A New Behavioral Approach for ADD/ADHD and Behavioral Management Without Medication

Attention-Deficit-Hyperactivity Disorder (ADHD) is generally considered a biologically or neurologically determined disorder that is effectively managed with a combination of stimulant medication and a behavioral approach featuring prompts, reminders, and token economies, while minimizing disciplinary contingent responses to target behaviors. Recent reviews of the extant quality research and consensus conclusions among leading experts do not support this current prevailing paradigm and management. A new conceptualization of the basic nature and cause of ADD/ADHD behaviors is proposed, in which cultural forces prevalent in or unique to our culture combine to produce a behavioral syndrome that is primarily developmental in nature and may be largely preventable by parenting approaches and other environmental modifications. A behavioral approach based upon underlying premises differing from those in conventional management is discussed, and evidence that this may provide an effective treatment for ADD/ADHD behaviors without the use of stimulant medication is presented.