Summer is that time every kid looks forward to. It is the “light at end of the tunnel” of a long school year. It is a time to “let loose” and have a great time. For kids with ADHD this is a big change. The day to day structure goes away, the daily routine is gone.
In just a few days or weeks, this long anticipated break can become a potential nightmare for kids with ADHD. It becomes a time when these kids are going around whining and saying, “I’m bored.” They come in complaining about an argument with peers or they are tormenting their siblings.
With a little planning ahead these and many other events can be avoided. Kids with ADHD still need structure, although it can be more relaxed than during the school year. Use a calendar that shows upcoming activities. Make a collage of things they can do when there is no planned activity (like games, toys, books, etc) and tell them when they are bored they need to check it and select an activity and do it.
Plan intermittent structured activities such as day camp, vacation Bible school, various recreation programs (like tennislessons, swimming lessons, computer workshop or drama club and summer sports leagues) provided by schools, churches, and community recreation departments.
Think about summer camp. If decide this is a good idea, make sure the camp can handle ADHD kids and are willing to administer medications if your child takes them during the summer. Check out the list of Summer Camp Programs from CHADD which provide structure, fun and skill building. For other possible camp suggestions please visit the American Camp Association website.
Make this family fun time. When parents get home from work, devote a half hour or so to play time. Play around your home; go to a park or some other fun spot. Have a family game night or movie night. Enjoy a hobby together. Check out the Family Activities page from our main website for more suggestions.
No matter what the situation, you can make it enjoyable and productive for your ADHD child by thinking ahead and providing a little guidance and structure to curb impulsivity and teach them how to create their own fun time.
Attention and Concentration Problems: Biofeedback and Neurofeedback as Alternative Therapies for Helping Your Kids Perform Better in School, Sports, and Life
Few of us have gone an entire day without hearing a commercial for neurofeedback training as an alternative to medication for children’s attention and concentration problems. For parents who are fearful about the lack of long-term research about the effects of medications, especially stimulants, on their children’s brain, the idea that a non-drug treatment could impact their child’s attention and concentration problems is highly appealing. However, there are also questions about whether or not neurofeedback works, how much it costs, how long it takes, and whether or not there are any negative effects of the treatment.
“Dust mite allergy,” the allergist told John and Tamara, consulting with them about their constantly scratching 10 year old who now had constant red marks on his arms and the backs of his hands, “You’ll have to wash everything, buy hypoallergenic covers, it’ll take a lot of housecleaning.” This sounded like a perfectly reasonable explanation to the couple, and so they cleaned. “I actually clogged my dryer vent with lint because of the number of loads of bed linens I washed.”
But there was another culprit that the couple had never thought of; a medication side effect.
A new study assessing the effectiveness of a restricted elimination diet on the behavior of children with attention deficit hyperactivity disorder was published in the February 2011 edition of Lancet. The study was conducted in the Netherlands and Belgium. They enrolled 100 children (4 – 8 years) and randomly assigned them to either a group that received this special diet or to a control group that was just given instructions for a healthy diet. They were to follow the assigned protocol for 5 weeks. They were assessed before and after using using several ADHD rating scales. The assessment indicated that 64% of those using the elimination diet had a significant improvement in symptoms. I commented in May 2010 on a similar study conducted in the UK.
So what does this mean? It probably means that the children who improved using the diet had a food allergy which produced symptoms similar to ADHD. Thus, the diagnosis of ADHD may have been incorrect given these findings.
There are many other questions that were not answered. For instance, the children’s parents knew which treatment they were receiving. Could this have influenced their ratings? Remember, they were recruited by advertising which may have attracted parents who wanted their children off medication and who may have believed that diet might be a significant factor. We also know that increased positive attention by a parent can reduce ADHD symptoms. I discuss this in depth in Total Focus. Could increased attention have played a role in the improvement? The study lasted for 5 weeks. Can the results be maintained over a long period of time? If the offending foods were reintroduced, would the symptoms return?
