Attention-deficit/Hyperactivity Disorder

Attention-deficit/Hyperactivity Disorder

In general, it appears that the attentional system of children with ADHD frequently functions inefficiently, so that relevant stimuli often go unidentified, irrelevant stimuli (distractors) are accorded disproportionate attention, and even on occasions when attention is paid to appropriate environmental information, such attention is often broken off prematurely; that is, the children frequently respond to environmental stimuli before consideration of all rel-evant data (Douglas, 1980).

These attentional difficulties seem to be strongly related to problems with behavioral inhibition (Barkley, 1999), a finding that still obtains even when global intelligence, reading achieve-ment and comorbid psychopathology are taken into account (Chhabildas et al., 2001; Nigg et al., 1998; Nigg 1999; Seidman et al., 1997). Within this perspective, treatments need to include components which address the fundamental problems regarding behavioral inhibition.

Various stimulant medications, most notably methylphe-nidate, have been shown to be efficacious in the acute treatment of ADHD. As noted by Kendall and MacDonald (1993), there are limitations to stimulant therapy that highlight the need for also de-veloping effective psychosocial interventions for ADHD: 1) some children with ADHD do not respond to stimulant medication; 2) medication appears to be limited in its effect on some higher or-der cognitive processes, such as problem solving; 3) medication may not ameliorate longstanding deficits in social skills; 4) some children experience difficulties complying with medication regi-mens; and 5) gains made during medication therapy are often not maintained after termination of treatment. Cognitive–behavioral treatment interventions for ADHD, therefore, would appear to constitute a potentially valuable supplement and/or alternative to medication.