Friday, December 22, 2006

Parenting (Behavior Modification) Therapy for Children's Mental Disorders

The New York Times reviews a trend towards using behavior modification based parenting as an alternative to, or at least, as a complement to medication to treat various disorders including Autism, ADHD and Obsessive-Compulsive Disorder. Parents of autistic children have been fighting for years in Canada and the US for Applied Behavior Analysis therapy for their children. But professionals and parents are now looking at behavior based approaches to parenting and treating children with a variety of disorders. And avoiding over reliance on medication.

"In a study involving 128 families, psychologists at the university had found that about a third of parents who completed the program saw enough improvement in their children that they had decided that medication was unnecessary. The other two-thirds put their children on stimulant medication at school but at doses significantly lower those typically prescribed, said William Pelham, a psychologist who is director of the Center for Children and Families at Buffalo and the senior author of the study. Eighty percent of the families who participated in the program, with follow-up parent training, decided that their children did not need medication at home.

“Most parents seeking help for a child with a psychiatric disorder never hear about programs like this,” Dr. Pelham said. “The only option they’re given is medication. Now, it may be that the best treatment for that child is medication. But how do you know if you never try anything else?”

Behavior modification for A.D.H.D. and for related problems, like habitually disruptive or defiant behavior, is based on a straightforward system of rewards and consequences. Parents reward every good or cooperative act they see: small things, like simply paying attention for a few moments, earn an “attaboy.” Completing homework without complaint might earn time on a Gameboy. Parents remove privileges, like television and playtime, or impose a “time out,” in response to defiance and other misbehavior.

And they learn to ignore annoying but harmless attempts to win attention, like making weird noises, tapping or acting like a baby."

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