Catherine Browne, MA. BCBA, ABA Consultant at Beam ABA Services
凯瑟琳·布朗，马萨诸塞州BCBA、ABA Beam ABA Services 顾问

A common desire for a lot of parents of children with ADHD is to provide the best support for their child so they can develop the skills they need to live a positive and productive life. ADHD symptoms impact social interactions, cause communication difficulties, and can lead to challenging behaviour.
许多多动症儿童的父母的共同愿望是为他们的孩子提供最好的支持，以便他们能够发展积极而富有成效的生活所需的技能。 ADHD 症状会影响社交互动，导致沟通困难，并可能导致具有挑战性的行为。

For the typical developing child, communication skills and social abilities develop intuitively as they learn from the environment around them. However, for those with ADHD, while some of these skills may be present, they can struggle to use them appropriately in everyday life.  
对于典型的发育中的孩子来说，沟通技巧和社交能力随着他们从周围环境中学习而直观地发展。然而，对于患有多动症的人来说，虽然其中一些技能可能存在，但他们可能很难在日常生活中正确使用它们。

Impulsive and hyperactive behaviours can be seen in children with ADHD which can impact their academic and social progress. It can cause issues with staying on task and following instructions at home and at school. Social and communication skills are such vital areas in any child’s development that it is important to determine the best support for these children.
患有多动症的儿童可能会出现冲动和过度活跃的行为，这会影响他们的学业和社交进步。它可能会导致无法在家里和学校继续完成任务并遵循指示。社交和沟通技能对于任何孩子的发展来说都是至关重要的领域，因此确定对这些孩子的最佳支持非常重要。

Research into treatments for ADHD
ADHD 治疗方法研究

Medication is cited as a common treatment for those with ADHD, but studies have shown that medication, combined with behavioural therapy, has demonstrated great success in treating ADHD. This was evidenced by the landmark National Institute of Mental Health's (NIMH) Multimodal Treatment Study of Children with ADHD. NIMH found that medication therapy alone, and medication and behavioural therapy together, resulted in the greatest improvement in children's ADHD symptoms.
药物被认为是多动症患者的常见治疗方法，但研究表明，药物与行为疗法相结合在治疗多动症方面取得了巨大成功。美国国家心理健康研究所 (NIMH) 具有里程碑意义的多动症儿童多模式治疗研究证明了这一点。 NIMH 发现，单独的药物治疗以及药物和行为治疗的结合，可以最大程度地改善儿童的 ADHD 症状。

While medication works on a neurological level to regulate the brain, behaviour therapy addresses specific problem behaviours by teaching the child self-management and self-regulation skills. Behavioural programmes may utilise effective strategies such as: visual supports, helping arrange the environment to support the child, task organisation and management. These supports help to establish predictability and routines, and increase positive attention.
药物在神经层面发挥作用来调节大脑，而行为疗法则通过教导孩子自我管理和自我调节技能来解决特定的问题行为。行为计划可以利用有效的策略，例如：视觉支持、帮助安排支持儿童的环境、任务组织和管理。这些支持有助于建立可预测性和常规，并增加积极的注意力。

The importance of behavioural therapy for ADHD
行为疗法对多动症的重要性

This highlights the importance of behavioural therapy as a viable option for helping support those with ADHD and especially for younger children where stimulant medications are not recommended for those under six.
这凸显了行为疗法作为帮助支持多动症患者的可行选择的重要性，特别是对于年幼的儿童，因为不建议六岁以下的儿童使用兴奋剂药物。

Research has shown that children with attention deficit disorder or ADHD respond positively to parent training interventions. Parent-Management Training (PMT) is one evidenced based approach which helps parents to use behavioural modification strategies to improve their child’s behaviour in the home. A lot of the strategies in PMT are based on the principles of Applied Behaviour Analysis (ABA), where positive consequences/reinforcement are given for appropriate behaviours such as task completion and specific social skill related behaviours.
研究表明，患有注意力缺陷障碍或多动症的儿童对家长的培训干预有积极的反应。家长管理培训 (PMT) 是一种基于证据的方法，可帮助家长使用行为矫正策略来改善孩子的家庭行为。 PMT 中的许多策略都基于应用行为分析 (ABA) 的原则，其中对适当的行为（例如任务完成和特定社交技能相关行为）给予积极的后果/强化。

