Treatments for Attention Deficit and Hyperactivity Disorder (ADHD) in Children

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Boston Children's Hospital's clinicians are regarded as world leaders in diagnosing and treating attention-deficit/hyperactivity disorder (ADHD). Your child is always treated as an individual, and never “just a patient.”

Our compassionate, family-centered care model considers you and your family central members of the treatment team, and you are involved in your child's care from beginning to end. 

What are the first steps in treating ADHD at Boston Children's Hospital?

When you come to Boston Children's for an initial appointment, your child's treating clinician will:
  • give your child a thorough physical exam
  • go over your child's medical, family and school history with you
  • talk to you (and your child) about his behaviors, symptoms, feelings and concerns
  • in some cases, give your child a comprehensive neuropsychological assessment—a sophisticated evaluation of his thinking, learning and behavioral functions

Because Boston Children's is a multidisciplinary center with experts in all relevant fields, your child's treatment plan will involve much more than medical care to manage his ADHD symptoms. You (and he) will also have access to an assortment of educational, emotional and psychosocial support services to meet all of your family's needs.

What treatment options does Boston Children's normally prescribe for kids with ADHD?

There are three major components of treatment for kids with ADHD here at Boston Children's:
  • medication
  • behavioral modification therapy
  • educational intervention

For some children, it may be appropriate to start with behavioral modification therapy and move to medication only if behavioral treatments don't work well enough. (As an example, if you have attended a behavioral parent training class, the teacher has worked for several months on classroom interventions and your child has received focused treatment—but you still see considerable room for improvement in his behavior and rate of progress—you and your child's treating clinician might consider starting him on medication.)

For many kids with ADHD, the combination of medication and behavioral approaches should be considered from the very start.


Stimulant medications (drugs that enhance the activities of the brain and nervous system) have been used to treat ADHD and related childhood disorders since the 1930s. These medications have proven to be very effective in improving the basic symptoms of ADHD—including inattention, impulsivity and hyperactivity—in up to 90 percent of children.

Stimulant medications work well for ADHD because they are able to “balance out” the brain chemicals that make it hard for kids with the disorder to maintain attention and control their impulses.

There two families of compounds commonly used for ADHD:

  • methylphenidate and its derivatives (Ritalin, Ritalin LA, Ritalin SR, Concerta, Metadate, Focalin)
  • amphetamine derivatives (dextroamphetamine, mixed amphetamine salts/Adderall)

These medications are available in different preparations under various brand names. The drugs will differ in how they're administered (for example, in tablets or capsules) and in how long they are effective (short-acting or long-acting).

Considerations before beginning medication

There are a few considerations involved when stimulant medications are prescribed for ADHD:

  • duration — Your doctor will likely want to prescribe the longest-acting preparation to control your child's symptoms throughout the day, both in and out of school.
  • side effects — Different kids respond to these medications in different ways. If your child has negative side effects when taking a certain medication, the doctor may recommend trying a different one.

The most common side effects of stimulants include:

  • insomnia (inability to fall or stay asleep)
  • decreased appetite
  • stomachaches
  • headaches
  • “jittery” feelings
  • tics (sudden, repetitive movements or sounds that are difficult to control)
  • re-emergence of symptoms when the medication wears off in the evening (unfortunately, this is usually the very time you want your child to be “winding down” for the day)

Most side effects associated with stimulant medications:

  • are mild
  • decrease with regular use
  • respond well to changes in the particular drug, dose and preparation

Before starting your child on a stimulant, your treating clinician will obtain a thorough medical and family history and perform a physical examination, including checking your child's pulse, blood pressure and heart rate. Electrocardiograms (EKGs) and further heart tests are not usually necessary, unless an abnormality shows up in your child's medical or family history or during a physical exam.

An important note: If your child has any type of heart problem, she should always be examined and cleared by a cardiologist before beginning any new medication.

Learn more about medications used to treat ADHD.

