Therapeutic intervention in ADHD do not target the core symptoms, but they teach skills they

can use to control them.

Functional Behaviour Analysis
 considers the behaviors to be conditional in that their occurrence, intensity, or
duration can covary with different arrays of causal variables.
 describes a functional relation between two variables (i.e., causal variable, behavioral
variable)
 emphasizes the importance of modifiable and relevant variables that most account for
the client’s behaviour problems.
Target behaviour- The behaviour you want to teach or modify. Observable, complete,
measurable and positive
Terminal behaviour- The desired behaviour.
Behavioural criteria- A desired performance level of the terminal behaviour. When the child
reaches this performance level, the program is complete.
Behavioural objective- A statement including the terminal behaviour and the behavioural
criteria

Example:
A child may have a problem staying in his seat during math class.
Target behaviour - “Staying in seat(teach)” or “getting out of seat(modify)”
Terminal behaviour- “Staying in seat for the entire 45-minute math class” may be the you
wish to observe at the end of your behaviour change program.
Behavioral criteria- what behavior will be exhibited (staying in his seat), when the behavior
will be exhibited (during each 45-minute math class), and for how many (three consecutive)
math classes the behavior must be exhibited.
Criteria may also be stated in the form of a percentage when a certain percentage of correct or
appropriate responses is desired. For example: Tom will comply with teacher requests with a
90% compliance rate over four consecutive days, or Tom will complete 80% of his class
assignments for five consecutive school days.
Behavioural objective- Tom will stay in his seat during each 45-minute math class, unless he
has permission from the teacher to leave his seat, for three consecutive math classes.
Frequency or number refers to a simple count of the number of times a behavior occurs
during a specific time period.
Duration data are recommended when teachers are concerned about how long a behavior
continues once started or the amount of time consumed when a behavior is performed. Total
duration and response duration.
Latency refers to the amount of time it takes for a student to begin a behavior once he or she
has received a direction or an instruction to complete a task or modify a behavior.
Rate refers to the frequency of a target behavior divided by the number of minutes or hours
of observation time. This will yield a rate-per-minute or rate-per-hour measurement.
Intensity refers to the force or strength of a behavior.
Before developing behavioural objectives, baseline observations and data collection must be
completed. With this information, establish objectives that are challenging yet realistic.
A Functional Behavior Analysis must include the systematic presentation of different
antecedents and consequences to identify or verify the purpose of the target behavior.
This can best be done through an ABC analysis:
Antecedent Behavior Consequence
First described by Bijou, Peterson, and Ault (1968), the focus of an ABC analysis - external
events that appear to influence the behavior.
Assessment Interviews
In addition to a structured observation as described in the ABC analysis, Umbreit and Blair
(1997, p. 77) developed an assessment interview. They used the assessment interview to
identify “the conditions under which a target behavior is likely and unlikely to occur” from
the perspective of teachers, parents, or other significant others who spend a significant
amount of time with the student and have the opportunity to observe patterns related to the
target behavior.
Curriculum-based assessment (CBA)
An FBA must consider the curriculum content in relation to the student’s present performance
level (PPL). A curriculum mismatch may serve as an antecedent to inappropriate behavior
when the function of the challenging behavior is to escape an activity that is too difficult or
boring.
Curriculum-based assessment (CBA) is a strategy for determining the instructional needs of
students in an effort to match the students’ needs and abilities with the classroom curriculum.
The primary goal of CBA is to eliminate curriculum mismatches between students’ skills and
teachers’ classroom assignments and expectations in order to increase student performance
and a reduction in challenging student behavior within the classroom
Curriculum probes are the primary tool for the CBA model and are used to assess a student’s
current skill level. Probes are most often teacher-made, criterion-referenced, functional tests
that the teacher builds directly from his or her own curriculum (e.g., math problems, spelling
words, reading passages, and writing assignments). By comparing the results of the probes
you used on Monday with the same probes administered on the following Tuesday or
Wednesday, you will know whether your teaching strategies have been successful. You will
also know whether you can proceed or whether you have to practice further. An error analysis
could help develop all sorts of innovative ways of helping the student work through the
presenting hurdles.
CBA probes yield data points that can be recorded on students’ growth-over-time charts.
Reinforcment
Reinforcement is most effective in maintaining or increasing a target behavior. Factors such
as immediacy and consistency of the reinforcement, behavior-specific praise, combining
verbal praise with the reinforcement, type of reinforcement, quality and quantity of
reinforcement, and who provides the reinforcement are important.
Reinforcement Stimulus Target Behavior
Positive Presented Increases
Negative Removed Increases
PRIMARY REINFORCERS naturally reinforcing to individuals—food, liquids, and warmth,
for example.
SECONDARY REINFORCERS-value to the individual has been learned or conditioned
through an association, or a pairing, with primary reinforcers. The purpose here is to fade out,
or decrease, the primary reinforcer and fade in, or increase, the value of verbal praise. If
successful, verbal praise will become a secondary reinforcer capable of maintaining or
increasing the target behavior
A method of developing a list of effective reinforcers is through naturalistic observation, trial
and error or preference assessment. High preferenced activities as reinforcement for the
completion of low-preferenced activities
Shaping and Chaining
Shaping refers to the reinforcement of successive approximations of a terminal behavior.
Within each step or successive approximation, responses that meet the criteria for that step
are reinforced, while other responses are not (differential reinforcement). As the child moves
from one step to the next, the criterion for reinforcement changes as expectations increase.
Each step in the shaping process brings the child’s behavior closer to the terminal behavior
Chaining refers to the performance of a series or sequence of behaviors rather than just one
independent behavior.
Step One: Walking into their classroom.
Step Two: Wishing the teacher
Step Three: Sitting at desk
Step Four: taking out Notebooks
Each link serves as a discriminative stimulus for the performance of the next step. After the
child has learned the appropriate sequence of behaviors, reinforcement may be faded from
after the performance of each link to after the performance of the whole chain of behaviors.
Token Economy Program
A token economy program is a symbolic reinforcement system. The child receives tokens for
specific appropriate behaviors, which they may exchange for objects or activities that have
been identified as reinforcing. After the child has learned to associate the tokens with the
purchase of reinforcers, the tokens become valuable and desirable
Contingency Contracting
Contingency contracting involves the establishment of a written behavioral contract between
a child and teacher regarding the performance of specific target behaviors and the exchange
of specific consequences. Behavioral contracts encourage teachers to communicate their
expectations clearly and provide the child with a good understanding of the rewards and
consequences available for his/her behavior
Generalization refers to the degree to which a behavior change transfers to other settings,
situations, or behaviors in addition to the setting, situation, or target behavior involved in the
behavior change program
Promoting Generalization of Behavior Change
 Teaching in natural settings
 Selecting natural antecedents for stimulus control
 Selecting natural consequences as reinforcers
 Reinforcing generalization- a behavior change program may begin and continue
within a specific classroom setting until the target behavior is achieved. Then teachers
gradually expand the program to other settings within the school until complete
generalization (within the school) is achieved

