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ADHD Center for Evaluation and Treatment (ACET)

Cleveland Clinic Children's ADHD Center for Evaluation and Treatment (ACET) offers a comprehensive and thorough assessment using state-of-the-art diagnostic methods based on the National Institutes of Health guidelines. The ACET team provides treatment recommendations designed specifically to assist children and families in managing ADHD at home, in school, and throughout life.

We offer several services for ADHD patients and their families:

  • Evaluation
  • Consultation
  • Parent and teen coaching
  • Individual therapy
  • Programs

To begin your evaluation process, please call 216.445.7574.

Attention Deficit-Hyperactivity Disorder (ADHD) is a treatable condition that affects about 5 percent of all children in the United States. Symptoms of ADHD usually appear by age 7 and are found in boys more often than girls. Associated with both the central nervous system and environmental factors, ADHD is characterized by one or more of the following core symptoms:

  • Inattentiveness
  • Distractibility
  • Impulsiveness
  • Excessive activity

Some children may have ADHD without hyperactivity. In such cases, the condition is more difficult to detect because these children do not "act up" in class or at home. They may seem lethargic and fail to complete work, or they may show signs of confusion, forgetfulness and disorganization.

Children with ADHD do not intentionally choose to be the way they are. They are not lazy, unmotivated or "willful." Children with ADHD are biologically different. Often, it is hard for them to do what is expected of them; they'd rather do what is interesting to them.

Frequently Asked Questions

Does my child have ADHD?

The ACET program will answer your question.

ADHD is difficult to diagnose. In some cases, what appears to be ADHD may actually signal another problem.

To ensure that your child receives an accurate diagnosis and proper treatment, our staff conducts interviews with you, your child and sometimes his or her teachers, performs direct observations in the clinic and uses psychological rating scales. Once collected, the data is analyzed and the results are summarized for you. Through this evaluation, we can determine if ADHD symptoms are present, if other disorders accompany it, or if other disorders may be the source of your child's symptoms. Based on this careful, complete evaluation, we will then recommend comprehensive treatment tailored to your child's needs.

Our staff focuses on your child's strengths and assets, what works for them, and emphasizes and builds on the skills that your child already has. We will provide a treatment program that integrates cooperation between home and school. Parents will receive coaching regarding the management of the child in both home and school settings and how the child handles himself or herself.

Our collaborative approach to care combines the knowledge of pediatric health care professionals including psychologists, psychiatrists, pediatric and child psychiatry residents, social workers and nursing staff. Your child will have access to the professionals at Cleveland Clinic Children's where high-quality expertise and innovative technology help meet the special needs of children and their families.

Could it be something else?

In some cases, what appears to be ADHD may actually signal another problem such as depression or anxiety. Before proper treatment can begin, pinpointing the real difficulty is important.

The ACET program was developed to

  • Find out if the symptoms of ADHD are there
  • Rule out other possible causes of the symptoms
  • Discover if there are any other conditions or concerns to treat

If your child is diagnosed with ADHD, we will outline an appropriate treatment program using a variety of treatment methods, such as a combination of medication, individual counseling and parent coaching. If the diagnosis is not ADHD, we will refer you to qualified professionals for other focused evaluation and treatment.

The element of uncertainty of your child's condition can largely be eliminated, and your child can receive needed and appropriate treatment.

Will my child outgrow it?

No. Children do not outgrow ADHD. If left untreated, their problems can be compounded over time. Symptoms can impair a child's behavior in social and academic situations, which will eventually affect his or her self-esteem. Treatment that is tailored to address the severity of the condition can alleviate the symptoms and help a child learn to cope with the disorder.

Is mediction the only answer?

Medication may be an option, but it is not the only one.

Treatment of ADHD depends on the child and the severity of the problem. In all cases, it involves a combination treatment approach designed to address the child's individual needs. This treatment may include interventions in the classroom and at home, individual and family therapy, parent coaching, behavior management techniques (such as the Summer Treatment Program), strategies for the child's teachers, and medication.

If medication is an option, our staff will work with you and your child's pediatrician to monitor your child's response and to find the optimal dosage level. We use a systematic, scientific approach to fine-tune the dosage to ensure both the safety and effectiveness of treatment.

What can I do?

If you think your child may have ADHD, begin by talking to your child's teacher, pediatrician or family practitioner. If the problem is not long-standing and has only developed over the past six months, you may learn that the condition is due to something other than ADHD.

However, if these core behaviors (inattentiveness, distractibility, impulsiveness, excessive activity) are persistent and occur in many different settings and situations, or if the behavior is causing significant social and/or academic problems, your child may have ADHD.

If this sounds like your child, contact the ADHD Center for Evaluation and Treatment at Cleveland Clinic Children's at 216.445.7574. We work with children, parents and teachers to assess the condition and recommend appropriate strategies for treatment.