Behavioral modification therapy

Kids with ADHD can also benefit from some common behavioral modification therapies, including:

  • point systems — rewarding your child through a system of “earning points” for positive behaviors
  • contingent attention —responding to your child with positive attention when she displays desired behaviors, and withholding attention when she takes part in undesired behaviors
  • teaching healthy life skills — working with your child to master skills in studying, setting goals, planning ahead and rewarding herself for positive behaviors

A combination of behavioral modification therapy and medication is usually more effective than either approach alone, at least in the short term. Your child's treating clinician is the best source of information in determining what treatment methods to try, when to implement them and for how long.

Educational intervention

A structured educational setting can be an especially difficult place for a child with ADHD. That's why the federal government has put some special rules in place to help kids with ADHD and other learning and behavioral conditions succeed in school.

It is critical to understand, however, that a formal diagnosis of ADHD does not automatically mean your child will qualify for either an Individual Education Program Plan (IEP) or accommodations under Section 504 of the Rehabilitation Act of 1973, which guarantees certain rights to individuals with disabilities (including ADHD). 

  • In order to qualify for special educational services through an IEP, your child must have demonstrated proof of either significant behavior problems in school that require special services or an associated, diagnosed condition, such as another learning disability
  • Eligibility for Section 504 is based on the confirmed existence of an identified physical or mental impairment that substantially limits a major life activity. In other words, a diagnosis of ADHD is not enough; your child's ADHD must also significantly—and demonstrably—affect his learning and/or behavior. 
  • If your child is deemed eligible under Section 504 and attends a public school, you can request that his teachers provide accommodations for his inattention and/or hyperactive and impulsive symptoms, such as:
    • giving him frequent reminders to stay on task
    • reducing distractions
    • rewarding persistence
    • prompting him to double-check work, complete assignment books and turn in homework
    • giving him extra time to complete work
    • providing opportunities for physical activity or "boredom breaks" during the day
    • providing a variety of interesting approaches to learning
    • giving rewards for good control of behavioral impulses
    • giving consequences for failing to control behavioral impulses 

Support and education for parents

Raising and caring for a child with ADHD can be very stressful at times, and may often present challenges for the entire family. In these circumstances, parent support and education about ADHD can make a big difference.

Boston Children's Hospital offers classes in behavior management skills for parents. Training in these skills usually occurs in a group setting, which encourages parent-to-parent sharing and the brainstorming of ideas. Contact our Department of Psychiatry to learn more.

Coping and support

The ups and downs experienced by a child—and family—living with attention-deficit/hyperactivity disorder (ADHD) can feel overwhelming sometimes. In addition to the information provided here, you may find comfort and support from the following resources: 

Patient and family resources at Boston Children's

  • Boston Children's Center for Families is dedicated to helping families locate the information and resources they need to better understand their child's particular condition and take part in their care. All patients, families and health professionals are welcome to use the center's services at no extra cost. The Center for Families is open Monday through Friday from 8 a.m. to 7 p.m., and on Saturdays from 9 a.m. to 1 p.m. Please call 617-355-6279 for more information.
  • The Advocating Success for Kids (ASK) Program at Boston Children's provides multidisciplinary evaluation, referral and advocacy services for children under age 14 who have behavioral, emotional, learning or developmental problems that affect them at home or at school. ASK works with children who receive their primary care either at Boston's Bowdoin Street Community Health Center, Martha Eliot Health Center or Joseph M. Smith Community Health Center or at Boston Children's Primary Care Center. For more information about ASK, please call 617-355-4690.
  • The ADHD Experience Journal was designed by Boston Children's psychiatrist-in-chief David DeMaso, MD, and members of his team. This online collection features thoughts, reflections and advice from kids and caregivers dealing with ADHD.
  • Boston Children's International Center is a dedicated resource for patients and families from countries outside the United States. The center can provide assistance with everything from reviewing medical records to setting up appointments and locating lodging. Contact the International Center by phone at 1-617-355-5209 or via e-mail at

Helpful links

Please note that Boston Children's Hospital does not unreservedly endorse all of the information found at the sites listed below. These links are provided as a resource.

 Helpful links for parents

Helpful links for teens

Helpful links for younger children

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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