Research into the effectiveness of ABA for individuals with ADHD is not as vast as the decades of research surrounding ABA and autism, however, ABA has been shown to be effective for students with ADHD in managing task-related behaviour, impulsivity, and academic responding (Bicard & Neef, 2002; Cook et al., 2014; Flood et al., 2002; Neef et al., 2001).
关于 ABA 对 ADHD 患者有效性的研究并不像围绕 ABA 和自闭症数十年的研究那么广泛，然而，ABA 已被证明对 ADHD 学生在管理任务相关行为、冲动和学业反应方面有效。 Bicard 和 Neef，2002；Cook 等，2014；Neef 等，2001）。

Reinforcement, effective prompting and adjustment of environmental contingencies have shown to improve student learning. Research has shown that problem behaviours, such as impulsivity, aggression as well as important life skills including social and self-care skills, are all behaviours that can be influenced by ABA. Using this behavioural approach, positive behaviours can be learned, negative behaviours decreased and new appropriate behaviours established.
环境突发事件的强化、有效提示和调整已被证明可以改善学生的学习。研究表明，问题行为，如冲动、攻击性以及重要的生活技能，包括社交和自我照顾技能，都是可能受到 ABA 影响的行为。使用这种行为方法，可以学习积极行为，减少消极行为并建立新的适当行为。

5 behavioural therapy strategies parents can implement
父母可以实施的 5 种行为治疗策略

So what are some of the things that parents can implement to help their child? Here are five key strategies:
那么家长可以采取哪些措施来帮助孩子呢？以下是五个关键策略：

1. Praise appropriate behaviours/reinforcement
   表扬适当的行为/强化

It is important to focus on the positive things your child has done and reinforce and praise these. These may be little things like, hanging their coat up or taking their dinner plate to the sink. They might spend a lot of their day being told what they are doing wrong so it is important to find the good and acknowledge it.
重要的是要关注孩子所做的积极的事情，并强化和赞扬这些事情。这些可能是小事，比如挂起外套或将餐盘拿到水槽。他们可能会花很多时间被告知他们做错了什么，因此发现好的一面并承认它很重要。

2. Use clear instructions  使用明确的说明

Give clear instructions about the behaviour you want to see. Keep the expectation reasonable and something the child is capable of doing. Avoid vague statements like “you need to listen better” or “you need to help more”, and instead be clear about the behaviour you expect, for example, “take your homework out of your bag” or “put your toys back in the box when you have finished playing”. It is easier to follow a direction that is simple and clear.
就您希望看到的行为给出明确的指示。保持合理的期望以及孩子有能力做的事情。避免诸如“你需要更好地倾听”或“你需要提供更多帮助”之类的模糊表述，而要明确你期望的行为，例如“从包里拿出作业”或“把玩具放回书包里”。当你玩完后，请在盒子里“。遵循简单明了的方向会更容易。

3. Token board/Points system
   代币板/积分系统

It is important for children to see their progress on a day-to-day basis. It also allows them to achieve rewards based upon progress. The goal is for the child to complete certain tasks or expectations — whether it’s a household chore, homework, etc. — so they earn tokens or points that count towards a reward. Short-term rewards are usually more effective, such as extra computer access or a preferred snack. Positive reinforcement is always a stronger motivation for children than negative reinforcement or punishment.
对于孩子来说，每天看到自己的进步很重要。它还允许他们根据进度获得奖励。目标是让孩子完成某些任务或期望——无论是家务、家庭作业等——这样他们就能获得代币或积分，从而获得奖励。短期奖励通常更有效，例如额外的计算机访问权限或首选零食。对于孩子来说，正面强化总是比负面强化或惩罚更强烈的动机。

4. Behavioural Contracts 行为契约

These often work better for older children and teens. Involve them in drawing up the rules and the rewards for following through. Establish that you are doing this with your child rather than something you are doing to your child. Keep expectations realistic and focus on a few important things as opposed to everything all at once. It is important to maintain their motivation so keep targets manageable and achievable.
这些通常对年龄较大的儿童和青少年效果更好。让他们参与制定规则和遵守规则的奖励。确定您正在对您的孩子做这件事，而不是您正在对您的孩子做的事情。保持现实的期望，专注于一些重要的事情，而不是同时关注所有事情。保持他们的动力非常重要，这样才能保持目标可管理和可实现。

