ADHD: What Helps
Evidence-based approaches to supporting your child. The most effective support combines environmental changes, skills teaching, and sometimes medication.
ADHD is a problem of performance, not knowledge. Your child likely knows what to do - the difficulty is doing it consistently. This means:
- Lecturing or explaining won't help (they already understand)
- Willpower and effort have limits (their brain works differently)
- Changing the environment is more effective than trying to change the child
The goal is to provide external scaffolding that does the job their executive functions struggle with - until those skills develop further.
Reduce working memory load
- • Written/visual instructions
- • One instruction at a time
- • Checklists
Make time visible
- • Visual timers
- • Clocks everywhere
- • Time warnings before transitions
Create external structure
- • Consistent routines
- • Visual schedules
- • Designated places for things
Shorten feedback loops
- • Immediate rewards
- • Frequent check-ins
- • Break tasks into small steps
Reduce distractions
- • Quiet workspace
- • Noise-cancelling headphones
- • Single-task environment
Evidence-based programmes:
Triple P (Positive Parenting Program)
Tiered support from universal to intensive
Strong evidence across multiple countries
Incredible Years
Group-based, focuses on positive relationships
Strong evidence, especially for younger children
New Forest Parenting Programme
ADHD-specific, home-based
Developed specifically for ADHD; good evidence
Parent-Child Interaction Therapy (PCIT)
Live coaching during parent-child play
Strong evidence, especially for ODD symptoms
Key principles from these programmes:
- Clear, consistent expectations
- Positive attention for desired behaviour
- Planned ignoring of minor misbehaviour
- Effective commands (specific, one at a time)
- Natural and logical consequences
- Time-in before time-out
Seating & Environment
Instructions & Assignments
Organisation Support
Testing Modifications
Behaviour Support
- •Stimulants (methylphenidate, amphetamines) are first-line treatments
- •Work by increasing dopamine and noradrenaline availability
- •Effect size is among the largest of any psychiatric medication
- •Response is individual - finding the right medication/dose takes time
- •Medication works best alongside environmental and behavioural support
- •Common side effects include reduced appetite and difficulty sleeping
Evidence summary
A quick reference for what has evidence behind it.
| Intervention | Evidence | Notes |
|---|---|---|
| Parent training programmes | Strong | Especially for younger children |
| Environmental scaffolding | Strong | Foundation of all ADHD support |
| Stimulant medication | Strong | Large effect size; individual response varies |
| School accommodations | Strong | When matched to individual needs |
| Cognitive behavioural therapy | Moderate | Especially for co-occurring anxiety |
| Social skills training | Mixed | Better when embedded in natural settings |
| Working memory training | Limited | Gains don't transfer to daily life |
| Neurofeedback | Limited | May be placebo; needs more research |
| Dietary interventions | Limited | May help individual children; not universal |
Age-specific priorities
- Parent training is first-line treatment
- Medication rarely used at this age
- Structure and routine are essential
- Positive attention for good behaviour
- Short, engaging activities
- Environmental support at home and school
- Parent training remains helpful
- Medication may be considered if significant impairment
- Homework support and organisation systems
- Building self-awareness and self-advocacy
- Increasing self-management skills
- Medication often most helpful at this stage
- Organisation apps and technology
- Exam accommodations
- Addressing co-occurring anxiety/depression
- Self-advocacy and disclosure decisions
- Life admin support (bills, appointments)
- Career/education planning
- Medication management independently
- Relationships and communication
Effective ADHD support is about fitting the environment to the child, not forcing the child to fit an unsuitable environment. When you reduce demands on executive function and provide external scaffolding, many ADHD "problems" become manageable.
This isn't about lowering expectations - it's about providing the support needed to meet them.