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.
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.
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.
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.
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
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.