Treatment of Attention-Deficit Hyperactivity Disorder: The Impact of Comorbidity

A significant percentage of children with attention-deficit hyperactivity disorder (ADHD) have comorbid, associated problems, such as learning disabilities, oppositional defiant disorder, conduct disorder, and internalizing disorders. However, it will be argued that comorbid diagnoses are not useful in treatment planning. In order to effectively treat the problematic behaviours associated with these comorbidities, clinicians must systematically assess for the impairment related to these comorbidities and implement treatment aimed to reduce impaired functioning and increase competencies in important functional domains. Clinicians who utilize this approach will find (1) that diagnosis matters little for treatment planning, while functional impairment matters a great deal, and (2) that the systematic application of behaviour modification principles improves functioning across diagnostic categories. A case study of a multiply comorbid child with ADHD is presented to illustrate effective treatment for ADHD and comorbid disorders.