On March 24, our regular Thursday morning segment on The Ranch, 99.1 FM, focused on treating Attention-Deficit/Hyperactivity Disorder. This can be a very unpopular topic even in my practice!
Attention-Deficit/Hyperactivity Disorder is a real neurological condition and it must be treated to reduce the potential for lifelong and very negative consequences. ADHD was not created by big-pharma. In fact, it has long been recognized as a serious condition, but was treated only at the university research-center level for decades. Treating ADHD with stimulant medications began about 70 years ago. Today, there are a wide variety of stimulant and non-stimulant medications designed to target the effects of ADHD. Other medications are used to treat very severe or atypical ADHD such as anti-seizure medications and mood stabilizers. But, you need a full support program.
Attention-Deficit/Hyperactivity Disorder is a real neurological condition and it must be treated to reduce the potential for lifelong and very negative consequences. ADHD was not created by big-pharma. In fact, it has long been recognized as a serious condition, but was treated only at the university research-center level for decades. Treating ADHD with stimulant medications began about 70 years ago. Today, there are a wide variety of stimulant and non-stimulant medications designed to target the effects of ADHD. Other medications are used to treat very severe or atypical ADHD such as anti-seizure medications and mood stabilizers. But, you need a full support program.
Dr. Daniel Amen has conducted significant research regarding the biological basis of ADHD He uses SPECT scan technology to diagnose the 6 different types of ADHD he has identified. The Diagnostic and Statistical Manual 5th Edition identifies 3 types of ADHD. Single photon emission chromotography technology follows blood profusion in the brain and is related to a diagnosis of ADHD. Some of his work is controversial, but he first broke open the conversation about ADHD and its many forms as well as treating the disorder nutritionally.
The first logical step is to get a competent diagnosis. I wrote an article on this blog about the critical components of an ADHD evaluation. If the diagnosis is confirmed and medical treatment is indicated, I recommend that a board-certified child and adolescent psychiatrist be consulted about treatment. Whereas many pediatricians have additional training in order to medically treat ADHD, the medications are powerful and can cause side effects.
Psychiatrists are experts in those medications that have a behavioral impact and have tremendous experience with the subtle aspects of treatment. In my 23 years of private practice, it is my experience that psychiatrists "hit the mark" in terms of identifying the most effective medication. As well, they seem to identify the correct dose more quickly and avoid over- or under-treatment. It is best for the medication to start at a low dose and be increased by small amounts
It is best practice to have an EKG (electrocardiogram) conducted to determine underlying heart conditions (irregular heart rhythm, murmurs) that may be impacted by stimulant medication. Make sure you get thyroid disorders ruled out, as well. ADHD symptoms overlap 17 other disorders, so make sure you are on the right track.
Psychiatrists are experts in those medications that have a behavioral impact and have tremendous experience with the subtle aspects of treatment. In my 23 years of private practice, it is my experience that psychiatrists "hit the mark" in terms of identifying the most effective medication. As well, they seem to identify the correct dose more quickly and avoid over- or under-treatment. It is best for the medication to start at a low dose and be increased by small amounts
It is best practice to have an EKG (electrocardiogram) conducted to determine underlying heart conditions (irregular heart rhythm, murmurs) that may be impacted by stimulant medication. Make sure you get thyroid disorders ruled out, as well. ADHD symptoms overlap 17 other disorders, so make sure you are on the right track.
LISTEN CAREFULLY!! ADHD is best treated with a combination of medication, nutrition, academic accommodations and behavioral/social interventions. Medication, nutrition and academic accommodations are typically not as time- and labor-intensive as are the behavioral/social interventions, especially if your child has moved into Oppositional Defiant and Conduct Disorder which I refer to as the "terror trifecta". If your child has developed behavioral issues, you will not see improvement until you address them specifically and this means that parenting has to be re-tooled. Once you know about ADHD, ODD and Conduct Disorder, your parenting approach must be very different.
Whereas team sports may not be a good fit, individual sports and water-based cardio activities are exceptionally effective for those with ADHD. Michael Phelps suffered from ADHD and his middle-school principal mother, made sure he was in the pool a great deal of the time to reduce his symptoms. However the job gets done, cardio activity is critical for those with ADHD.
Nutrition is also critical to the treatment of ADHD to help your child feel focused and under control. Let me say this...PROTEIN, PROTEIN, PROTEIN...
