Services We Provide

Behavior and Attention Management Program

What is the Behavior and Attention Management Program?

The Behavior and Attention Management Program serves children and teens ages 5 to 15 with disruptive behavior or attention problems, like attention deficit hyperactivity disorder (ADHD), and their families. Our focus is on understanding your child’s needs and providing training and support for you as their caregiver. Research shows that training and support for caregivers are the best ways to help kids who struggle with behavior or attention.

How will the Behavior and Attention Management Program meet my needs?

To offer care as quickly as possible and provide services that best match your family’s needs, we often start with a consult visit. Then we follow a stepped-care model built around parent behavior management training. We offer the frequency and intensity of treatment that best meet your needs.

  • Consult visit to identify your concerns

    A consult visit is a 1-hour telehealth (virtual) appointment with a mental health provider from the Behavior and Attention Management Program. During the visit, we talk with you to:

    • Find out the main challenges your child and family are having and what you would like help with
    • Choose treatments and services that would be a good fit for your concerns

    This approach allows us to understand your needs and connect you with care faster.

    • If your child is 12 years old or older, you will be scheduled two, separate 60-minute visits and your child will need to be at each visit. We will talk with them on their own.
    • If your child is under 12 years old, you will be scheduled for a 60-minute visit. Your child does not need to attend this visit.

    By the end of the consult visit, we will recommend next steps. We may recommend care in the Behavior and Attention Management Program, in other Seattle Children’s clinics or programs or in the community.

    To schedule a consult, ask your child’s primary care provider for a referral.

    Learn more about what to expect during a consult visit (PDF).

    (In some instances, you may not need a consult visit. New patients can be referred to the following without a consult visit: ADHD First Steps Parent Education Class [PDF], Disruptive Behavior Crisis Clinic, Foundations for Managing Disruptive Behavior and Intensive Caregiver Group for Managing Disruptive Behavior. You can learn more about these offerings later on this webpage under “Specialized Treatments and Services.”)

  • Stepped care to match your family with services

    The Behavior and Attention Management Program offers different treatment options based on how often families can participate and the level of services needed. This approach is called stepped care.

    During your consult visit, we will decide which level of care best matches your concerns. After your child and family start getting services, you may “step up” or “step down” to other levels based on how your child is doing and what they need next.

    Stepped care lets us quickly connect families with methods to prevent mild problems from getting worse. It also lets us serve families who need intensive treatment for the most complex challenges.

    Most families begin stepped care by taking part in a class or group therapy. Some go right to more intensive services.

  • Parent behavior management training (PBMT): Strategies to get results in real life

    The best way to improve behavior and attention is to use proven strategies each day in real-life settings like home, school and the community. This leads to better results than 1-on-1 therapy in a clinic.

    At Seattle Children’s, we focus on teaching parents and caregivers strategies to use with their children every day. This approach is called PBMT. Research and experience tell us that sharing evidence-based knowledge and skills with you is the best thing we can do to support you and your child. PBMT has been shown to:

    • Improve parent and caregiver confidence
    • Increase the use of positive parenting techniques
    • Lead to behavior change in children

    We have several group therapy options to help you learn more about behavior management. Groups like SuperParenting and Incredible Years also support you as you find what works best for your family.

    (Spanish)

  • Research to improve care

    Providers on the Behavior and Attention Management team do leading-edge research to learn more about helping children and families and getting services to them more quickly.

    Your child may be able to take part in research even if you have to wait for a consult visit. Learn more.

What kind of children’s issues are treated by the Behavior and Attention Management Program?

Our team works with families who want help dealing with their children who have mild to serious behavior problems, including these:

  • Getting easily distracted or off task
  • Complaining, whining and not doing what you ask
  • Yelling, screaming and being defiant
  • Verbal abuse, like yelling at an adult or cursing, or making verbal threats
  • Being physically aggressive or destroying property
  • Leaving the house without permission during an escalation (PDF)

Many of our patients have ADHD. We also see children and teens who do not have a diagnosis or have other conditions like oppositional defiant disorder; disruptive mood dysregulation disorder; or other attention, adjustment or conduct disorders.

