ADHD 7 Step Treatment Program
Treating ADHD from all angles:
Brain regulation | Attention enhancement | Behavioural optimisation
Scientific research has shown that a combination of several treatments are most effective for treating ADHD and its numerous co-occurring problems. This program is one of the only few available internationally and currently we have patients from not only all over Australia but also internationally.
Not everyone will need to do every stage and each person's therapy is individualised to their needs.
7 modules: From brain - to cognitive skills - to behaviour
- Brain-based treatment: Neurofeedback &/or medication monitoring
- Cognitive skill training: Attention & executive functioning
- Emotional management & resilience training
- Sleep management
- Behavioural management
- Social skills training
- Accommodations: Educational & workplace
Step 1: Brain-based treatment: Neurofeedback &/or medication monitoring
At the Sydney Cognitive Development Centre our philosophy is that medication is the last resort. This isn't to say that we are against medication, but we feel that medication should be considered only in very urgent situations (eg. school expulsion, legal issues) or when all other longer-term treatment options have not succeeded.
We prefer to work based on a model of actually enhancing core skills for life, rather than medicating and ‘putting a band-aid on it’ for the short-term. Most ADHD medication are short-lasting in that even the long-acting medication are usually ineffective after 10 hours. This means you wake up the next day and all the problems are back.
If we do recommend medication it is as a short-term solution whilst other skills are being built and worked upon, and we will refer you to a paediatrician or psychiatrist where applicable. We work with many medical professionals and help them monitor via our tests whether the medications are effectively improving abilities from clinical ranges to within normal limits.
As we find many skills such as attention span, working memory, switching attention, and executive skills are only rarely increased through medication, we find that with medication we prefer to combin Hence even if a child is already on medication we will still engage them in many of our other treatment modules such as neurofeedback and cognitive training program so that they can build core skills and hopefully work towards getting off, or at least reducing their medication.
Our preferred brain-based ADHD treatment is neurofeedback. Neurofeedback recognises that people with ADHD have scientifically proven differences in brain structures and brain activity. Neurofeedback aims at normalising brain functioning through a process of biofeedback. It has been recognised by the American Academy of Pediatrics since 2012 as having the highest level of scientific efficacy for treating ADHD. To do neurofeedback you will need to undergo a qEEG brain scan to look at the biomarkers for ADHD and identify regions of dysregulation. These brain regions are then targeted in a completely natural, noninvasive (and fun) ADHD therapy which involves teaching you to suppress brain waves which are excessive (often slow wave associated with sleep and drowsiness) and to enhance brain waves associated with a calm but very alert state. To find out more about this treatment click below.
Step 2: Cognitive skill training: Attention & executive functioning
Ultimately the aim of all ADHD therapy and treatment is to actually build the child’s core skills so that additional support is not required and the learning process is smooth and less effortful.
At the SCDC we currently run the HighQ Cognitive Training Program, a program which is the synthesis of over 16 of the top cognitive training programs. We utilise numerous programs to target a large range of cognitive skills, and each program is personally designed to suit your child’s specific profile of strengths and weaknesses.
Our cognitive training program will target your child’s weaknesses and each program is individualised. All training begins in building core skills, however unlike the majority of program that stop there, our program teaches children how to generalise these skills to the real world.
The focus of our training is to build functional everyday skills that support learning and are generalised, rather than to build skills on a specific task as done by all computerised non-specific training programs. For children with ADHD one of our key modules that we often include is our executive training. Executive functions are the skills necessary for completing goals; including planning, organisation, problem solving, utilising feedback and flexible thinking.
Difficulties with these skills are very common in children with ADHD. Our training program includes both classroom and home interventions to reduce the negative effects of weak executive skills, as well as direct intervention to help improve your child’s capacity for using their own executive skills.
Please note: cognitive training is based upon a cognitive profiling assessment that has identified the precise cognitive issues that are underlying the behavioural inattention manifestations. Please review our ADHD assessment procedures in the link below to make sure you clinican has conducted these assessments if you have already been diagnosed by another centre and wish to engage in this type of therapy.
Step 3: Emotional management & resilience training
Children and adults with ADHD are at increased risk for developing emotional issues such as depression, anxiety, low self-esteem, and anger/low frustration tolerance. They get bored easily and hence can be very emotional labile.