5. Consistency 一致性

For anything to truly work and last over time, it needs to be applied consistently. Implementing agreed rules on a daily basis and providing rewards when they are earned is important for establishing positive behaviour change.
任何事情要想真正发挥作用并持续一段时间，就需要始终如一地应用。每天执行商定的规则并在获得奖励时提供奖励对于建立积极的行为改变非常重要。

Parent-led behavioural therapy programmes
家长主导的行为治疗计划
While these strategies are set out as a helpful guide for parents, it is important to acknowledge that parents often need additional support to successfully implement effective behaviour change. With the right support, parents can master and consistently apply the necessary skills leading to long term benefits for their child’s development and also the child-parent relationship.
虽然这些策略是为父母提供有用的指南，但重要的是要承认父母通常需要额外的支持才能成功实施有效的行为改变。在正确的支持下，父母可以掌握并持续运用必要的技能，从而为孩子的发展以及亲子关系带来长期利益。

Beam's new service, ABA Pathfinder, is a parent-led behavioural intervention which brings a BCBA certified ABA Consultant into family homes using video technology. The ABA Consultant works directly with the parent/carer, who adopts the role of an ABA tutor. The Consultant creates a person-centered ABA programme carefully tailored to the individual, identifying behaviours to reduce which are replaced with the acquisition of skills generalised across people, settings and time.
Beam 的新服务 ABA Pathfinder 是一项由家长主导的行为干预服务，利用视频技术将 BCBA 认证的 ABA 顾问带入家庭。 ABA 顾问直接与家长/照顾者合作，家长/照顾者扮演 ABA 导师的角色。顾问创建了一个以人为中心的 ABA 项目，为个人精心定制，确定要减少的行为，并用获取跨人群、环境和时间的通用技能来取代这些行为。

Parents/carers receive all the tools, strategies, coaching and support needed to implement an ABA programme individually designed for their child, with the Consultant having full oversight of the programme to ensure it meets its goals and is aligned with best practice clinical standards. Read more about ABA Pathfinder.
家长/照顾者可以获得实施为孩子单独设计的 ABA 计划所需的所有工具、策略、指导和支持，顾问对该计划进行全面监督，以确保其实现其目标并符合最佳实践临床标准。了解有关 ABA 探路者的更多信息。

References 参考

Bicard, D.F., & Neef, N.A. (2002). Effects of strategic versus tactical instructions on adaption to changing contingencies in children with adhd. Journal of Applied Behavioural Analysis, 35(4), 375-389
Bicard, D.F. 和 Neef, N.A. (2002)。战略与战术指导对多动症儿童适应不断变化的突发事件的影响。应用行为分析杂志，35(4), 375-389

Cook, A., Bradley-Johnson, S., &Merle Johnson, C. (2014). Effects of white noise on off-task behaviour and academic responding for children with adhd, Journal of Applied Behaviour Analysis. 47, 160-164
Cook, A.、Bradley-Johnson, S. 和 Merle Johnson, C. (2014)。白噪音对多动症儿童的偏离任务行为和学业反应的影响，《应用行为分析杂志》。 47、160-164

Flood W.A, Wilder D.A, Flood A.L, (2002). Peer-mediated reinforcement plus prompting as treatment for off-task behaviour in children with attention deficit hyperactivity disorder. Journal of Applied Behaviour Analysis, 35, 199-204.
Flood W.A，Wilder D.A，Flood A.L，（2002）。同伴介导的强化加提示作为治疗注意力缺陷多动障碍儿童偏离任务行为的方法。应用行为分析杂志，35，199-204。

Kazdin, A. E. (2005). Parent management training: Treatment for oppositional, aggressive, and antisocial behavior in children and adolescents. Oxford: Oxford University Press
卡兹丁，A.E.（2005）。家长管理培训：治疗儿童和青少年的对抗性、攻击性和反社会行为。牛津：牛津大学出版社

MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder: Multimodal Treatment Study of Children with ADHD. Archives of General Psychiatry, 56 (12), 1073-1086
MTA 合作组。 （1999）。一项为期 14 个月的注意力缺陷/多动症治疗策略随机临床试验：多动症儿童多模式治疗研究。普通精神病学档案，56（12），1073-1086

Neef, N. A., Bicard, D. F., & Endo, S. (2001). Assessment of impulsivity and the development of self-control in students with attention deficit hyperactivity disorder. Journal of Applied Behaviour Analysis, 34, 397–408.