57 Top Behavioral Interventions for ADHD

57 Top Behavioral Interventions for ADHD
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Dr. Roseann Capanna-Hodge

Every parent wants the best for their child, especially when that child has Attention Deficit Hyperactivity Disorder (ADHD) and their child is prone to dysregulation. As parents, we sometimes feel lost and confused about how to best support our children, especially when conventional treatments, like ADHD medications, may not be enough or may have side effects. The good news is that behavioral therapy, specifically behavioral interventions for ADHD, can provide significant assistance and even improve outcomes for children with this condition.

Behavioral Parent Training for ADHD

 

Behavioral Parent Training involves teaching parents effective strategies for dealing with their child's ADHD behaviors. This can include setting clear and consistent rules, offering positive reinforcement for appropriate behaviors, and maintaining a structure that benefits the child's unique needs.

  1. Positive Reinforcement: Recognize and praise your child's good behavior. When your child behaves in a desirable way, provide immediate and enthusiastic praise. This could be verbal, like saying, “Great job tidying your toys!” or physical, like a high-five or a hug (Eyberg, 1988).
  2. Clear and Calm Instructions: Make sure your directions to your child are clear and calm. Too many instructions at once can overwhelm a child with ADHD. Break down tasks into smaller, manageable steps (Sanders, 2008).
  3. Skill Development: Encourage the development of key skills such as problem-solving and communication. This could be through games, role-play, or guided activities (Kazdin, 2005).
  4. Consistent Routines: Establishing consistent daily routines can help a child with ADHD understand what is expected of them and reduce anxiety. Make sure the routines are structured and predictable (Kazdin, 2005).
  5. Limit Setting: Set clear, reasonable limits for your child and stick to them. This can provide a sense of security and help your child learn self-control (Barkley, 1987).
  6. Modeling Appropriate Behavior: Children often learn by imitating adult behavior. Try to display behaviors you would like your child to adopt, like patience, calmness, and perseverance (Eyberg, 1988).

School-Based Interventions

 

School-Based Interventions are also a crucial part of managing ADHD as they help children with ADHD improve their academic and behavioral performance at school.

  1. Establish Clear Classroom Rules: Work with your child's teacher to set clear and consistent rules for the classroom. Ensure the rules are visually displayed and regularly reviewed (DuPaul, Eckert, & Vilardo, 2012).
  2. Use of Visual Aids: Teachers can use visual aids to help children with ADHD follow along with lessons. This can include charts, diagrams, or color-coding (DuPaul, Eckert, & Vilardo, 2012).
  3. Preferential Seating: Arrange for your child to sit closer to the teacher and away from windows or doors to minimize distractions (DuPaul, Eckert, & Vilardo, 2012).
  4. Break Down Assignments: Large assignments can be overwhelming for children with ADHD. Teachers can break down tasks into smaller, more manageable parts (DuPaul, Eckert, & Vilardo, 2012).
  5. Frequent Feedback: Teachers can provide regular feedback to children with ADHD, highlighting positive behaviors and gently correcting inappropriate behaviors (DuPaul, Eckert, & Vilardo, 2012).
  6. Incorporate Physical Activity: Regular movement breaks during the school day can help children with ADHD burn off excess energy and improve focus (Verret et al., 2012).
  7. Provide Additional Time: Allowing extra time for tasks can help children with ADHD work at their own pace and reduce the pressure they might feel to rush through their work (DuPaul, Eckert, & Vilardo, 2012).
  8. Peer Tutoring: Working in pairs or small groups can help children with ADHD improve their social and academic skills (DuPaul, Eckert, & Vilardo, 2012).
  9. Use of Technology: Assistive technology, such as speech-to-text software or digital organizers, can be beneficial for students with ADHD (DuPaul, Eckert, & Vilardo, 2012).

Self-Management Interventions

Self-Management Interventions can also be highly beneficial, as they empower children with ADHD to take control of their own behavior. Self-regulation is the foundation of learning in all areas and it is critical in the development of executive functioning. 

