivered in conjunction with BPT; thereby, increasing the magnitude and timeliness of its effects. Finally, we illustrate how development of a child-focused intervention for ADHD promotes opportunities to reach more children in need across a variety of settings. Implications for expanding clinic-based standards of care are discussed as well as innovative practices for addressing ADHD-related problems in school and primary care settings.