Treatment methods for toddlers/preschoolers with AD/HD

Teeter (1998) points out that at the toddler stage, interventions typically focus on psychosocial interaction, i.e. parent-child bonding and attachment, peer relations, and behavioral adjustment (p. 84). Blackman, Westervelt, Stevenson, and Welsch (as cited in Teeter, 1998) recommend the following interventions for preschool children to effectively address AD/HD symptoms: 1. parent training and support; 2. structured, tolerant preschool experiences; 3. social skills training and self-control; and, in severe cases, the children may have to take medication (p. 84). Teeter (1998) points out that “during the infancy, toddler, and preschool stages, treatment may need to focus on building positive parent-child relationships, particularly if this bond is not securely and positively established” (p. 85). LeFrancois pointed out that the elements of parenting that affect parent-child relationships including attentiveness, physical contact, verbal stimulation, material stimulation, and responsive care (as cited in Teeter,1998, p. 85). Educating parents about the nature of AD/HD is important as it improves the parent-child relationship. Some components of parent-management technique programs consist of methods for dealing with difficult, noncompliant children by focusing on using consistent and firm limit setting, with reasonable and fair expectations, and teaching parents to attend to positive behaviors and to use praise and reinforcement (Teeter, 1998, p. 87).

Individual or group structured parenting programs utilize methods that improve parents’ discipline practices and parent-child interactions; the strategies consist of behavior management and family systems techniques (Teeter, 1998, p. 89). The various programs may be incorporated into other therapeutic approaches, such as Family Therapy to strengthen parent-child relations and to address family interaction patterns that influence child behaviors. Positive interactions between parents and children are essential components of helping children develop ways to interact positively, despite the children’s temperamental difficulties, noncompliance, and impulsivity (Teeter, 1998, p. 94).

According to Anastopoulos & Shelton (2001), children with AD/HD have difficulty regulating their behavior in response to situational demands, which include the stimulus properties of the settings and also the consequences of their behavior. When these situational parameters change, one may anticipate changes in behavior. When these behavioural changes are negative, it provides justification of using Behavior Therapy techniques in the clinical management of children with AD/HD (p. 173). Cognitive-Behavioral Therapy has also been widely used in treating children manifesting AD/HD symptoms. Interventions include self-monitoring, self-reinforcement, and self-instructional techniques (Anastopoulos & Shelton, 2001, p. 174). The intervention’s focus is on some of the primary deficits of AD/HD, such as impulsivity, poor organizational skills, and difficulty with rules and instructions (Anastopoulos & Shelton, 2001, p. 175).

There are many methods and techniques to use for treating children with AD/HD but a goodness-of-fit between a person’s skills (i.e. parent/caregiver) and the environment's demands are crucial for optimal development. The fact is that a lack of fit characterizes the whole issue of functional impairment in a child with AD/HD. The child’s AD/HD symptoms negatively impact his or her ability to develop or use competence to meet the demands of the environment, such as having difficulty complying with parental requests. (Anastopoulos & Shelton, 2001, p. 181).