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ADHD treatment – changing the approach, not the child

A study conducted by the ZHAW and the University of Fribourg concluded that parents, specialists and teachers should cooperate more closely and involve the child more in the decision-making process during ADHD treatment. The results of the study were included in a brochure containing recommendations for action – a completely new idea in Switzerland.

Attention Deficit Hyperactivity Disorder (ADHD) is today one of the most common neurodevelopmental disorders in childhood worldwide. Up to now, when ADHD was diagnosed, the focus was often placed on the deficit and not the child. A recent interdisciplinary study on how to deal with ADHD («Kinderförderung – eine interdisziplinäre studie zum Umgang mit ADHS») focuses on the child’s well-being and examines why parents choose drug treatment for their children. Furthermore, specialists were questioned about collaboration in relation to children who have ADHD and about the causes of the disorder. The results were included in a brochure that contains recommendations for action. According to Dominik Robin, the project leader, it is crucial to change the perspective and focus on the child. It is therefore recommended that measures be taken to familiarise the people involved with the child’s disorder and special needs.

More than a medical or psychological phenomenon

Robin explains that models excluding the social context and the environment of affected children fail to capture the complexity of the ADHD phenomenon. Thus, one-sided diagnoses and medical ADHD tests are insufficient. In order to enhance children’s well-being, ADHD must be understood and diagnosed as a complex phenomenon that involves multiple agents. The study's authors also underline the importance of a careful diagnostic clarification by competent specialists, as well as effective cooperation between these specialists.

The brochure created within the scope of the project contains recommendations for action for specialists and others involved. It is the first of its kind in Switzerland and aims to support all agents in the decision-making process when they are dealing with ADHD. The goal of these recommendations is to prevent a situation where children showing ADHD symptoms receive hasty premature drug treatment or remain unnoticed and therefore untreated. To achieve better cooperation, the recommendations for action suggest at least one round-table discussion with all the people involved. Such a discussion may take place in addition to the usual bilateral meetings between parents and teachers or parents and medical professionals. Furthermore, it is crucial that children be given the opportunity to attend these meetings. This will allow children to be informed about possible next steps and to express their opinion.

Parents consider drug treatment carefully

The study’s results show that parents think carefully before opting for drug treatment for children with ADHD. They usually choose drug treatment if, after a lengthy period, other treatments have been unsuccessful. The parents’ responses reveal that school performance requirements, family problems, as well as psychological stress in everyday school and family life in general, are the most frequent reasons for them to use drugs. Initially, psychological stress is often observed within the school context and is later perceived within family life as well. Consequently, interaction between school and family should be considered to a greater degree when it comes to intervention to improve the situation.

Joint project by ZHAW and University of Fribourg

«Kinder fördern – eine interdisziplinäre Studie zum Umgang mit ADHS» is a cooperation project between the ZHAW Zurich University of Applied Sciences and the University of Fribourg. Quantitative and qualitative surveys were conducted including parents of children diagnosed with ADHD who were between the age of 6 and 14, teachers, remedial teachers and paediatricians. Researchers conducted the surveys in cooperation with specialists in the field of paediatrics (Centre for Social Paediatrics [Sozialpädiatrisches Zentrum, SPZ] at Winterthur cantonal hospital), as well as with those in the field of child and juvenile psychology (Psychiatrische Universitätsklinik in Zurich) and with specialists from the field of education. The project was financed by the Swiss foundation Mercator (Stiftung Mercator Schweiz).

Contacts

Dominik Robin, Institute of Health Sciences, ZHAW School of Health Professions, phone +41 (0)58 934 63 42, email dominik.robin@zhaw.ch

Frank Wieber, Institute of Health Sciences, ZHAW School of Health Professions, phone +41 (0)58 934 43 47, email frank.wieber@zhaw.ch

Sandra Hotz, Institute for Family Research and Counseling, UUniversity of Fribourg, phone +41 (0)26 300 73 51, email sandra.hotz@unifr.ch

José Santos, Head, Communications School of Health Professions, phone +41 (0)58 934 63 84, email jose.santos@zhaw.ch