By Dr. Christine Powell
Child holding a pill (arms resting on a table) with an open pill container with pills in a pile Leo finally did it.
For the first time in his ten years of life, he sat down at the kitchen table, opened his planner, and started his math homework without a single prompt from his mother.
Sarah watched from the hallway, almost in astonishment. For years, Leo’s life had been a storm of lost sneakers, forgotten assignments, and the kind of emotional “meltdowns” that left everyone in the house exhausted. Sarah had been under immense pressure to start Leo on stimulant medication for his diagnosis of ADHD. Like so many parents I meet, she hesitated. She didn’t want to just change his brain chemistry, she wanted to give him the tools to manage his own mind.
This moment was worth the hard decision of trying something else besides medication. It was the “win” she had been praying for. A victory in providing support instead of a pill.
The Rising Tide Sarah is far from alone in her search for alternatives. We are currently seeing a surge in ADHD awareness and diagnosis across the United States. As of 2026, roughly 1 in 9 children, that is over 7 million, have been diagnosed with ADHD. That number has climbed steadily from just 8% a few years ago.
Among those diagnosed, nearly 62% are prescribed medication. While I will always advocate that prescriptions can be a game-changer for some, they often represent a “top-down” approach. They can mask symptoms, but they don’t necessarily build foundational skills.
Now, a growing wave of parents is thinking twice. They are seeking “bottom-up” strategies that prioritize neuroplasticity and skill-building over chemical intervention alone.
The “Invisible Gap” Despite the clear benefits of Educational Therapy, Sarah hit a major roadblock. Her insurance provider immediately approved Leo’s stimulant prescription but denied coverage for his executive functioning (EF) sessions.
This is what I call the “Invisible Gap.”
To an insurance payor, medication is a “medical necessity” with a clear barcode and decades of pharmaceutical data. Educational therapy, however, is often dismissed as a service that looks suspiciously like tutoring. Because many clinicians lack the tools to show the high-density work happening in a session, the actual neural rewiring remains invisible to the people paying the bills.
Bridging the Gap with Data: The Science of “How” If we want to make brain-building as accessible as medication, we have to change how we talk to payors. We need to stop talking about “hours spent” and start talking about outcome-driven data rooted in biological truth.
Let’s start with Hebb’s Law: “Neurons that fire together, wire together.”
This is the biological basis of learning, but it requires action. This brings us to the second critical law of rehabilitation: The SAID Principle (Specific Adaptation to Imposed Demands). This principle states that the human body and brain adapt specifically to the demands placed upon them. You cannot build a “time management” neural pathway by taking a pill; you can only build it by repeatedly practicing the specific act of managing time under the “load” of real life.
But where is the proof?
How can we claim a student achieves “40+ cognitive repetitions” in a session? We know because we count them.
In a clinically structured Educational Therapy session, we don’t track “chapters read” or “homework completed.” We use precision teaching metrics to track decisions made. Every time Leo inhibits the impulse to check his phone, that is one data point. Every time he successfully “shifts set” from math to history without an emotional drop, that is another.
We capture this micro-data to prove that the brain is getting the “reps” it needs to change.
This data does more than just convince insurance companies; it fuels the student’s Growth Mindset. When a child like Leo sees a chart showing that he successfully managed his attention 40 times in an hour, he stops seeing himself as “broken” and starts seeing his brain as a muscle that is getting stronger. He enters a positive feedback loop where the dopamine release from these small wins reinforces the learning, allowing him to achieve significantly more neural growth than a disengaged student ever could.
When we combine Hebb’s Law, the SAID Principle, and hard data on inhibitory control, we shift the conversation. We prove that Educational Therapy isn’t just “academic help” but a clinical intervention that shortens treatment cycles and builds long-term independence.
Securing Our Children’s Future We are at a crossroads. We can continue to rely on a system that defaults to medication because it’s the easiest thing to measure, or we can close the Invisible Gap with better data.
For Sarah, the proof wasn’t in a pharmacy receipt; it was in seeing Leo take ownership of his day. We are not just helping kids with their homework; we are helping them build the neural architecture for a successful life.
It’s time our healthcare system recognized — and rewarded — that value.
If you found this blog interesting or think someone might benefit, please pass it on.
Best, Dr. C
