ADHD Treatment
The most widely recommended treatment for ADHD, according to Clinical Practice Guidelines (CPGs), is multimodal therapy, which includes psychoeducational, psychological, and pharmacological approaches. Early intervention is also recommended, as it promotes a better outcome and prognosis for the disorder.
Psychoeducational and psychological intervention is recommended in mild cases. In moderate-to-severe cases, psychoeducational intervention and psychotherapeutic treatment are also recommended, in addition to considering pharmacological treatment.
Psychopedagogical re-education
Psychoeducational remediation is individualized academic support provided after school hours. Its objective is to address the negative impact of core ADHD symptoms on learning and academic performance. This type of intervention aims to improve attentional mechanisms, working memory, inhibitory control, and cognitive flexibility. Guidelines and resources (learning habits, study techniques, educational support) are offered to enhance performance, increase motivation, and improve self-esteem in relation to academic competence.
Psychological treatment
Regarding psychological treatment , the psychological interventions that have shown some scientific evidence are based on behavioral therapy, cognitive therapy, social skills training, and parent training, which includes psychoeducation on ADHD and behavior management guidelines.
Pharmacological treatment
In moderate or severe cases, or when initial measures have proven insufficient, pharmacological treatment is also considered. In Spain, we have two main groups of medications indicated for ADHD in children aged 6 and over. The first group consists of stimulants (methylphenidate and lisdexamfetamine), and the second group consists of non-stimulants (atomoxetine and guanfacine). The medications indicated for ADHD are effective and safe. More than 70% of the children treated respond effectively to the first course of treatment. Side effects are mild and rarely require discontinuation of treatment.
Among these side effects, the most frequent are loss of appetite, especially at midday, and difficulty falling asleep. To address the decreased appetite, it is advisable to distribute food intake into 5-6 meals a day, aiming for larger portions at breakfast, afternoon snack, and dinner. At lunchtime, raw, unsalted nuts (almonds, hazelnuts, walnuts) can be included, provided there are no allergies to these types of foods. For sleep problems, we usually administer low doses of melatonin 30-60 minutes before the desired bedtime.
Furthermore, it's important to ensure they have a varied diet , with sufficient intake of fruits, vegetables, and fish (Mediterranean diet), and limited consumption of simple sugars, artificial colors, and sugary or energy drinks. We also know the benefits of regular exercise; this should be fun and appropriate for each child's age.
There is also evidence of the benefits of mindfulness practice for children with ADHD in several studies conducted to date. Among these, we highlight a standardized, freely accessible mindfulness program for children with ADHD, developed by Dr. Anna Huguet and Dr. José Ángel Alda.