Intervention more important than ADHD diagnosis, researcher says

All children — with or without ADHD — can benefit from behavioral strategies.

A recent study published in the Journal of Child Psychology and Psychiatry suggests the youngest children in a classroom are being diagnosed with attention deficit hyperactivity disorder (ADHD) and medicated more often, but FIU psychologist Erika Coles says using simple behavioral strategies, at any age, can help to prevent difficulties at home and at school from becoming more problematic.

“It is very normal for children to misbehave and that is not necessarily attributable to a mental health disorder,” Coles said. “However, there is an increased awareness of ADHD and associated behavioral concerns, which may be leading to children being identified at an earlier age.”

In the United States, medication is the first line of treatment for 90 percent of children with ADHD. However, FIU researchers have determined behavioral therapy — when used first — is more effective in treating children with ADHD than medication. The behavior-first approach is also the recommended course of treatment by the American Academy of Pediatrics for children under 6.

For Coles, the important thing is to identify disruptive or impairing behaviors early, including difficulty staying seated for brief periods of time, difficulty playing quietly and difficulty following simple directions at home and school. That is the perfect time to intervene. By identifying those who exhibit challenging behaviors, teachers can effectively manage common difficulties and help improve the learning environment for all students.

Regardless of age, using behavioral techniques — praising appropriate behavior, providing structure and establishing routines — can help mitigate the risk of developing more serious behavior problems in the future or even an ADHD diagnosis.

Fifty percent of mental health disorders begin before age 14, affecting the learning and school experience for all children. The FIU Center for Children and Families offers services for kids and teens struggling with ADHD and behavioral problems, anxiety and fears, academic and social skills, trauma, mood and depression, and more. The center also offers training and education for teachers who often are the frontline mental health providers for these children.

For information, visit or call 305-348-0477.

Erika Coles

Coles is the clinical director for the Center for Children and Families. Her research focuses on the effectiveness of behavioral interventions in the school setting. She studies how consultation interventions can be used to enhance teacher integrity, knowledge, attitudes and skills to improve student outcomes in the classroom. Coles also specializes in behavior interventions to assist children with ADHD in the classroom, including the implementation of a daily report card transitioning into the school year with a behavioral plan for the classroom to prevent behavior problems from interfering with academic and social functioning.


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