  1. Goal Setting: Teach your child to set realistic, achievable goals and create a plan to reach them. This helps improve their planning and organizational skills (Shapiro, 2011).
  2. Self-Reflection and Self-Regulation: Encourage your child to engage in self-reflection exercises to identify triggers, recognize their emotions, and develop self-regulation strategies. This intervention promotes self-awareness, impulse control and emotional control (Barkley, 2012).
  3. Self-Monitoring: Help your child learn to monitor their own behavior by keeping a diary or chart of their positive and negative behaviors. This awareness can promote self-control and responsibility (Shapiro, 2011).
  4. Visual Reminders: Using visual reminders, like stickers or charts, can help children track their progress towards achieving their goals (Shapiro, 2011).
  5. Cognitive Behavioral Techniques: Encourage your child to identify and challenge their negative thought patterns. This can help promote more positive thinking and behavior (Knapp, Dahl, & Swift, 2013).
  6. Time Management Strategies: Teach your child effective time management techniques, such as creating schedules, using timers or alarms, and breaking tasks into smaller, manageable steps. These strategies can help improve their organization and ability to prioritize tasks (Barkley, 2012).
  7. Self-Reward Systems: Implement a self-reward system where your child can earn rewards or privileges for meeting specific behavioral goals or completing tasks. This intervention can increase motivation and reinforce positive behaviors (Barkley, 2012).
  8. Problem-Solving Skills: Teach your child problem-solving techniques, such as identifying the problem, brainstorming solutions, evaluating options, and implementing the best course of action. This intervention enhances their critical thinking and decision-making abilities (Power, Karustis, & Habboushe, 2018).

 

Social Skills Training

Children with ADHD often struggle with social interactions. Social Skills Training can help them develop the necessary skills to navigate social situations effectively. This training focuses on improving communication, empathy, problem-solving, and other essential social skills. Through structured activities and guidance from professionals, children with ADHD can gain confidence and build meaningful relationships. Acquiring these skills not only improves immediate interactions but also sets a foundation for long-term social competence and success.

  1. Role-Play: Use role-play to practice appropriate social interactions and self-regulation. This could include taking turns, sharing, or responding to conflict (Shapiro, 2011).
  2. Practice Social Scripts: Role-play and practice social scripts with your child for common social situations, such as introducing themselves, joining a group, or initiating a conversation.
  3. Teach Conversation Skills: Guide your child in maintaining eye contact, listening attentively, and waiting their turn to speak during conversations (Shapiro, 2011). 
  4. Cooperative Games: Arrange activities where your child needs to cooperate with others. This can improve teamwork and negotiation skills (Shapiro, 2011).
  5. Provide Social Opportunities: Arrange playdates, outings, or group activities to provide regular opportunities for your child to interact with peers and practice social skills in different settings.
  6. Encourage Cooperative Play: Encourage your child to engage in cooperative play activities, such as building with blocks, completing puzzles, or playing board games, which promote turn-taking, sharing, and collaboration.
  7. Model Social Skills: Be a positive role model by demonstrating effective social skills yourself. Use polite language, active listening, and respectful behavior in your interactions with others.
  8. Prompt Social Behaviors: Provide gentle reminders and prompts to your child when engaging in social situations. Encourage them to greet others, ask questions, and express empathy or compliments.
  9. Teach Conflict Resolution: Guide your child in learning constructive ways to resolve conflicts or disagreements. Teach them strategies such as compromise, active listening, and finding win-win solutions.
  10. Promote Perspective-Taking: Encourage your child to consider others' perspectives and feelings. Discuss different points of view and help them understand the impact of their words and actions on others.
  11. Teach Empathy: Help your child understand and respect the feelings of others through stories, videos, or real-life examples (Shapiro, 2011).
  12. Foster Emotional Intelligence: Help your child develop emotional intelligence by encouraging them to recognize and label their emotions, understand the emotions of others, and respond appropriately in social interactions.
  13. Peer Modeling: Encourage your child to observe and learn from positive social behaviors exhibited by their peers. Peer modeling can provide valuable examples and help your child understand appropriate social cues and responses (Bellini & Akullian, 2007).
  14. Social Skills Groups: Consider enrolling your child in social skills groups or classes specifically designed to teach and practice social interaction skills with peers. These groups provide structured opportunities for learning and practicing social skills in a supportive environment (Laugeson, Frankel, & Mogil, 2010).

Sensory Processing Interventions

In the realm of supporting children with sensory processing challenges, various interventions can make a significant difference in their daily lives. Sensory Processing Interventions encompass a range of strategies and activities aimed at helping children with sensory sensitivities or difficulties. 