Your kids will want SUGAR, SUGAR, SUGAR!!! The ADHD brain craves sugar, but needs protein. Go figure. You need to "re-think" how you describe food to yourself. Breakfast is still breakfast even if you are serving left over meatloaf.
Your kids will want SUGAR, SUGAR, SUGAR!!! The ADHD brain craves sugar, but needs protein. Go figure. You need to "re-think" how you describe food to yourself. Breakfast is still breakfast even if you are serving left over meatloaf.
Yes, many a morning in my home consisted of a breakfast burrito with the beef/bean/cheese combo with red sauce. Protein like crazy. And, it can be eaten neatly and it's portable!! The protein lasts throughout the morning unlike cereal. Ugh.
Many kids do not like eggs for breakfast although the choline in egg yolk is taken up by the brain and turned in to cholinesterase which is critical for brain functioning. In light of many kids' needs for something a bit savory in the morning, add your favorite taco seasoning (in my house it's Lawry's) and add it to both the beef and the beans. Middle schoolers LOVE it according to the moms in my practice. Avoid juice which will give kids that "sugar coma" at about 9 am Milk has a lot of natural sugar in it, so re-think the drink. Gatorade may be the way to go, but even this in reasonable amounts.
Many kids do not like eggs for breakfast although the choline in egg yolk is taken up by the brain and turned in to cholinesterase which is critical for brain functioning. In light of many kids' needs for something a bit savory in the morning, add your favorite taco seasoning (in my house it's Lawry's) and add it to both the beef and the beans. Middle schoolers LOVE it according to the moms in my practice. Avoid juice which will give kids that "sugar coma" at about 9 am Milk has a lot of natural sugar in it, so re-think the drink. Gatorade may be the way to go, but even this in reasonable amounts.
Left over meatloaf and mashies, hamburgers, casseroles, mac and cheese all fulfill the protein and carb combo that supports an ADHD brain.
I know that I have mentioned this on previous posts, but if you have a kid who won't stop to eat at school, consider the Kellogg's Special K drinks or Ensure to give them the protein/carb combo that will carry them the rest of the day. They can guzzle these, get some nutrition and still have time to play.
I know that I have mentioned this on previous posts, but if you have a kid who won't stop to eat at school, consider the Kellogg's Special K drinks or Ensure to give them the protein/carb combo that will carry them the rest of the day. They can guzzle these, get some nutrition and still have time to play.
Get accommodations in school. If your child has ADHD and the symptoms impact their ability to perform in the classroom, ask for accommodations. You'll need a doctor's note indicating they diagnosis of ADHD. Ask for extra time on tests, extra time for homework and other supports as necessary.
It wasn't until Edward Hallowell and John Ratey came along and wrote Driven to Distraction that ADHD in adults came to be accepted. No longer did we consider adult ADHD symptoms as being "adult residual ADHD". Oh no, it is it's own full-blown deal and needs to be managed. Previously, adult ADHD was treated by anti-depressants. OK, I get it. ADHD leads to depression, but why not just "have at it" and treat the root cause? Oh yeah. The turn-around I have seen in my adult clients is nothing less than miraculous.
Well, getting back to the kids. You may have some social skills programs available in your community for your ADHD child. Other than that, taking it slowly and re-teaching impulse control, delayed gratification and the power of their words and actions is your most valuable approach. I've written several articles on this site that may be helpful especially about talking to your kids. Teeny tiny baby steps. It's the only way to make change.
Overall, when parents come into my office and I learn that a child's ADHD symptoms are causing social isolation, I worry. It's too late when they have trained others to avoid them, so get busy. If your child isn't invited to birthday parties or other activities outside of school, they've already gotten a reputation for out-of-control behavior and it will take time.
It your child has been diagnosed, self-education is critical for you as parents and for your child. Imagination Press has great books to describe ADHD to kids. ADD WareHouse has everything you need in one spot to get a thorough education. Join CHADD...Children with ADD. Included in the subscription is a terrific monthly magazine called Attention!
You've got a lot on your list to do now! Do the best you can,
TTFN, Claudia
It your child has been diagnosed, self-education is critical for you as parents and for your child. Imagination Press has great books to describe ADHD to kids. ADD WareHouse has everything you need in one spot to get a thorough education. Join CHADD...Children with ADD. Included in the subscription is a terrific monthly magazine called Attention!
You've got a lot on your list to do now! Do the best you can,
TTFN, Claudia