As part of our program we teach people with ADHD long-term skills in emotional management using techniques from both cognitive behavioural therapy and ACT therapy.
We have found that certain components of ACT therapy very valuable in child ADHD and adult ADHD. Specifically we find that teaching people with ADHD how to accept internal feelings of boredom and low stimulation, in order to follow their goals, can help them cope with many inattentive behaviours.
For people with ADHD focusing can feel “painful”, hence having them learn to cope with this ‘pain’ can quickly overcome many behavioural issues. We have also found that teaching people with ADHD mindfulness, (ie. the ability to stay within the present), can be extremely helpful in supporting them with their sustained focus.
In this module of our program we aim to reduce frustration and alleviate any negative emotions, whilst maximising self-esteem. This therapy is short-term as we want to give children and adults with ADHD tools they can use themselves throughout their lives to remain resilient in this world.
Step 4: Sleep management
One of the most co-occuring issues with ADHD is a sleep disorder. People with ADHD often have issues falling asleep, maintaining their sleep and getting into deeper levels of sleep (often having very restless or light sleep). These issues with sleep can be present for up to 70-80% of people with ADHD, and often treating the sleep issues alone can make a massive difference in people's lives and attention skills. We all know when we are more tired our attention skills deteriorate significantly whether we have ADHD or not. As part of our ADHD sleep management program we give you techniques to improve your sleep issues, and try to identify causes of poor sleep. We go through a sleep hygiene program and other techniques such as CBT (to help settle a racing mind) or neurofeedback (to strengthen the sleep spindle in the brain that helps maintain sleep) may be used.
Step 5: Behavioural management (including parenting)
ADHD does not just affect the child or adult– it can have widespread effects upon the family and family relationships. This behavioural therapy is designed to reduce the problems of noncompliance, poor communication, defiance and/or aggression, and help better manage any difficult behaviours in and outside of the home.
This can reduce the isolation many parents experience when they feel they can’t take their child to places without them being embarrassed. Many times parent are extremely frustrated with their child’s behaviours at home and have found themselves shouting and getting into regular arguments.
For adults this can increase communication in relationships and help manage behaviours that create chaos or problems either for the individual or for those around them (relationships or workplace).
We will show parents and partners how to reduce and control their frustration and learn how to better interact with the person with ADHD to get the results they are after. Modelling good techniques to deal with frustration is essential in the household, and we can not expect our children to control their behaviour when we ourselves are struggling to control our own responses when angry. Likewise for partners to have expectations for the adult with ADHD that is out of their control can be frustrating on both sides.
We use techniques of both behaviour therapy and cognitive behaviour therapy to create happy and functioning households, and to build strong foundations for relationships within the family. We can also offer family therapy or therapy to siblings or partners should other people within the family need extra support.
Step 6: Social skills training
Children and adults with ADHD often suffer from high rates of social interaction problems and rejection by their classmates and peers.
This program will help train children and adults with ADHD in social skills including interrupting appropriately, greeting others, eye contact, conversation & listening skills, dealing with anger, apologizing and other skills.
When we conduct social skill training we often find that we need to train people with ADHD in impulse control and thinking through the consequences of behaviour.
Step 7: Accommodations: Classroom, educational & workplace
For some people with ADHD they can manage OK without having to do the therapies above, but simply need some accommodations either in the classroom, higher educational setting or in the workplace. For children with ADHD we are happy to work with teachers to come up with compensations and strategies to help manage symptoms in the classroom. For young adults at university, we are happy to devise study strategies and provide applications for special consideration during exams and if assignments are late. For adults with ADHD we can go through the work structure and help devise strategies to make sure any ADHD symptoms that are affecting the individual in the workplace are minimised through a variety of techniques.
We also are happy to work closely with the teachers and attend school meeting and provide advice for best school placement as well as special needs.
At the end of the year we often help manage the transition period from one classroom to another alongside the school counsellor, making sure that pass over to the new teacher is done smoothly and that techniques that were working well with your child are passed along.
ADHD treatment options: A 2020 scientific analysis of medication versus natural options Just published January 2020 in the Journal of Psychiatric Research (see reference below): This is the first meta-analysis which collated the most prominent behavioural and cognitive interventions for ADHD and examined their effect on cognitive symptomatology. They sought to investigate the effect of…
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