We do not treat sexual abuse or sexual aggression. Call the King County Sexual Assault Center at 888-998-6423 or Harborview Abuse and Trauma Center at 206-744-1600.

Specialized Treatments and Services

We offer a wide range of specialized treatments and services within the Behavior and Attention Management Program, from community classes to high-intensity treatment programs, to meet the diverse needs of families across Washington state.

This list is organized mainly by the intensity of the service, from lower intensity to higher intensity.

  • Diagnostic evaluation for ADHD through the Program to Enhance Attention, Regulation and Learning (PEARL) (ages 5 to 15)

    PEARL offers evaluations for children and adolescents with concerns about attention, behavior and learning. (This is different from a Behavior and Attention Management Program consult visit.) During a diagnostic evaluation, we talk with you and your child separately to discuss concerns and check for signs of ADHD. We also talk about your child’s medical history, review their school records and identify their strengths. Before the end of the visit, we explain our findings. We also talk with you about any treatments we recommend.

    Some new patients are referred directly to a PEARL diagnostic evaluation. Other new patients start with a consult visit first to decide if they need a diagnostic evaluation. Not all children with behavior or attention problems need this type of evaluation.

    Learn more about PEARL.

  • ADHD First Steps Parent Education Class (ages 5 to 15)

    This live class is for caregivers of children and adolescents who have been diagnosed with ADHD or may have ADHD. We cover topics like what causes ADHD; which treatments are supported by science; and how parents, teachers and schools can help children with ADHD.

    To join the class, you need a referral to ADHD First Steps from your child’s primary care provider or community mental health provider. Your child does not have to be a patient of Seattle Children’s already, and you do not need to have a consult visit with us first.

    Learn more about ADHD First Steps (PDF) (Spanish).

  • SuperParenting (ages 5 to 15 at the time of referral)

    SuperParenting is a group program based on treatments that have been shown to help parents improve their child’s behavior, coping skills, relationships and well-being. You will learn ways to connect and communicate with your child or teen, encourage more positive behaviors and respond to challenging behaviors. Sessions are telehealth (virtual) visits. Kids do not attend.

    We offer 3 groups:

    • One group for caregivers of children ages 5 to 8
    • One group for caregivers of children ages 9 to 11
    • One group for caregivers of adolescents ages 12 to 15 at the time of referral

    The first step is a consult visit with the Behavior and Attention Management Program to decide whether SuperParenting matches your family’s needs. Many families begin treatment in the Behavior and Attention Management Program by coming to SuperParenting. Many find it so helpful that they do not need further services.

    Learn more about SuperParenting Children (ages 5 to 11) (PDF) and SuperParenting Teens (ages 12 to 15) (PDF).

  • Parenting with Purpose (ages 5 to 11)

    The Parenting with Purpose group is designed to help parents and caregivers of children who have challenging behavior problems. This group will provide instruction in healthy, safe, and effective behavior management strategies, with enhanced instruction and support in parent self-regulation skills and strategies. These sessions are offered via telehealth (virtual) visits. Kids do not attend.

    Parenting with Purpose is more intensive than SuperParenting. The group meets for longer sessions over more weeks and includes 1-on-1 sessions with a group leader. Some families begin with Parenting with Purpose. Others “step up” to Parenting with Purpose if they want more help after they do SuperParenting.

    To join a Parenting with Purpose group, you will have a consult visit first to see if this group is the best fit for your family. For caregivers of children ages 2 to 5, an Incredible Years Preschool Basic Parent Group is available through Seattle Children’s Early Childhood Clinic.