Cognitive Behavioural Modification

It is based on the reciprocal relationship between one’s thoughts and behaviors. Thus, the
intent of these interventions is to modify thoughts and beliefs to change behavior. The major
goal of CBM, therefore, is to teach students to manage their own behavior through cognitive
self-regulation. Self-management training, self-instruction, problem solving, anger control, ,
alternate response training are all interventions that are included under the rubric of CBM.
Teachers use behavioral principles with their students (e.g., reinforcement) to teach them
cognitive strategies. The strategies use some form of self-instruction or verbal mediation to
control behavior.
Three procedures often used in self-management training: self-monitoring, self-evaluation,
and self-reinforcement.
Self-Monitoring- Recording the frequency of a particular behavior or behaviors
Self-Evaluation- Comparison of self behavior against a preset standard to determine whether
the performance meets a particular criterion
Self-reinforcement- Choosing a reinforcer by self and delivering the reinforcer following
appropriate behavior.
Cognitive Training
Cognitive training entails the repeated exercise of a specific cognitive process over a period
of time to improve performance on the trained task as well as on tasks that were not
specifically trained (transfer effect). The rationale is that improving that particular process
would lead to improvements of all skills under its influence (i.e. broad transfers). Cognitive
training in case of ADHD focuses on training cognitive processes such as attention, working
memory, response inhibition. Elements from psychometric assessments such as digit
vigilance, stroop test, color trails, mazes etc. have been used for cognitive training to improve
sustained attention, planning, problem solving, response inhibition.
Adolescents with ADHD
Though ADHD is chronic in nature, symptoms may present in differing ways as a person
moves through life stages. These symptoms may even diminish as that person grows older—
for example, hyperactivity and fidgetiness may decrease with age. Difficulties persisting into
adulthood may present in areas such as:

 maintaining relationships
 work

 school/academic performance

 impulsive behaviors

The overall prognosis can also depend on the severity of ADHD during the childhood years.
since ADHD puts individuals at risk for developing an anxiety or mood disorder, many of
them require individual therapy for those disorders.

Relaxation Techniques

 Progressive muscle relaxation -- alternately tightening and then relaxing different

muscle groups
 Guided imagery -- concentrating on a specific image (such as the color and texture of
an orange) to focus your mind and make you feel more relaxed
 Mindfulness meditation -- focusing your thoughts and letting go of negative emotions

Parental Interventions
 Examine possible causes of acting up which could be transient due to possible life
changes and inner turmoil.
 Refrain from blaming the child or yourself as a parent. It does not raise questions on
parenting so keep in physical and emotional space when overwhelmed. Being attuned
to own risk factors that could exacerbate conflict could help one identify when to step
aside.
 Taking time every day for your child, taking help from school, behaviour therapist etc.
 Trying to relate to the child’s perspective. The child might know what he’s doing
wrong, but his internal urge tells him to continue the appealing tasks. Maybe his
temperament makes him furious that he has to stop, memories of previously getting
away with it edges him on.
 Refrain from criticising child’s personal integrity. It is not the child who is undesirable
but it is some specific forms of behaviour.
“You are a bad boy.”
“The way you are disobeying me is very bad.”
  Consistency in rule setting, conveying expectations, paying attention, encouraging
good behaviour and consequences for bad behaviour. Inconsistency or unpredictable
parenting is a ground for the child to test your limits.
 Priorities goals to streamline efforts to certain tasks so that the child can also focus on
one task at a time. Meanwhile, letting other behaviour slide for the time being.
Improve self-care skills? Improve behaviour at school?
 Consequences of good behaviour whether it be target behaviour or an approximation
must be reinforced immediately. If they have to go through lengthy tasks, they might
not do it again. The feel-good input has to be quick.
 Consequences of bad behaviour also must be quick. If a child is stalling or resisting
and parents give in, it might be considered by the child as a win in the given moment
and the behaviour most likely will re occur.
 Consequences of bad behaviour should be proportional to seriousness or nature of
transgression.
 Each transgression to be deal with then and there. Cumulative punishment could
cause escalation.
 Establishing incentive programs.
 Anticipate situations where more people might be inconvenienced and proactively
plan using incentives and only then use punishment.
 Essentially building a predictable framework of action and response for the child to
depend on.
Barkley, R. A., & Benton, C. M. (2013). Your defiant child: Eight steps to better behavior.
Guilford Press.
Zirpoli, T. (2014). Behaviour Management- Positive Applications for Teachers (6th Ed.).
Pearson Education Limited.
Virués-Ortega, J., & Haynes, S. N. (2005). Functional analysis in behavior therapy:
Behavioral foundations and clinical application.
Tajik-Parvinchi, D., Wright, L., & Schachar, R. (2014). Cognitive rehabilitation for attention
deficit/hyperactivity disorder (ADHD): promises and problems. Journal of the Canadian
Academy of Child and Adolescent Psychiatry, 23(3), 207.