Expert Advice: ADHD and Adoption

Treatments

The three main types of treatment for children with ADHD are behavioral interventions, educational interventions, and medication. During the preschool years, ADHD is generally easily managed with behavioral interventions. Preschool children with significant developmental delays or behavior problems qualify for special education services. Children who are unable to function well in a regular preschool program may need to attend a special education preschool, where additional staffing with better training is available. These preschools are generally cost-free to eligible children; parents should contact their local school district for more information.

Although school-age children with ADHD also respond to behavioral interventions, treatment with medication has been shown to be the single most effective intervention in this population. Stimulants (including Ritalin, Concerta, and Adderall) are the most commonly prescribed medications, and their relative safety and efficacy have been recognized in many research studies. Occasionally, other types of medication need to be used either instead or in addition to the stimulants.

The Individuals with Disabilities Education Act mandates that children with ADHD may be eligible for part-time special education services, such as resource room. Occasionally, children with ADHD may need placement in a self-contained classroom - a smaller class with other students who likewise require more intensive services. Also, under the Americans with Disabilities Act, children with ADHD are entitled to educational accommodations -- such as additional time for written tests, abbreviated homework assignments, and preferential classroom seating (nearer the teacher).

Although many preschool children will respond to behavioral interventions and many school-age children will do well with medication management alone, it is most helpful to take a multi-modal approach -- combining behavioral, medical, and educational interventions.

Parents who feel concerned about ADHD symptoms in their child should consult with their pediatrician and, at the same time, gather additional information about its diagnosis and treatment. Remember: Most children who are adopted will not have ADHD, and there are many effective ways to help children who do.

For more information on ADHD or other issues in this article, call SPARK Child Development for Adoptive Families at 212-360-0259 or e-mail jcleary@spence-chapin.org.

Andrew Adesman, M.D. serves at the Schneider Children's Hospital Adoption Evaluation Center

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