Areas › Focus, starting, and ADHD › Treatment and medication
The stack goes: understand it, medicate where that is right, change what the adults do, change what the day asks, and keep arguing the child's corner. Each layer does a job the others cannot.
None of them stands in for another, which is why swapping one out leaves a gap rather than a smaller plan. Medication does not reorganise a classroom. A reorganised classroom does not follow the child to football. Advocacy is what keeps the accommodations in place when the teacher changes in September. Families who feel they are doing a great deal and getting nowhere are often doing one layer very thoroughly and none of the others.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
Conduct their affairs by mutual consultation (Quran 42:38). The verse sits in a list of practices held together, none of them standing in for the others.
وَٱلَّذِينَ ٱسۡتَجَابُواْ لِرَبِّهِمۡ وَأَقَامُواْ ٱلصَّلَوٰةَ وَأَمۡرُهُمۡ شُورَىٰ بَيۡنَهُمۡ وَمِمَّا رَزَقۡنَٰهُمۡ يُنفِقُونَ
respond to their Lord; keep up the prayer; conduct their affairs by mutual consultation; give to others out of what We have provided for them
Qur’an 42:38read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A multicentre single blind randomised trial added mindfulness based cognitive therapy to treatment as usual in adults with ADHD and compared it with treatment as usual alone. Adding a layer and measuring what it contributes is exactly how a stack like this gets built and checked. That trial concerns one specific addition in adults, so it illustrates the method rather than validating this particular list of five.
Janssen L, Kan CC, Carpentier PJ, Sizoo B, Hepark S, Schellekens MPJ, Donders ART, Buitelaar JK, Speckens AEM. (2019). Mindfulness-based cognitive therapy v. treatment as usual in adults with ADHD: a multicentre, single-blind, randomised controlled trial.. Psychological medicine doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
The difficulty runs across every setting and most of the day, so help that covers only one part of it leaves the rest uncovered.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Behaviour work for ADHD is mostly about changing what the adults do. The child's behaviour shifts afterwards, as a consequence.
One social approach does have a real evidence base behind it, and what makes it different is who delivers it. Parents do the coaching, in the middle of actual play with actual friends.
The trouble now is not that nothing works. It is that the things which work are spread unevenly, and whether a family gets any of them depends heavily on where they happen to live.