Remember, ADHD doesn't have to impair your child's social and academic life. There isn't anything wrong with your child or your parenting skills. By pinpointing the condition, you and your child are on the way to managing this behavior.

The ADHD Center for Evaluation and Treatment offers a variety of programs for children, families and instructors. These programs can be help ADHD children to form healthy habits and relationships. From medication to summer enrichment, ACET programs provide caregiving and instruction skills for living with ADHD.

ACET Programs

Working with an ADHD Child: Effective Strategies for the Classroom

This program aids teachers and professional staff in their interactions with children who have been diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD).

Medication Monitoring Program
Description

The ACET Medication Monitoring Program is designed to help parents and physicians select the best dose of a medicine when treating ADHD. It is a safe, systematic, and well-monitored method for testing whether a stimulant relieves symptoms of ADHD. The service confirms:

  1. The stimulant’s efficacy
  2. The presence or absence of side effects
  3. “Best” dose

This four-week therapeutic monitoring can be used to start or to change medicine. The patient will receive one week each of a placebo, low, moderate, and high dose of the medicine in a double-blind trial. (You may download the attached protocol.) After the trial, a one-page summary of the results is provided to the primary care physician who will manage ongoing care.

ACET Medication Monitoring Program fulfills guidelines of the American Academy of Pediatrics and Practice Parameters of the American Academy of Child & Adolescent Psychiatry. It benefits patients in several ways:

  • Demonstrates medication effects to parents who are uncertain about pharmaceutical treatment
  • Shows potentially positive effects to treatment-reluctant teens
  • Circumvents media disinformation regarding medical treatment of ADHD

ACET Medication Monitoring Program also generates reliable patient information to help physicians thoroughly monitor medication response when busy schedules preclude doing so.

Details

Please contact our office if you have questions regarding the ACET Medication Monitoring Program. Appointments take 20-30 minutes and are scheduled on Fridays. If you have questions and wish to reach us directly, please call 216.445.7574.

Cost

Cost of medicine for the four-week therapeutic monitoring is $52.00. Cost for the visit is billed to insurance and based on insurance benefits. Patients may be responsible for co-pay per visit.

Social Skills Training for Children & Adolescents with ADHD
Description

The Behavioral Skills Training Group offers focused behavioral teaching of age-appropriate social skills. Children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) may have difficulties in social interaction. Groups of 6 to 8 children meet for 90 minutes a week for seven weeks. The program is facilitated by ACET staff, Hilary Parsons, LPC, and Rebekah Bryson, LSW, under the supervision of Dr. Manos.

Caregiver/Parent Coaching Groups are offered simultaneously. In the parent group, parents will learn behavioral techniques and interventions based on social learning approaches to behavior management. Children between the ages of 6-14 may participate based on enrollment. Treatment goals are individualized for the group, and children are grouped by age and social challenges. The following list illustrates examples of targeted skills:

  • Initiating cooperative ventures
  • Initiating conversation
  • Participating in a group
  • Interrupting appropriately
  • Giving/accepting negative feedback
  • Making/keeping friends
  • Listening during conversation
  • Following instructions/rules
  • Solving problems/negotiating
Purpose of Child Sessions

The purpose of this group is to teach specific social skills that will improve children’s ability to act positively and effectively in school, at home, and with peers. After learning specific social skills, children practice the skills in a safe, accepting atmosphere. Teachers are also involved in the reinforcement of social skills outside of the group to foster carryover.

Parent/Teenage Collaboration Groups

Developmentally appropriate exercises foster good communication skills and following activity rules and role-plays encourage use of skills outside the group. Adolescents and their parents work on parent-teenager negotiation techniques that can improve quality of relationships, and they practice these techniques during mediated sessions with ACET staff members.

Purpose of Parent Sessions

The purpose of the parent coaching group is to teach behavioral strategies and interventions that can be used at home, with siblings, at school, with friends, and in various settings where children diagnosed with ADHD tend to have difficulties. Parents will be asked to participate in sessions, role-play, complete various assignments, and rate their child’s success with each skill weekly. Furthermore, parents will be involved with practicing reciprocal skills with their child. Topics for these sessions include, but are not limited to: using descriptive statements, direct commands, labeled rewards and other effective strategies for behavior management.

When and Where

The seven sessions are scheduled weekly for 1.5 hours between 5 p.m. – 6:30 p.m. at Cleveland Clinic Children’s Hospital for Rehabilitation Campus. Please enter the building through the Autism Center and wait in the lobby for group instructors.

