So you have an explanation for your child's school and perhaps exasperating home life difficulties and perhaps it makes you look in a new way at yourself, a spouse or other relative who also likely has ADHD. You may make an appointment to discuss medication with your pediatrician. What other, non pharmacologic, treatment options might you look at?
Sleep: A classic study in a landmark sleep text talks about a group of children with obstructive sleep apnea who had snoring, their tonsils and adenoids out. Amazingly there were some in the group with ADHD and some with bedwetting who stopped having those problems. What's going on? Poor or inadequate sleep can cause those and other significant difficulties. Sleep hygiene is the term for good sleep habits: No caffeine for 6 hours prior to sleep, no screen time for one or two hours prior to bed time, reasonable and similar bed and wake times between school and off school days, good bed time routines like brushing your teeth, shower, read or be read to. Exercising daily for 30-40 minutes helps to relax us for sleep. Especially in a child with ADHD, the structure of a good bed time routine is comforting, relaxing and promotes a good night's sleep.
Diet: Another old study, the Feingold, said dyes and additives caused ADHD and that a diet free of them worked for a high percentage, there is a lot of controversy around this. There are a small number of individuals in whom red dye causes a marked behavioral disturbance just as some people instead of being made sleepy by Benedryl become wired. These are inherited genetic variations. With the Feingold diet, parents had to carefully plan, structure and monitor what their children ate and when they at it. I never cease to be amazed at how poorly many people eat. Children with ADHD respond to sturcture and quality in their diet or the lack thereof. Some newer thinking on diet, research proven, is around essential fatty acids. A study of the Mediterranean diet in a group of children with ADHD showed that those who followed the diet more closely had fewer ADHD symptoms. Was it the more fruits and vegetables, more complex carbohydrates, fewer simple sugar? No, it was felt to be from the Omega 3's found in the fish emphasized in that diet. That is the basis for one of the medical foods currently being given for ADHD and some other brain issues, like age related cognitive decline. Diet is important; the Mediterranean diet has been shown to help ADHD and many chronic illnesses. Feed your children and yourself breakfast. Find something with adequate protein and calories to sustain them until lunch and if possible make fatty fish like tuna, salmon and other Omega 3:'s a part of your diet. If you're vegetarian, seek out the plant sources like Flaxseed, chia seeds, brussel sprouts, hemp seeds and walnuts.
Exercise is so remarkble in it's ability to calm us, to help us sleep, to relieve anxiety, to impose our sense of well being, to give us confidence. And it has been shown to improve school performance. It is essential for all of us if physically possible and is certainly not limited benefitting ADHD but all of us, find something you and they like to do and do it.
Cognitive Behavior Therapy (CBT) can improve ADHD behaviors by teaching skills for handling life challenges or overcoming negative thoughts. CBT for children with ADHD seeks to improve their behaviour and functioning via praise and rewards for acceptable outcomes like staying in your seat, being attentive, not interrupting and handing in homework. Such therapy should come before medication in ADHD children especially the very young.
School can implement IEP's for children with ADHD, individualized educational programs tailored to the result obtained by testing. In the home, we can implement similar plans like how, where and when homework gets done, rooms tidied, chores done.
So, outside of medication, leading a sturctured, secure life with a good diet, exercise and enough sleep and healthy expectations about behaviors can optomize life outcomes with those special people among us with ADHD.