Alternatives to Ritalin in Children with ADHD

Contributor:  W. Travis Stewart, LPC, NCC writer for Addiction Hope

Group of students in a hallwayOver the past 20 years there has been an increase in the diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) as well as the controversy surround that diagnosis and the related treatments available. If you do an internet search on the effectiveness of Ritalin or other medications for ADHD in children you will quickly find yourself neck-deep in studies, claims and counter-claims and heated arguments on the topic.

Many people already feel uncomfortable giving medication to their adolescents or children and turn to the internet to find alternative treatments to help their children focus and overcome behavioral and educational difficulties. After spending a few hours reading material on the internet they may simply walk away feeling confused and discouraged.

The goal of this article is to provide some helpful information on alternatives to Ritalin treatment that are available.

What is Recommended Treatment for ADHD?

Prescription drugsThe American Academy of Pediatrics “recommends behavioral therapy first for preschool- aged children, with short-acting methylphenidate prescribed if therapy does not sufficiently improve symptoms. For older children, a Food and Drug Administration–approved ADHD medication with or without behavioral therapy is recommended. Combination therapy (medication and behavioral therapy) is preferred, particularly for elementary- aged children.” [1]

Despite the fact that the recommended treatment is a combination of medication and behavioral interventions, a recent study [2] found:

  • Less than 1 in 3 children with ADHD received both medication treatment and behavioral therapy, the preferred treatment approach for children ages 6 and older.
  • Only half of preschoolers (4-5 years of age) with ADHD received behavioral therapy, which is now the recommended first-line treatment for this group.
  • About half of preschoolers with ADHD were taking medication for ADHD, and about 1 in 4 were treated only with medication.

Behavioral Interventions

問診をする医師This lack of focus on behavioral interventions should be concerning, both to those resistant to medication for children and those who believe in the effectiveness of Ritalin. This likely means that both professionals and parents of children with ADHD are overly reliant on medication “curing” the child and that they may be neglecting some of the effective behavioral approaches. This can result in the child becoming dependent on medication to deal with emotional, neurological and relational problems rather than learning healthy coping skills.

Janet Currie, a professor at Princeton University and director of Princeton’s Center for Health and Wellbeing, along with research partners Mark Stabile and Lauren Jones, recently examined [3] the effectiveness of stimulants such as Ritalin on children and concluded that “parents should not expect medication alone to resolve their child’s difficulties—counseling and life coaching are likely to also be essential for teaching children the skills that they need to thrive with ADHD.” [4]

Life Skills Coaching

Group therapy in session sitting in a circleCoaching is a growing field of mental health. Rather than focusing on the underlying psychological factors of mental health, coaching focuses on building strengths and setting goals. Coaching for those with ADHD focuses on overcoming the distractibility, disorganization and time management difficulties common with ADHD. The EDGE Foundation [5] is a non-profit organization which will help you find a coach to work with your child. Their stated mission is to “ensure that each student, regardless of their economic circumstances, who wants and needs an Edge Executive Coach gets one so that they can complete their education and not drop out.”

Behavioral Approaches for ADHD

Behavioral approaches for children with ADHD focus on the parents providing consistency, routines, clear goals and expectations for children. The focus needs to be on the behavior of the child – not the value of the child.  The magazine ADDITUDE [6] provides lots of online resources for parents, professionals and children dealing with ADHD.

In addition to learning different parenting approaches you can enlist the help of an experienced professional. A licensed professional counselor or child psychologist, particularly one who specializes in working with children with ADHD, see multiple children walk through their doors each week. They will have a helpful grasp on what seems to work best for children and parents. An experienced professional can be a wonderful partner for your child and a supportive figure for parents.

Mindfulness Training for ADHD

Woman enjoying freedomExecutive functioning problems are at the heart of ADHD. Executive functions in the brain are the skills which involve time management, decision-making, self-regulation and juggling multiple tasks. A child with ADHD has deficits in the prefrontal cortex—the part of the brain responsible for the functions.

Mindfulness is the ability to be aware of your thoughts, emotions and sensations with a calm, non-judgmental stance. Those who develop mindfulness can observe and then modify their choices more effectively, leading to healthier behaviors. In other words, mindfulness is the opposite of ADHD. Yet, evidence seems to be pointing to the fact that even those with ADHD can learn to develop mindfulness through practice and training.

A study by Susan Smalley and Lisa Flook published in the Journal of Applied School Psychology [7] showed that mindfulness training improved executive function, particularly in children who initially showed lower executive function skills.

Specific Strategies

Close up of person walking on streetFinally, here is a list of practical strategies which may help your child with directing their energy in more positive directions and learning to direct their thoughts:

  • Enroll your child in activities which have outlets for their energy such as soccer or martial arts
  • Provide hands-on activities
  • Teach your children relaxation techniques
  • Use natural and logical consequences
  • Allow your child to express his or her needs verbally
  • Separate the child from the behavior
  • Affirm your child’s positive behavior
  • Express delight and joy in being with your child
  • Break down tasks into clear and manageable steps
  • Develop a consistent morning routine
  • Set up a consistent bedtime to ensure your child is getting at least 9 hours of sleep
  • Use tokens and positive rewards to motivate positive behavior
  • Take care of yourself as a parent
  • Stay calm – learn to identify your rising level of frustration and step away before things feel out of control
  • Don’t take your child’s choices personally – or allow it to be a reflection on your parenting
  • Attend a support group with other parents who are parenting kids with ADHD


About the Author:

Travis Stewart has been mentoring others since 1992 and became a Licensed Professional Counselor in 2005. His counseling approach is relational and creative, helping people understand their story while also building hope for the future.

Travis has experience with a wide variety of issues which might lead people to seek out professional counseling help. This includes special interest in helping those with compulsive and addictive behaviors such as internet and screen addiction, eating disorders, anxiety and perfectionism.

Travis graduated from the University of Nebraska in 1991 with a degree in advertising and immediately began working with the international ministry of The Navigators, mentoring students. After 8 years, his desire to better understand how people change, and through his own experience of receiving help from a professional counselor, Travis decided to return to school. He earned a Master of Arts in Counseling (2001) and a Master of Arts in Theological Studies (2003), both from Covenant Seminary in St. Louis, MO. Travis is a Licensed Professional Counselor in the State of Missouri.


Community Discussion – Share your thoughts here!

Have you or a loved one suffered from ADHD, what treatments did you utilize?  Have you tried alternatives to Ritalin?  What has worked well?




  2. Advance/journals/ympd/Visser.pdf
  4. Personal email communication



Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on August 24, 2015. Published on