The Fall 2014 Spring 2014 Social Skills Groups will be held on Tuesdays from 5 p.m. - 6:30 p.m., beginning October 7, 2014. Check-in time for each session is at 4:45 p.m. This session will last seven weeks and conclude on November 18, 2014. The Fall 2014 sessions will be held on the following dates:

  • October 7, 2014
  • October 14, 2014
  • October 21, 2014
  • October 28, 2014
  • November 4, 2014
  • November 11, 2014
  • November 18, 2014
Details

Several conditions help to insure that participants receive the greatest benefit. First, children must attend all seven sessions. Second, parents must complete the attached Application for Participation. The application helps focus parent’s main concerns and helps the group leaders structure the sessions to optimize the children’s experience. Finally, we ask that parents participate in the parent coaching groups while their child participates in the social skills class.

Cost

It is the patient’s responsibility to check with their insurance provider regarding benefits and co-pays for group and family therapy. These sessions will be billed under Dr. Michael Manos as the provider. Parent sessions will be billed as CPT code 90849. Children sessions will be billed as CPT code 90853. Both codes will be used for the seven sessions.

Application Process

Please note that application deadlines are two weeks prior to the start of each group.

Complete the Application for Participation form and return it to:
Cleveland Clinic Children's, ACET Programs—Desk CR11
2801 MLK Jr. Drive
Cleveland, OH 44104
Attn: Hilary Parsons

Parents will then be contacted for the pre-group telephone screening to verify appropriate placement. Call Hilary Parsons, Group Facilitator at 216.445.7574 with any specific questions.

Cleveland Clinic’s Summer Treatment Program for children with ADHD provides families with individually designed treatment plans that address their children’s behavioral, emotional and learning difficulties. The overall goal of the seven-week daytime treatment program is to help children and families manage ADHD symptoms throughout the year.

2014 Program Dates are Monday, June 16th through Friday, August 1st.

Summer Treatment Program phone: 216.444.0075

Application Information Sheet - for participants

Staff Application - for staff

Award-winning Program

The Summer Treatment Program (STP) is directed by Michael J. Manos, PhD, Head of the Center for Pediatric Behavioral Health at Cleveland Clinic Children's. Cleveland Clinic's STP is one of 10 sites in the country. It is based on an award-winning program developed over the past 20 years by William E. Pelham, PhD, a nationally recognized expert in ADHD. It is the only program selected for the national Multimodal Treatment of ADHD (MTA) study funded by the National Institutes of Health and the U.S. Office of Education. To date, more than 2,500 children and their parents have taken advantage of this unique resource. Cleveland Clinic's treatment program has earned a high rate of parent satisfaction (95 percent) and produces demonstrable results in most ADHD children.

Although the program is highly structured and emphasizes behavioral treatment, parents should be aware that most children enjoy it tremendously. Besides being beneficial for them, the program is a lot of fun.

A Typical Day

ADHD children and adolescents of similar ages are placed in groups of 10 to 12. Groups are supervised by five clinical staff members. These groups remain together throughout the day so children receive intensive experience in functioning as a group and in making friends.

Children spend three hours each day in a classroom context to learn to manage their behavior in the school environment. Developmental specialists conduct these group sessions. Children receive individual, computer-assisted and art instruction.

To learn and practice successful note-taking skills, teens spend two hours each day in an academic learning center and one half-hour in study hall.

The remainder of each day involves age-specific, recreational group activities, including swimming, soccer, baseball, basketball and other games. During these recreation periods, children participate in group problem-solving discussions, social-skills training, a behavioral point system and other treatment strategies.

Program Goals

A social learning approach is used that focuses on achieving the following goals, which are to: develop the child's social skills and social awareness; improve the child's learning skills and academic performance; develop the child's ability to follow through with instructions, complete tasks and comply with adults' requests; improve the child's self-efficacy by developing competencies in interpersonal, recreational, academic and other task-related areas necessary in daily life; teach parents how to develop, strengthen and maintain these positive changes; and evaluate the effects of medication (when appropriate) on the child's academic and social functioning in a natural setting. Treatment includes individually adapted reward and cost programs, training in group problem-solving skills, behavioral contracting, social skills training, instruction in learning deficits, strategies for improving concentration and completing tasks, strategies for improving self-concept, use of time-outs, and a daily feedback system. As part of the program, children can participate in weekly field trips to educational and recreational sites in and around the Cleveland area.

Treatment plans and strategies are continuously monitored and modified as necessary. A final report, which includes a summary of the child's progress and recommendations for future treatment, is sent to parents and referring professionals at the end of the program.

Parent Training Groups

In addition to the child's daytime involvement, parents may participate in weekly evening training groups. The parent sessions include topics such as: basic information on ADHD, behavior management programs for home and school, appropriate and effective methods of discipline, combining behavior modification, and medication improving parent-teenager communication through negotiation techniques. The training groups help parents develop the skills to cope with and change their child's unacceptable behavior at home. This includes reducing disobedient and disruptive behaviors while improving the child's homework skills and relationships with family members. The goal of the parent sessions is to extend the gains made in the program to the child's natural environment, especially at home and in school.

