Nonpharmacological management of attention deficit hyperactivity disorder in children

Nonpharmacological management of attention deficit hyperactivity disorder (ADHD) should be provided as a component of an individualised multimodal management plan. The management plan should be made in collaboration with the child, family or carers, and teachers; it should outline the treatment approach and developmental goals.

Provide psychoeducation to the child, parents or carers that includes information about ADHD, any comorbid conditions and treatment options.

Nonpharmacological interventions for ADHD can include:

  • social and organisational skills training
  • cognitive training
  • parent behaviour training
  • classroom management measures (eg strategically positioning the child in the classroom, setting rules and expectations, using a daily report card).

Advise parents or carers of the importance of having a close relationship with staff in the child’s school—they can help monitor the effectiveness of treatment and ensure the child receives additional help for learning and other developmental problems.

Routine dietary modification is not indicated to reduce symptoms of ADHD because only a minority of children are sensitive to the effects of synthetic dyes, flavours and preservatives. Use of a food diary can be beneficial to link symptoms to dietary exposures. Refer children in whom a link between certain foods and ADHD symptoms is observed to a dietitian for consideration of dietary modification.

Do not use dietary supplements (eg omega-3 fatty acids, omega-6 fatty acids, vitamins, minerals) unless the child has a deficiency.

Give family or carers information about relevant support groups and community organisations where they can receive training about managing children with ADHD (see ADHD Australia).

Other resources that may be useful include: