ADHD 7-Step Program
Scientific research has shown that a combination of several treatments are most effective for treating ADHD and its numerous co-occurring problems.
We offer an individualised program to help treat your child as a whole; cognitively, socially, academically, behaviourally and emotionally.
This program is one of the only few available internationally and currently we have patients from not only all over Australia but also internationally.
Whilst all children complete step 1, the other stages are dependent upon what specific issues your child presents with. All children are treated as individuals and we design a unique therapy program according to your child’s needs.
For children who have already been diagnosed with ADHD we are happy to enrol these children in the rest of our program where applicable.
Step 1: Accurate Diagnosis of ADHD
Difficulties concentrating don’t necessarily mean your child has ADHD, and ADHD often goes hand in hand with many other behavioural and emotional disorders. Correct diagnosis of ADHD and any co-occurring problems is one of the most critical stages in your child’s treatment. Your child will undergo a thorough cognitive, academic, behavioural and emotional assessment to assess whether they have ADHD (opposed to other disorders which may appear similar to ADHD such as basic visual and auditory processing disorders). We will also assess which subtype of ADHD your child has and their specific cognitive profile so that we can individually tailor the required therapy to your child’s needs.
Our ADHD diagnostic testing is highly detailed and usually only neuropsychologists will have access to the indepth attention assessments we have available.
Accurate diagnosis is essential for identifying correct treatment.
Step 2: Parent management training
ADHD does not just affect the child– it can have widespread effects upon the family and family relationships. This parent training program is designed to reduce the problems of noncompliance, 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.
We will show you how to reduce and control your frustration and learn how to better interact with your child to get the results you 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.
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. At times we find that other children in the family either mimic negative behaviours or begin to act out to gain attention. We can also offer family therapy or therapy to siblings should this be occurring.
Step 3: Classroom & educational interventions
As part of our assessment we will give you a individualised teacher’s report with extensive recommendations for how your teacher can compensate for your child’s specific profile of issues within the school environment.
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.
If your child has any literacy-based issues we work together with Ciara Holland at our centre, who offers a large array of literacy programs to help close the gaps in learning.
Step 4: Individualised cognitive training program
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.
Step 5: Social skills training
Children with ADHD often suffer from high rates of social interaction problems and rejection by their classmates.
This program will help train your child 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 as part of our HighQ program, we often find that we need to train children in impulse control and thinking through consequences of behaviour.
We incorporate elements of the Stop Think Do program as well as train core impulse control skills.
Step 6: Emotional management & resilience training
Children 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 children 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 children with ADHD. Specifically we find that teaching children 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 children 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 children mindfulness, the ability to stay within the present, 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 tools they can use themselves throughout their lives to remain resilient in this world.
Step 7: Medication monitoring
At the Sydney Cognitive Development Centre our philosophy is that medication is the last resort.
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.
We do support medication in some cases where the child is too young for cognitive training and the learning gaps are becoming too large. We may also support medication if a child is engaging in risky behaviours and is at risk for legal problems or school expulsion.
In all cases however we only recommend medication as a short-term solution whilst other skills are being built and worked upon. Medication is only effective for a very small amount of cognitive deficits (such as sustained attention, divided attention and impulsivity).
Many other skills such as attention span, working memory, switching attention, and executive skills are very rarely increased through medication. Hence even if a child is already on medication we will still engage them in our cognitive training program so that they can build core skills and hopefully work towards getting off, or at least reducing their medication.
As part of our program we work closely with numerous paediatricians in Sydney are around Australia to provide proper monitoring of medication. As part of this process we assess core skills off medication so that we know which skills we need to make sure are improved on medication.
We then assess the child on medication to see what affects medication has. We especially look for decreases in cognitive ability as a certain percentage of children actually have slower processing speed on medication (as it reduces impulsivity) and this can result in increases in issues with divided attention.
For the majority of children we see we find we need to send the children back to the paediatrcian to change the dosage or type of medication due to the medication not being optimal.