Medication Evaluation

When medically appropriate, our staff evaluates the potential effectiveness of medication treatment for the child. Comprehensive and carefully controlled, this evaluation covers the major areas of the child's functioning (such as social behavior, learning ability and self-concept) that could be affected by medication. Staff also can determine the effectiveness of combining medication with behavioral treatment. Following the assessment, we provide the referring physician and parents with a report on the child's response to medication, including specific recommendations for maintaining treatment gains.

Eligible Children

Children aged 6 to 11 and adolescents aged 12 to 14 years are eligible to participate in the Summer Treatment Program. Referrals can be made by parents, physicians, school personnel or mental health professionals.

Enrollment is limited, and participants are selected based on evaluations conducted by the program's staff or other qualified professionals. During this evaluation, children are screened for inattention, overactivity, learning problems, oppositional behavior and other behavioral problems. While an evaluation conducted by the ADHD Center for Evaluation and Treatment (ACET) of our Children's Hospital may be required for admission, in some cases recent testing from other sources are accepted. Children who meet the program's criteria are offered admission.

The seven-week Summer Treatment Program is part of the ADHD Center for Evaluation and Treatment (ACET) of Cleveland Clinic Children's. ACET is a comprehensive diagnostic and treatment service that informs you and your child's pediatrician about the presence of symptom criteria for ADHD. ACET also can provide a systematic procedure for monitoring treatment. For more information on ACET, call 216.444.0075.

Program Evaluation and Investigation

Professionals within Cleveland Clinic Children's are committed to learning about the underlying causes of and most promising treatments for pediatric medical and behavioral problems. Research and investigation lead to the best clinical care for children.

Although the Summer Treatment Program uses only those treatments that have been well-documented and shown to be effective through research, our staff continues to evaluate the impact of new, potential treatments. The effects of treatment are measured carefully both at the individual and program levels, using observational, psychometric, neuropsychological and rating measures.

To further understand behavioral problems in children, we gather information from the children and families enrolled in the program. For example, children may participate in activities that help measure their attention, memory, performance of computerized tasks, or interactions in competitive situations. Similarly, parents may be asked to complete rating scales or to be observed in controlled settings that help measure how the family functions.

To maintain confidentiality and to ensure a complete understanding of evaluation and investigation projects, parents are asked to review and sign consent forms before participation begins.

Parent Testimonials

The following are excerpts from letters sent voluntarily by parents whose children participated in Cleveland Clinic’s STP.

“Our nine-year-old son knows he has ADHD; he has a greater awareness of his strengths and weaknesses and this program has encouraged him to take greater responsibility for his actions and to be more proactive in self-control, self-discipline, and to feel confident in a leadership role. He has gained invaluable insight into himself and is much better at socializing with his peers and in participating in group activities. In this summer’s program he willingly adopted many valuable habits and pieces of knowledge to help him lead a happy life and had FUN doing it.”
Parents of a 9-year-old boy

"Along with many others I went through some very dramatic growth and change with [my son] and, maybe more importantly, within myself over the past year. I stated in class and I reiterate here that I was angry and recalcitrant about attending and participating in the process when this all started last June. By the middle of the summer I saw clear results and by the end of summer I was a true believer.”
Father of a 9-year-old boy

“The STP is ingeniously structured to meet the needs of this population. It is apparent that every activity, every rule, every minute of every day is carefully planned and implemented. Although the program is well defined, it is also flexible enough to adapt to the individual differences of the children. The STP provided my son with opportunities for growth and development. He began to learn how to monitor his behavior, how to work independently on academic assignments, how to be a friend, and how to function as a group member. My son loved the camp! Even after a difficult day, he was excited to go back.”
Mother of a 10-year-old-boy

“[My daughter] was painfully self-conscious about having ADHD. Before the Summer Treatment Program, she had never been around other kids with ADHD. It was a relief for her to meet children like herself and to finally talk openly about her behaviors and learn how to handle them. As a result of the program, [my daughter] is having an extremely successful year, both academically and socially, in sixth grade.”
Mother of an 11-year-old girl

“Managing ADHD takes total involvement from the child, parents, and whole family. The Summer Treatment Program helps you realize that instead of fighting this, you can learn to accept and deal with it.”
Parents of an 11½ year-old-boy

“I want you to know what a blessing the camp proved to be for our entire family. We have been very impressed with Dr. Manos, the counselors and with the commitment of all the families we met at the STP. We are learning to enjoy the climb. That wouldn’t be a possibility without learning the skills our son continues to teach us through the STP, and the parent training sessions."
Parents of an 8 year-old-boy

Scholarship Opportunities
Scholarships for the Summer Treatment Program are available through the Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) Summer Camp Award Fund. Visit the CHADD website to learn more about this scholarship opportunity.

Additional Resources

Additional valuable resources for families: