The Use of Focus with Children and Young Teens with Attention Deficit Disorder Is Backed by Clinical Research and Professional Practice

Professional Guidelines Recommend The Use of Proven Psychological Methods Along With or Without Medication In The Treatment of Attention Deficit Disorder:

The prescribing information provided by CIBA ( the manufacturers of Ritalin) states "Ritalin is indicated as an integral part of a total treatment program which typically includes other remedial measures (psychological, educational, social) for a stabilizing effect in children with a behavioral syndrome characterized by the following group of developmentally inappropriate symptoms: moderate-to severe distractibility, short attention span, hyperactivity, emotional ability, and impulsivity."

The same literature also states, "Drug treatment is not indicated for all children with this syndrome..... Appropriate educational placement is essential and psychosocial intervention is generally necessary. When remedial measures alone are insufficient, the decision to prescribe stimulant medication will depend upon the physician's assessment...."(1)-Physicians' Desk Reference 1998

Dr. William Barbaresi notes that "Comprehensive treatment, including both medication and nonmedical intervention, should be coordinated by the primary-care provider."(2)-Mayo Clinical Proceedings 1996

Similarly Dr. Michael Taylor concludes, "The most successful management of children with attention deficit disorder involves a coordinated team approach, with parents, school officials, mental health specialists and the physician using a combination of behavior management techniques at home and at school, educational placement and medication therapy."(3)-American Family Physician 1997

Research and Clinical Practice Has Shown Well Constructed Behavior Modification Programs To Be Very Useful In The Management of ADD/ADHD:

Behavior modification programs emphasizing positive reinforcement of appropriate behavior have been useful in reducing maladaptive behavior at home and at school. Research has shown that behavior modification can improve impulse control and adaptive behavior in children of various ages (4)-Perceptual Motor Skills 1995, and (5)-Abnormal Child Psychology 1992.

The use of positive reinforcement related to daily reports from school has been found to be useful in improving task completion and reducing disruptive behavior in the classroom (6)-Behavior Modification 1995.

Some parents have been found to prefer behavioral to medical treatment (7)-Strategic Interventions for Hyperactive Children 1985.

Families are often able to succeed with their behavior modification efforts through the use of written materials only (8)-Journal of Pediatric Health Care 1993.

Teaching children with attention deficit disorder how to relax can be effective in reducing hyperactivity and disruptive behavior while increasing attention span and task completion:

Relaxation training conducted by parents in the home has been found not only to be effective in improving behavior and other symptoms but also improves over all relaxation when measured by biofeedback equipment (9, 10)-Journal of Behavior Therapy & Experimental Psychiatry1985 & 1989.

A review of a number of studies related to relaxation training with children concluded, "Findings suggest that relaxation training is at least as effective as other treatment approaches for a variety of learning, behavioral, and physiological disorders . . ."
(11)-Journal of Abnormal Child Psychology 1985.

Cognitive Behavioral Therapy Can Help ADD Children Improve Problem Solving and Coping Skills:

Cognitive Behavioral Therapy (CBT) consists of teaching children to change their thought patterns from ones that lead to maladaptive behavior to ones that produce adaptive behavior and positive feelings. This technique can be used to help children to improve their self-esteem. It can also be used to help them improve coping skills, problem solving skills and social skills.

In one study CBT was found to be helpful in helping hyperactive boys develop anger control. The findings indicated that "Methylphenidate (Ritalin) reduced the intensity of the hyperactive boys' behavior but did not significantly increase either global or specific measures of self-control. Cognitive-behavioral treatment, when compared to control training, was more successful in enhancing both general self-control and the use of specific coping strategies." (12) Journal of Abnormal Child Psychology 1984. (It should be noted that CBT has not proven to be successful in all studies. The problem may be related to the fact that each study uses different strategies and measures of success).

Cognitive Rehabilitation Exercises (Brain Training) Can Improve Attention & Concentration Well As Other Intellectual and Self-Control Functions:

Victims of strokes or head injury may have significant impairments in attention and concentration. Cognitive Rehabilitation exercises are often used to help these people to improve their ability to concentrate and pay attention. This approach has been applied to children with attention deficit disorder with some success. The repeated use of simple (attentional training) exercises can help children to train their brains to concentrate and pay attention for longer periods of time. (13)-Behavior Modification 1996

Focus is a multi-media psychoeducational program that combines all of the above methods in a package that can be easily and effectively implemented at home by parents:

The training manual provides a behavior modification program using the daily report card to improve performance at school.

A token economy program is provided to improve behavior at home and foster a positive parent/child relationship.

The manual also provides a series of Cognitive Rehabilitation exercises that are fun and easy to implement to improve attention and concentration while also helping to reduce hyperactivity and improve impulse control.

The manual along with audio tapes help not only teach how to improve their ability to relax but also how to apply this skill to home, school, social and sport activities.

A temperature biofeedback card is supplied as an additional aide for relaxation training.

Audio tapes provide Cognitive Behavioral Therapy to help improve motivation, self-control and self-esteem.

The program is organized in a way to provide materials appropriate for two different age levels (6-11 and 10-14).

The program also provides additional parent education material related to attention deficit disorder as well as a set of forms for recording progress.

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References

(1) Physicians' Desk Reference. 52nd ed. Montavle (NJ): Medical Economics Data Production Company, 1998

(2) Barbaresi, W Primary-care Approach to the Diagnosis and Management of Attention-Deficit Hyperactivity Disorder. Mayo Clin Proc 1996: 71; 463-471

(3) Taylor, M Evaluation and Management of Attention-Deficit Hyperactivity Disorder. American Family Physician 1997: 55 (3); 887-894

(4) Cociarella A, Wood R, Low KG Brief Behavioral Treatment for Attention-Deficit Hyperactivity Disorder. Percept Mot Skills 1995: 81 (1); 225-226

(5) Carlson CL, Pelham WE Jr, Milich R, Dixon J Single and Combined Effects of Methylphenidate and Behavior Therapy on the Classroom Performance of Children with Attention-Deficit Hyperactivity Disorder. J Abnorm Child Psychol 1992: 20 (2); 213-232

(6) Kelly ML, McCain AP Promoting Academic Performance in Inattentive Children: The Relative Efficacy of School-Home Notes With and Without Response Cost. Behavior Modif 1995: 19; 76-85

(7) Thurston, LP Comparison of the Effects of Parent Training and of Ritalin in Treating Hyperactive Children In: Strategic Interventions for Hyperactive Children , Gittlemen M, ed New York: ME Sharpe, 1985 pp 178-185

(8) Long N, Rickert VI, Aschraft EW Bibliotherapy as an Adjunct to Stimulant Medication in the Treatment of Attention-Deficit Hyperactivity Disorder. J Pediatric Health Care 1993: 7; 82-88

(9) Donney VK, Poppen R Teaching Parents to Conduct Behavioral Relaxation Training With Their Hyperactive Children J Behav Ther Exp Psychiatry 1989: 20 (4); 319-325

(10) Raymer R, Poppen R Behavioral Relaxation Training With Hyperactive Children J Behav Ther Exp Psychiatry 1985: 16 (4); 309-316

(11) Richter NC The Efficacy of Relaxation Training With Children J Abnorm Child Psychol 1984: 12 (2); 319-344

(12) Hinswaw SP, Henker B, Whalen CK Self-control in Hyperactive Boys in Anger-Inducing Situations: Effects of Cognitive-Behavioral Training and Methylphenidate. J Abnorm Child Psychol 1984: (12); 55-77

(13) Rapport MD Methylphenidate and Attentional Training. Comparative Effects on Behavior and Neurocognitive Effects on Behavior and Neuorcognitive Performance in Twin Girls With Attention-Deficit/Hyperactivity Disorder Behav Modif 1996: 20 (4) 428-430

(14) Myers, R Focus: A Comprehensive Psychoeducational Program For Children 6 to 14 Years of Age To Improve Attention, Concentration, Academic Achievement, Self- Control and Self-Esteem Villa Park (CA): Child Development Institute 1998

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