Behavior therapy helps improve a child's behavior, self-control and self-esteem. It has supportive evidence for improving symptoms of ADHD in children 12 and younger. Behavior therapy should include the parent or caregiver as an active participant. Your child's therapist can describe how to guide your child with clear instructions, for example, or help shape their behavior with reward systems and consequences. In older children with ADHD and anxiety, depression or oppositional defiant disorder, cognitive behavioral therapy may be helpful for those related symptoms.

If ADHD is affecting your child at school, discuss with the teacher or principal if there are supports available. Examples of school support systems include include daily report cards, planners or meeting with a counselor about study skills. Publicly funded schools may consider if the child is eligible as part of a 504 plan or special education individualized education plan (IEP).

Extensive research points to the value of time spent outside in easing ADHD symptoms. Even 20 minutes in a natural setting can improve concentration and focus. Look for wide-open settings where you can walk together or encourage safe, free play.

Some research suggests that kids living with ADHD may benefit from mindfulness activities. Examples include identifying what's around them using their five senses. Or, they can practice slow, controlled breathing, tracing their fingers or a shape like a square to guide when to breathe in and out. Activities like these can help with challenges regulating emotions or stress that are associated with ADHD. In addition, certain mindfulness and movement activities such as yoga and tai chi have small studies showing potential benefits.

For older children, consider a self-directed plan for organization and calm. Tweens and teens can feel more centered and in control by designing their own routines.

If it seems that no one understands what you and your child are going through right now, please know that your pediatrician is concerned, too. We are deeply worried by the shortage of ADHD meds. In many cases, we're also scrambling to help children waiting for other medications that are in short supply.

Since most ADHD prescriptions are controlled substances under federal law, doctors have to follow very specific rules when prescribing. Pharmacies face equally tough requirements — which is why they can't simply transfer an existing prescription to a new location. The best they can do is suggest another pharmacy that might have supplies on hand.

Once you relay this information to your child's doctor, a new prescription must be sent through the electronic system that handles controlled substances. By the time you arrive at the pharmacy, hoping for a refill, you may find that they ran out within minutes of your doctor's request. You may want to call the pharmacy first to confirm that they have the medication in stock and can fill the prescription.

Pediatricians are also concerned about rising costs for ADHD medications, which add to the burden many families face in caring for kids who live with ADHD. Issues like this one have an uneven and unfair impact on millions of young people who already face elevated risks for mental health struggles. The American Academy of Pediatrics is advocating for wider access to insurance plans that help cover costs while seeking solutions to rising drug costs.

For more information, go to HealthyChildren.org.

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Jennifer Poon, MD, FAAP, is a developmental-behavioral pediatrician and Professor of Pediatrics at the Medical College of Georgia in Augusta. Her clinical work focuses on developmental delay, ADHD and autism spectrum disorders. Dr. Poon is an Executive Committee member of the American Academy of Pediatrics Section on Developmental and Behavioral Pediatrics.

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