Behavior Therapy – A Non-Medication Treatment for ADHD
Wartel Behavioral Services
6346 Orchard Lake Rd., Suite 107
West Bloomfield, MI 48322
Phone: (248) 626-1330
With ADHD, it is important to determine what are the motivations/reinforces for the behaviors. A reinforcer is anything that follows behavior and maintains or increases its frequency. This is necessary for developing an effective behavioral intervention. Common reinforcers for ADHD behaviors are obtaining attention, gaining a desired object or activity or avoidance of an unpleasant task or activity.
Attention may be the reinforcer of an ADHD behavior if; the ADHD behavior occurs when the parents attention is directed elsewhere, the behavior intensifies if it does not immediately result in the child getting the parent's attention, stops when the child gets the parents attention or the behavior begins again if the parent directs his/her attention elsewhere.
It is likely the ADHD behavior is reinforced by gaining a desired object or activity if the behavior occurs after the parent told the child he cannot have or do something, stops after allowing the child to have or do something, or is successful in getting the child objects and activities that are otherwise not available to him/her.
ADHD may be reinforced by avoidance of unpleasant tasks if the behavior occurs when he/she is asked to do something boring or difficult. An ADHD child's negative behavior often increases after being asked to something they find boring, difficult or unpleasant, or if they are currently doing something they like doing more. Sometimes the behavior can increase to point the parent/adult decide it isn't worth it and withdraws the request. This reinforces the negative behavior because it allows the child to avoid the unpleasant task. If the child's negative behavior stops after parent withdraws his/her request to do an unpleasant task, this further supports the negative behavior is an effective method for avoiding unpleasant activities. In addition, the child is reinforcing the parent/adult for withdrawing the request by terminating the negative behavior. If the negative behavior frequently stops after the child completes the undesired activity, it is likely that the negative behavior stopped because the aversive task ended.
Behavior therapy is an approach that focuses on what triggers and reinforces problem behaviors and changing those patterns. When working with children, it is most effective when using a systems approach. This means developing behavioral interventions with all aspects of the child's environment that may be impacting his or her behavior, especially the home/parents and school. This includes, but is not limited to behavioral non-medication approaches for improving attention, decreasing behavioral problems at home and in school, and for completing homework and classwork. School visits are sometimes necessary to develop effective behavioral interventions in that setting.