Another study published in the December 2010 issue of Clinical Pediatrics conducted a systematic and comprehensive review of all the literature related to diet and ADHD and concluded that there are a select group children who present with ADHD symptoms who show improvement as a result of a change in their diet. The Feingold Diet Program has been around for 35 years. While it has its share of advocates, all of the professional societies issuing treatment guidelines have concluded that there is insufficient evidence to prove its efficacy as a primary treatment for ADHD. Please go to the Feingold Diet website to learn more. Then go to the Quakwatch as well as the Clinical Pediatricsarticle for another point of view. If you are inclined to try a diet approach, PLEASE CHECK WITH YOUR CHILD’S PHYSICIAN, before proceeding.
While diet appears to be helpful for some children (the size of this group is in question), another intervention that has proven to be successful when used with or without medication and most likely would enhance any benefits derived from a dietary approach is behavioral treatment. This is often either overlooked or only partially implemented due to constrictions of time and resources. This results in parents, teachers, and providers seeking what seems to be the convenient solution. However, in the latest review of the results of the “gold standard” MTA study, children who’s family received behavioral interventions had the best long-term outcome. According to a principal investigator in that study after conducting a review of the Total Focus program, “it incorporates a wealth of extremely helpful information and programming, derived largely from evidence-based practice presented in an extremely user-friendly format for the families of children with attention-deficit/hyperactivity disorder (ADHD).” Parents who are looking for an alternative from medication as well as for significant, long lasting improvement may be surprised at the results they achieve by investing just a few hours per week working with their son or daughter implementing the researched based interventions in Total Focus. Visit this link for a free trial.
For the parents of a child with ADHD – Attention Deficit Hyperactivity Disorder, everyday tasks turn into battles—from getting the child out the door in the morning to getting him to bed at night. My son was diagnosed with ADHD at age 6, so I remember what it was like to have a daily tug of war with an attention disordered child all too well. Parents look for help everywhere. They may read one book after another and hear a parade of behavioral experts speak who give them parenting tips that don’t seem to work. The more books they read and experts they seek out, the worse their child’s behavior seems to get.
“ADHD is a ‘brain difference.’ Your child’s brain works differently than 95% of his peers. So ‘one size fits all’ parenting techniques won’t necessarily fit your child.”
In my practice and in my work with my own son, I discovered a number of techniques and strategies that can help parents of children with ADHD improve behavior. Here are 8 Secrets I have learned that can help parents improve their child’s behavior and school achievement:
A recent study published in the Archives of General Psychiatry showed that children diagnosed with ADHD between 4 to 6 years old were at higher risk of developing depression and suicidality in their teen years. Girls were at especially higher risk than boys. Patients with Attention Deficit Disorder have different subtypes, with and without Hyperactivity. It appeared that patients with just attention problems were at higher risk of depression and those with hyperactivity were at higher risk of suicidality.
This study indicates the importance of identifying and treating ADHD as early as possible to prevent these issues. Parents should discuss treatment options with their physicians. ADHD can be treated with medications and/or cognitive behavioral therapy.
An excellent book on Attention Deficit Disorder is Driven to Distraction; this book is written in clear understandable language.
According to a recent study by a Michigan State University economist, nearly one million children in kindergarten in the United States are misdiagnosed with ADHD. The study attributes this to the disparity of ages in a kindergarten classroom. Most kindergarten classrooms have children who are either 5 or 6 years old. The study shows that the younger children are more likely to be rated by their teacher as being inattentive and hyperactive. However, these ratings may more likely reflect the immaturity of these children rather than a mental disorder.
ADHD is considered a developmental disorder. There is always a disparity in when children within the same age range reach a given developmental milestone and this of course is more pronounced when there is also a disparity in age as well. Actually most children do not develop selective attention until 6 or 7 years of age. For years, studies have shown that teachers will rate 50% of the children in the class with scores indicating possible ADHD when the prevalence is known to be no more than 10%.
Children are starting kindergarten later due to increased academic demands. It make sense that a class of kindergarten children are able to do first grade work since many of them are 6 years old. Imagine the stress of a five year old who may be somewhat on the late side of developing selective attention being required to achieve at least one grade level above his age level. The pressure from teachers and parents and peers can lead to acting out behavior that might be expected under the circumstances but could lead to a professional evaluation.
Parents, teachers, and physicians should be careful to consider not only the chronological age of the child but also the developmental age when considering a possible diagnosis of ADHD. Perhaps the child should be placed in a pre-K class where he or she is truly with peers and the work is more appropriate to the child’s development. This would be a far more appropriate intervention than medication. Unfortunately, I have found that school districts may not want to put a 5 year old in preschool or pre-K because they may not receive funding for the child when state guidelines say a child of 5 must be in kindergarten.