By addressing the unique sensory needs of each child, these interventions provide targeted support to enhance their sensory experiences, promote self-regulation, and improve overall well-being. 

  1. Sensory Integration Therapy: Engaging in activities that involve the simultaneous input of multiple senses to improve sensory processing and integration (Watling & Hauer, 2015).
  2. Environmental Modifications: Making adjustments to the physical environment to reduce sensory distractions and create a more sensory-friendly space (Watling & Hauer, 2015).
  3. Sensory Diet: Create a “sensory diet” with a variety of sensory activities tailored to your child's needs, such as swinging, jumping on a trampoline, or deep pressure exercises (Bundy & Murray, 2002).
  4. Sensory Breaks: Provide regular breaks for sensory activities throughout the day. This can help your child stay focused and calm (Bundy & Murray, 2002).
  5. Fidget Tools: Use fidget tools, like stress balls or putty, to help your child focus and self-regulate (Bundy & Murray, 2002).
  6. Weighted Blankets: These can provide deep pressure which may help calm and comfort children with ADHD (Bundy & Murray, 2002).
  7. Deep Pressure Therapy: Applying deep pressure through techniques like weighted vests or deep pressure massages to promote a calming effect and sensory regulation (Koegel et al., 2012).
  8. Visual Supports: Using visual aids, such as visual schedules or cue cards, to enhance comprehension and provide structure in daily routines and activities (American Occupational Therapy Association, 2020).

Coping Skills Techniques

 

Coping skills techniques are invaluable tools that can empower children to navigate challenges, manage emotions, and build resilience. For children with ADHD, developing effective coping strategies is particularly important in promoting their overall well-being and success.

  1. Relaxation Techniques: Teach your child deep breathing exercises or progressive muscle relaxation techniques to help them manage stress (Sukhodolsky et al., 2005).
  2. Problem-Solving Skills: Help your child develop problem-solving skills by working through challenges together, step by step (Cunningham, 2006). This helps not only with frustration tolerance but also improves communication skills.
  3. Anger Management Skills: Teach your child to recognize signs of anger and use coping strategies like counting to ten or deep breathing (Sukhodolsky et al., 2005).
  4. Resilience Building: Encourage your child to learn from setbacks and persevere. This could involve discussing challenges and brainstorming ways to overcome them (Cunningham, 2006).

Mindfulness and Relaxation Techniques

 

Mindfulness and Relaxation Techniques provide valuable tools for promoting calmness, self-awareness, and emotional well-being in children. In the fast-paced and often demanding world we live in, children with ADHD can greatly benefit from these practices to enhance focus, reduce stress, and improve overall mental health.

  1. Mindfulness Exercises: Practice mindfulness exercises with your child, such as guided meditation or mindful coloring (Zylowska et al., 2008).
  2. Yoga: Encourage your child to practice yoga. Yoga can help children relax, focus, and improve self-awareness (Haffner et al., 2006).
  3. Neurofeedback: Teach your child to control their body's responses (like heart rate) using biofeedback and neurofeedback techniques (Monastra, Monastra, & George, 2002).
  4. Guided Imagery: Use guided imagery exercises to help your child relax and focus. For instance, have them visualize a peaceful place (Zylowska et al., 2008).

Contingency Management

 

Contingency Management is a powerful approach that helps children with ADHD develop positive behaviors and make effective choices. By utilizing rewards, consequences, and structured systems, this blog section explores the concept of Contingency Management and its application in supporting children's behavioral development. 

From implementing reward systems and behavior contracts to ensuring consistent consequences and using daily report cards, these techniques provide practical strategies for parents and caregivers.

  1. Reward System: Create a reward system for positive behavior. Use tokens or points that can be traded in for larger rewards (Fabiano et al., 2009).
  2. Behavior Contract: Develop a behavior contract outlining expected behaviors and consequences for not meeting those expectations (Fabiano et al., 2009).
  3. Consistent Consequences: Ensure consequences for inappropriate behavior are consistent and immediate (Fabiano et al., 2009).
  4. Daily Report Cards: Implement a daily report card system where your child's behavior is evaluated and rewarded each day (Fabiano et al., 2009).

As parents, we feel inspired by the transformative potential of learning about behavioral therapy, positive reinforcement, and parent training programs as empowering alternatives to ADHD medications for supporting our children with ADHD. 

