A Medical Viewpoint on Combining Behavior 
Modification and Drug Treatment

For parents, coping with a child who has ADHD can be a struggle. Medication is 
helpful in many cases; (define „helpful¾, please!) however, behavior 
modification and drug therapy in combination have proven to be the most 
effective treatment approach. Behavior modification frequently results in 
improvement, but can be extremely difficult for the child's family (Breakstone, 
1987). The ADHD child requires more than the usual amount of parenting time.

The ADHD child should be given feedback when prosocial or acceptable behavior 
is displayed, and it should be clear, specific, and follow as close to target 
behaviors as possible. Feedback might be in the form of praise, physical 
affection, or even rewards. All too often, parents initiate punishment to stop 
unwanted behavior. In order to change problem behavior in an ADHD child, the 
desirable or positive alternative should be defined. This helps parents to be 
vigilant for positive behavior and reward it when it occurs. It is important to 
begin punishing undesirable behavior only after the desirable behavior has been 
rewarded consistently for at least one week (Barkley, 1990). Some direct negative 
consequences for inappropriate behavior are clear and concise verbal reprimands, 
removing privileges, and time-out (McNamara, 1993).

Parents must be in agreement in regard to child-rearing techniques. It is 
important that parents be consistent - specific consequences need to occur with 
certain behaviors. Consistency leads to predictability, providing the child with a 
sense of confidence and security (McNamara, 1993). The following guidelines are 
helpful for parents:
 
(1) keep meals and bedtime on a regular schedule; 
(2) avoid too much stimulation of any kind; 
(3) avoid junk foods;
(4) do not confront the child unnecessarily;
(5) guard the child from threats;
(6) prepare the child before entering a public place; 
(7) review rules and consequences beforehand;
(8) do not require the child to perform overly demanding, repetitive, and 
frustrating tasks;
(9) keep study areas clean and organized; and 
(10) provide simple one-step rules for as many tasks as
possible (Hafner, 1987).