For now, hopefully, this study will evoke caution in all concerned so that decisions will be made based on all of the factors that should be considered. In the future, the whole issue of the mismatch between child development and academic expectations needs to be re-evaluated but that is another blog post.
A research study conducted at Nottingham University in the UK found that immediate reward in the form of points in a video game had a similar effect on brain activity as stimulant medication. Based on EEG results, the team found that both the rewards and the child’s usual dose of stimulant medication resulted in the normalization of brain regions and improved task completion though the medication yielded a slightly higher effect.
The researchers cautioned that immediate consequences in this case, reward are associated with positive effects on behavior in ADHD children. They stated that it may be difficult for parents and teachers to provide rewards immediately. However, other research shows than children with attention deficit hyperactivity disorder actually respond as well or better to social reinforcement such as a smile as they do to tangible reinforcers like points, tokens or money. This means that a smile or a brief word of encouragement may achieve significant benefits and could reduce or eliminate the need for medication for some children.
Years of research and current professional guidelines indicate that behavioral interventions should be tried first before medication except of children with severe symptoms. However, many parents find it difficult to find an effective, affordable and user friendly option for behavioral interventions. Total Focus is a comprehensive behavioral program using evidence-based techniques to improve behavior, learning, self-esteem and social skills. Parents and children work together as a team to bring about real lasting change involving activities that are fun and require less than an hour per day. Total Focus costs less than one visit to a mental health professional.
Up until now, the prescribing of medication for children with attention deficit hyperactivity is often tedious for the physician and the family. Children who do not respond to the first stimulant prescribed may respond to the next one tried or the one after that.
There are two types of stimulants found to be effective for treating ADHD: amphetamine and methamphetamine. A study involving 89 children between the ages of 7 and 11 conducted at Cincinnati Children’s Hospital found that subjects with at least one copy of the 7-repeat DRD4 gene had a positive response to methylphenidate (a methamphetamine) while children without this gene related to dopamine did not. Methylphenidate is the active drug in Ritalin and Concerta along with several other ADHD medications.
This is good news for physicians and parents. This may prove to become part of the prescribing process that could lead to finding the best medication on the first try. According to the lead researcher in Cincinnati, Dr. Froehlich, “with more information about genes that may be involved in ADHD medication response, we might be able to predict treatment course, tailor our approach to each child, and improve symptom response while decreasing health care costs.”
A recent research study to be published in the August 2010 issue of Child Psychiatry and Human Development found that low blood levels for zinc and iron are associated with symptoms of attention deficit hyperactivity disorder based on scores on the Conner’s Parent Rating Scale through the low levels were not associated with higher scores on the Conner’s Teacher Rating Scale.
There were 118 with ADHD (ages 7-14 years). While Conduct Problems and Anxiety were associated with lower zinc levels, increased Hyperactivity scores were related to both lower zinc and iron levels. It is known that these two minerals as involved with dopamine metabolism, one of the two neurotransmitters related to ADHD.
Parents may want to ask their child’s physician to check these levels and recommend supplements if they are found to be out of the normal range. Parents should be cautioned however, to not rush to some the supplement products on the market containing zinc and/or iron. Unless a child’s level is low for either of these two minerals, there is no evidence that boosting normal levels would be beneficial and could be harmful.
It is known that a healthy diet and regular exercise is good for brain development for all children and certainly beneficial for children with attention deficit hyperactivity disorder. With the exception of fish oil with Omega 3 antioxidants, no other supplements containing mega doses of vitamins, minerals or other “natural” substances have been proven through rigorous scientific research to be beneficial for kids with ADHD.
Parents concerned about their child’s ADHD symptoms should rely on treatment recommended by professional organizations which are (1) behavioral interventions, (2) school interventions and (3) stimulant medication for severe symptoms that do not respond to the first two approaches.
Many parents find it difficult to find an effective, affordable and user friendly option for behavioral interventions. Total Focus is a comprehensive behavioral program using evidence-based techniques to improve behavior, learning, self-esteem and social skills. Parents and children work together as a team to bring about real lasting change involving activities that are fun and require less than an hour per day. Total Focus costs less than one visit to a mental health professional.