By equipping ourselves with the knowledge and tools to implement these interventions, we have the opportunity to make a positive impact on our children's lives. Behavioral therapy offers a holistic approach, teaching our children new skills and strategies that can help them thrive. 

By implementing positive reinforcement techniques, we can create an environment that celebrates and reinforces their positive behavior, nurturing their growth and development. 

Parent training programs serve as invaluable resources, guiding us in navigating the challenges of ADHD and empowering us with effective strategies. By embracing these treatments, we can foster positive behavior and support our children's journey with attention deficit hyperactivity disorder (ADHD) in a manner that aligns with our values and aspirations. 

Through these interventions, we, as parents, have the power to create a nurturing environment that promotes positive behavior and enables our children to flourish.

Grab our free resource, “147 Therapist-Endorsed Self-Regulation Strategies for Children: A Practical Guide for Parents,” is a game-changer. 

Citations:

American Occupational Therapy Association. (2020). Occupational Therapy Practice Framework: Domain and Process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 1-658.

Barkley, R. A. (1987). Defiant children: A clinician's manual for parent training. Guilford Press. 

Bundy, A. C., & Murray, E. A. (2002). Sensory integration: A. Jean Ayres' theory revisited. In A. C. Bundy, S. J. Lane, & E. A. Murray (Eds.), Sensory integration: Theory and practice (pp. 3–33). F.A. Davis. LINK

Cunningham, C. E. (2006). COPE: Large group, school-based, family-centered intervention. In R. B. Mennuti, A. Freeman, & R. W. Christner (Eds.), Cognitive-behavioral interventions in educational settings: A handbook for practice (pp. 447-472). Routledge. 

DuPaul, G. J., Eckert, T. L., & Vilardo, B. (2012). The effects of school-based interventions for attention deficit hyperactivity disorder: A meta-analysis 1996–2010. School Psychology Review, 41(4), 387-412. LINK

Eyberg, S. M. (2008). Parent-child interaction therapy: Integration of traditional and behavioral concerns. Child & Family Behavior Therapy, 10(1), 33-46. LINK 

Fabiano, G. A., Pelham, W. E., Coles, E. K., Gnagy, E. M., Chronis-Tuscano, A., & O'Connor, B. C. (2009). A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review, 29(2), 129-140. DOI:10.1016/j.cpr.2008.11.001

Haffner, J., Roos, J., Goldstein, N., Parzer, P., & Resch, F. (2006). The effectiveness of body-oriented methods of therapy in the treatment of attention-deficit hyperactivity disorder (ADHD): results of a controlled pilot study. Zeitschrift für Kinder-und Jugendpsychiatrie und Psychotherapie, 34(1), 37-47. DOI:10.1024/1422-4917.34.1.37

Kazdin, A. E. (2005). Parent management training: Treatment for oppositional, aggressive, and antisocial behavior in children and adolescents. Oxford University Press. LINK

  • Knapp, P., Dahl, M., & Swift, J. K. (2013). Handbook of cognitive-behavioral therapies. The Guilford Press.
  • Laugeson, E. A., Frankel, F., & Mogil, C. (2010). Social skills training for young adults with high-functioning autism spectrum disorders: A randomized controlled pilot study. Journal of Autism and Developmental Disorders, 40(7), 867-876. DOI:10.1007/s10803-011-1350-6

Monastra, V. J., Monastra, D. M., & George, S. (2002). The effects of stimulant therapy, EEG biofeedback, and parenting style on the primary symptoms of attention-deficit/hyperactivity disorder. Applied Psychophysiology and Biofeedback, 27(4), 231-249. DOI:10.1023/a:1021018700609

Sanders, M. R. (2008). Triple P-Positive Parenting Program as a public health approach to strengthening parenting. Journal of Family Psychology, 22(4), 506-517. DOI:10.1037/0893-3200.22.3.506

Shapiro, E. S. (2011). Academic skills problems: Direct assessment and intervention (4th ed.). The Guilford Press.

Sukhodolsky, D. G., Kassinove, H., & Gorman, B. S. (2005). Cognitive-behavioral therapy for anger in children and adolescents: A meta-analysis. Aggression and Violent Behavior, 10(3), 247-269. LINK

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