  • Parent-School Partnership Consultation Group Program (ages 5 to 11)

    This group program is for caregivers of children with attention, impulse control or behavior problems at school. It’s designed to help you work closely with your child’s teacher and school team. We support you in setting up a plan to increase communication between home and school and change your child’s most pressing behaviors. Sessions are telehealth (virtual) visits. Kids do not attend.

    To take part in this program, you will have a consult visit first with the Behavior and Attention Management Program.

    Learn more about the Parent-School Partnership Consultation Group Program (PDF) (Spanish).

  • Parents and Tweens Tuning In, Engaging, Relating and Nurturing (PATTERN) (ages 10 to 13)

    PATTERN is for tweens (ages 10 to 13) and their caregivers who struggle to manage intense emotions that affect the parent-child relationship. This program can help if your child has anxiety, depression, adjustment issues or behavior problems that lead to lasting conflict.

    Both you and your tween will attend most sessions. A few sessions are for caregivers only. Caregivers also meet with a group leader for short 1-on-1 coaching sessions. All sessions are telehealth visits.

    Most caregivers complete SuperParenting or Parenting with Purpose before joining PATTERN. Families who are new to the Behavior and Attention Management Program will need a consult visit first.

    Learn more about PATTERN (PDF).

  • Supporting Teens’ Autonomy Daily (STAND) (6th to 10th graders)

    STAND is for teens with ADHD, learning problems or trouble keeping track of and organizing things. The teen attends the sessions with their primary caregiver. Sessions are telehealth (virtual) visits.

    The STAND program is for youth in 6th through 10th grades. In weekly sessions, we focus on helping your teen improve their organization, motivation and ability to do things on their own at home and school. Your teen will choose personal goals to work on and practice ways to help meet these goals. You will learn ways to promote and encourage your teen’s independence and motivation.

    To join STAND, you will have a consult visit first so we can check if this program matches your teen and family’s needs.

    Learn more about STAND (PDF).

  • Disruptive Behavior Crisis Clinic (ages 5 to 12)

    The Disruptive Behavior Crisis Clinic helps parents and caregivers of children ages 5 to 12 who are having a mental health crisis related to behavioral issues. We serve families who have been in or are at risk of coming to the emergency department or think they need immediate 911 intervention. We aim to support families with quick access to 4 visits held 1 day a week with a mental health provider.

    Your child will need a referral, but you do not need a consult visit before getting care from this clinic.

    Learn more about the Disruptive Behavior Crisis Clinic, including how to get referred.

    For families who need more support after their Disruptive Behavior Crisis Clinic (DBCC) sessions, the DBCC providers and case managers can place a referral to other services in the Behavior and Attention and Management Clinic.

  • Foundations for Managing Disruptive Behavior (ages 5 to 12)

    Foundations for Managing Disruptive Behavior is a series of 1-on-1 therapy sessions for caregivers of children ages 5 to 12 who struggle with extreme emotion and the inability to regulate their behavior. This can lead to issues at home, at school and in the community. Our goal is to serve families who need more help after trying other options, including the emergency department or hospital stays. We teach families how to help their child manage their emotions and behaviors.

    Caregivers meet 1-on-1 with a therapist 2 times a week and a peer partner 1 time a week. A peer partner is someone who has experience living with a child in crisis. Sessions are 1 hour. The series goes for 5 weeks.

    We accept referrals from the Psychiatry and Behavioral Medicine Unit, the Emergency Department and the Disruptive Behavior Crisis Clinic through Psychiatry and Behavioral Medicine at Seattle Children’s. We also accept referrals from other emergency departments in Washington state.

    For families who need more support after Foundations, we offer group therapy options:

    • Parenting with Purpose Group, which lasts 14 weeks and runs about 2 to 3 hours a week
    • Intensive Caregiver Group for Managing Disruptive Behavior, which lasts 12 weeks and runs about 5.5 hours a week
  • Intensive Caregiver Group for Managing Disruptive Behavior (ages 5 to 12)

    This group is for caregivers of children ages 5 to 12 who have extreme levels of emotion and are unable to control their behaviors at home, at school or in the community.

