ADD/ADHD & Disruptive Behavior Disorders

Whether it be ADD/ADHD or Disruptive Behavior Disorder, by definition, the child displays an inability to attend to tasks and the ability to attend varies from child to child. The biology of the child is such that they can be extremely active a great deal of the time. If their needs for activity are not met, or are restricted, the high level of activity can organize into disruptive behavior(s) and make a difficult situation worse.

Here, too, we can set up behavioral interventions (technically tested and approved to be consistent with the best Applied Behavioral interventions). BUT what about the physical and emotional drain on parents, let alone the lack of attention to any sibling(s)? What are the parents feeling about their child, and toward themselves for having those feelings? What is the child picking up in terms of the parent’s feelings toward them? As a result of these feelings, what are the consequences/punishments and rewards/reinforcement that are being implemented? Are the rewards or consequences too severe, too lenient, inconsistent, or non-existent with resulting ineffectiveness and/or unintended consequences?

In my approach, I work with the child’s biology to understand their activity level and gain the ability to direct and/or re-direct their behavior. Behavioral interventions are designed to help the child focus on regulating their attention and focusing their efforts on completing a desired activity. I work to discover if the child is really trying and succeeding or, in spite of their efforts, they “can’t help themselves.” How much can a parent cope with high activity if they, too, are highly active? This can happen: A hyperactive parent with a hyperactive child…no problem! A hyperactive child with a Zen-like parent could be a big problem…like no Zen for mom!

Children with significant acting out or drug addiction can also benefit from behavioral and dynamic interventions. Arguably, there is both a biological need and/or a social/emotional need for the drugs. Having a full developmental, psychiatric, and educational/social emotional assessment is critical to understanding the genesis of the behavior. After a child returns from detoxification programs, in which a therapeutic environment supported healthier behaviors and utilizing new skills to cope, support needs to continue and the child weaned upon return “home.” If the child’s independence and efforts are not supported or generalized to everyday life, reoccurrence is likely.

Note: Some information is taken from the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, American Psychiatric Publishing, Washington D.C., London, England, 2013.