After the usual shock and denial stage after their child has been diagnosed with AD/HD, parents often ask, is there any cure?

Honestly speaking, AD/HD has no quick fix. It is unlike your common tension headache or menstrual cramps that goes away after you take a paracetamol pill. But if given proper care and support, as well as the right opportunities for development, children with AD/HD have a vast potential that can be fully maximized.

What is Multi-Modal Treatment?

Studies abroad show that multimodal treatment is the most effective form of treatment for children with AD/HD.

It includes multiple elements such as medication, behavior management therapy; and parent training.

These modes of treatment work best together and support each other thereby producing the best outcomes for children with AD/HD.

Again, it should be stressed that the treatment of a child with ADHD must suit his/her individual needs. Thus, it would be incorrect to think that one intervention, like therapy or medication, by itself is already sufficient. A child might respond to one intervention better than another, but these should not be understood as "either/or" options.

Medication is indicated when the AD/HD symptoms significantly impair the function of the child and the problems that can be attributed to the core symptoms of inattention and distractibility, impulsiveness and hyperactivity. It may help many children focus but medication is not used to control behavior.

For example, it can help improve classroom behavior, make a child complete his school work and even get better grades, but it cannot teach self-control, social skills, organizational skills, manners and routines, among others. A noted AD/HD medical specialist explains that the specific action of drugs cannot address other areas that are commonly part of the AD/HD picture, such as deficiencies in communication and social skills, organization and planning, nor can they give the child the moral fiber he must build up. Motor abilities, as well as language processing, is commonly impaired among the AD/HD population and this would need specific management. There are two types of medications available in the market: the stimulant and the non-stimulant medications.

Stimulants increase the activity in the frontal parts of the brain that are not doing well in filtering out distractions. It has been observed that stimulants dramatically reduce hyperactivity and impulsivity and improve the child’s ability to focus, work, and learn.

In some cases, stimulants also helped improve physical coordination, such as those needed in handwriting and in sports.

The three most common types of stimulants used to treat AD/HD are methylphenidate, amphetamine and dextroamphetamine.

A recently approved medication for AD/HD is a non-stimulant called generically as atomoxetine. Non-stimulants also help with the inattention, hyperactive and impulsive symptoms of AD/HD but unlike stimulants that work on dopamine, it works primarily on the brain neurotransmitter, norepinephrine. These two neurotransmitters are believed to play a crucial role in ADHD.

Studies show that children with AD/HD have deficits in dopamine/norepinephrine neuro-transmitter system. Neuro-imaging studies likewise show a diminished size and activity in the Fronto-Striatal-Cerebellar network of the brain of a patient with AD/HD. Some children get better results from one medication, some from another. Thus, it is important to work closely with the prescribing physician to find the right medication and the right dosage. There may also be some side effects such as loss of appetite, headache, stomachache, and sleeping problems, but all these can be temporary and can be managed.

Aside from medication, behavioral therapy can help the AD/HD child in everyday life. It helps develop more effective ways to work on immediate issues by changing the child’s thinking and means of coping with situations.

Practical assistance skills, like help in organizing tasks or schoolwork or dealing with emotionally charged events are part of behavior therapy. Support may also be in self-monitoring one’s own behavior and giving self-praise or rewards for acting in a desired way such as controlling anger or thinking before acting. For some, the effects on the improvement in the behavior of a child with AD/HD may take some time. There may also be some emotional issues to consider — frustration, blame, and anger — that may have developed over a long period of time.

In cases such as this, parents may need professional help to develop techniques for managing the child’s behavior. Mental health professionals like psychiatrists and psychologists can counsel the child and the family.

Family counseling is recommended when the problem affects the whole family thus making it essential for the entire family to get professional help. This type of counseling assists the family in finding better ways to handle the disruptive behaviors of the child and help the child and the family to develop new skills, attitudes, and ways of relating to each other. Sometimes only the child with AD/HD needs counseling support. In individual counseling, the therapist helps children with AD/HD learn to feel better about themselves. It can also help the child to identify and build on his/her personal strengths, cope with daily problems, and control their attention and aggression.

Parent Training

Aside from medication and behavior therapy, another integral part of multi-modal treatment for children with AD/HD is parent training.

The American Academy of Child and Adolescent Pyschiatry notes that it is a way to improve the social functioning of children with AD/HD by teaching parents to recognize the importance of peer relationships, to use naturally occurring opportunities to teach social skills and self-evaluation, to take an active role in organizing the child's social life, and to facilitate consistency among the adults in the child's environment.

Some may consider the ideas and techniques taught in parent training as common sense parenting techniques, but most parents need effective teaching and support to learn parenting skills that they should use consistently.

In parent training classes conducted by the AD/HD Society of the Philippines, participants are taught effective communication skills (focused attention, constructing messages, giving clear instructions to child); positive reinforcement skills to good behavior; anger management and other behavior management techniques.

Facilitators equip parents with skills so they could help motivate their children and develop their self-esteem, among others. Parents are also encouraged to be advocates for their children so that they can ensure a better quality of life for their children.

As in any medical condition, AD/HD requires the concerted effort of a team — the child, the parents, the medical professionals, the therapists and the educators — to make the home, school and the social environment more conducive and encouraging to the child with AD/HD. Each member is integral to the team and if everyone plays their part well, the ultimate victor will be the AD/HD child. Together, they must ensure that every AD/HD child is protected, cared for and understood.