    It is a series of group therapy sessions for families who need more help after trying other options. The series lasts 9 weeks and is about 5.5 hours a week. Caregivers come to all sessions. Your child will come to some sessions with you. You will also have some 1-on-1 time with a therapist and peer partner. 

    We accept referrals from the Psychiatry and Behavioral Medicine Unit, the Emergency Department and the Disruptive Behavior Crisis Clinic through Psychiatry and Behavioral Medicine at Seattle Children’s. We also accept referrals from other local emergency departments in Washington state.

    For families who need more support after the Intensive Caregiver Group, we offer another group therapy option: the Parenting with Purpose, which lasts 14 weeks and runs about 2 to 3 hours a week.

  • First Approach Skills Training: Behavior Basics (On-Demand Virtual Class)

    The First Approach Skills Training: Child Behavior Problems is an on-demand virtual class for parents and caregivers of children ages 5 to 12 with disruptive behaviors. In this class, you will learn best practices and practical tips to use at home to help your child with behavior challenges. View class details.

We do not offer these services 

  • Long-term individual therapy or long-term medicine management.
  • In-home therapy. Some community mental health centers provide this service for youth with a high level of need.
  • Parenting evaluations for legal purposes, such as developing parenting plans. Visit the Parenting Evaluation Treatment Program (PETP) Graduates webpage for a list of trained providers in the community.
  • School evaluations after suspension or expulsion. Contact your child’s school for a list of providers who do “return to school” evaluations.

Scheduling an Appointment With the Behavior and Attention Management Program

Who’s on the team?

The Behavior and Attention Management Program team includes psychiatrists, psychologists, advanced registered nurse practitioners, mental health therapists, mental health therapist associates, trainees, family advocate/case managers, peer partners and program coordinators. They work together closely to understand your child’s needs, develop a complete treatment plan and support your family throughout your child’s care.

Meet your team.

How to Get Services

For most treatments and services, the first step is a consult visit. To make an appointment for a consult visit, you need a referral from your child’s primary care provider. We often have more requests from new patients than we have openings. Once we get a referral from your provider, we will let them know if we have an opening for your child or not.

For the Disruptive Behavior Crisis Clinic, your child may be referred directly without a consult visit.

For Foundations for Managing Disruptive Behavior and Intensive Caregiver Group for Managing Disruptive Behavior, your child may be referred from the Disruptive Behavior Crisis Clinic, the Psychiatry and Behavioral Medicine Unit or an emergency department in Washington state without a consult visit. These offerings have their own screening and intake processes to make sure they are a good fit for your family.

You may register for ADHD First Steps (PDF) with a referral from your child’s primary care provider or community mental health provider. A consult visit is not required.

Providers, see how to refer a patient.

Telemedicine at Seattle Children’s

You may be offered a telehealth (virtual) appointment. Learn more.

Have insurance questions?

Some insurance plans have Seattle Children’s as an in-network provider for medical services and an out-of-network provider for mental health services.

Even if your plan offers an out-of-network benefit, we are not accepting new patients for our mental health services if their insurance does not include Seattle Children’s as an in-network provider.

Learn about mental health insurance coverage at Seattle Children’s.

Paying for Care

Learn more about paying for care at Seattle Children’s, including insurance coverage, billing and financial assistance.

In crisis?

If you, your child, family or friend needs help right away, call or text 988. Chat is another option. The 988 Suicide & Crisis Lifeline provides free and confidential support for people in distress, as well as prevention and crisis resources. The Lifeline is available 24 hours a day, 7 days a week in the United States.

Hotlines for Youth (PDF) provides other options for immediate help for children and teens. (Also available in Amharic, Arabic, Russian, Simplified Chinese, Somali, Spanish, Ukrainian and Vietnamese.)