ADHD: Part 3 of 3

ADHD - "TO DRUG OR NOT TO DRUG?" - Part III

In the last part we looked at the conventional medical management of ADHD, which hinges largely on the use of psychoactive drugs to try & control undesirable behaviour. We explored the benefits (improved behaviour) plus some of the pitfalls (side effects & associated negative sociocultural issues). The bottom line which is agreed upon by all experts is that "treatment should be multimodal - not left to medications alone". In other words, to see medicating your child as the 1st &/or only option to deal with ADHD, is not an option!

The second of the 2 prongs of traditional management of ADHD is behaviour "training". More than 1/3 of kids treated with behavioural techniques alone will improve their ADHD symptoms. The cornerstone of this type of approach is "structured daily routines". Even though ADHD kids appear to be less structured in their behaviour & habits, they respond best to a daily schedule & time limits. More so than others, these kids need to be taught to pay close attention when they are being spoken to, & quizzed to see that they have comprehended instructions.

Parents need to be committed to becoming masters of time honoured behaviour management strategies. Discipline & direction are difficult to create unless parent-child rapport has been developed. Constant caring dialogue, the sharing of stories & activities help to build trust. Good behaviour needs to be rewarded, & the child needs to be involved with making deals as to what rewards are received for successful behaviours."Time-outs" need to be appropriately administered with consistency & firmness. Another key with these kids is to help & encourage them to communicate about their feelings.

The role of diet in managing ADHD has been controversial. The plain fact is that some ADHD kids respond very effectively to dietary management. What this means to me is that every child with ADHD should be trialled with exclusion diets to determine if they are one of those kids. The Feingold Diet is the most commonly utilised method. The Feingold diet is more about what you shouldn't eat than what you can eat. Certain food & chemical types have been implicated in nervous system toxicity, which can lead to deterioration in behaviour, amongst other things.

Food allergies such as dairy & wheat need to be detected. Sugar & Caffeine need to be kept to a minimum. Artificial additives such as flavours, colourings (especially yellow & red), preservatives (most common offenders are sulfites, nitrites & nitrates), MSG & salicylates (present in asprin, many fruits & perfumes) also may need to be avoided. Expert guidance may be needed to work through these issues. The Feingold web-site is an excellent resource to get you started. Go to http://www.feingold.org 

Vitamins & supplementation may also be of some help. Lots of essential fatty acids are needed for a healthy brain. The best sources are the Omega 3 fish oils, rich in DHA & EPA. Of the minerals, magnesium is an excellent nervous & muscular systems relaxant, chromium helps with blood sugar stability, & selenium is a strong antioxidant. Nutritional experts recommend the more the sources of antioxidants the better: Vitamins A, C & E, & the pine bark/grape seed extract called Pycnogenol are some of the best. Of the herbs Valerian is well known as a general relaxant & St Johns Wort is a natural option for an antidepressant effect. The amino acids phenylalanine, taurine, tyrosine, carnitine & phosphatidylserine can be used to positively manipulate brain function. However some of the other amino acids can be detrimental, so the expert guidance of an MD or Naturopath who specialise in nutritional medicine should be sought.

Another practitioner that should be part of the multidisciplinary ADHD team is the Chiropractor. As regular readers of this newsletter will know, chiropractic is good for more than just bad backs! The most dramatic changes seen by patients of chiropractors are due to the effects spinal & cranial adjustments can have on the central nervous system, brain included. One small scale case study demonstrated the disapearance of abnormalities in EEG (ElectroEncephaloGraph) readings following adjustments. Another larger study found improvements in verbal output, reading & comprehension, attitude & self esteem, coordination & emotional maturity in children receiving chiropractic care.

One of the most common quotes we hear from the parents who bring their kids to us regularly, is that they can tell when their child is "due" for a check-up by the deterioration in their behaviour! So, ADHD kids could similarly benefit from visiting a Chiropractor.

And from the cosmic debris department: EEG has been used as an assessment of ADHD kids, & can also be used as therapy. Kids are taught to enter a very specific brainwave state called Alpha Theta. Kids can learn to revisit this state in situations when they need to improve their concentration. Full spectrum lighting & sufficient sunlight help to reduce the symptoms of ADHD. And, Mozart played as background music can also improve childhood behaviour, & has been used as another form of therapy.

A final issue that should be considered is the question: "Is your child gifted?" Some kids who have been diagnosed with ADHD, & even with Ausbergers syndrome, when properly assessed, are actually found to have extremely high IQs! Basically these kids brains are working at a higher level than the classroom setting they are working in. They become understimulated which leads to the unacceptable behaviours that develop. Both Einstein & Thomas Edison were thought to be unteachable as kids, & by today's standards would have had ADHD. The bottom line is that kids with ADHD can be successful, talented & gifted too!

We should redefine ADHD FROM a mental illness, FROM kid's with abnormal behaviour due to a malfunctioning brain; TO a "mental difference", kids with different behaviour strategies due to brains that work differently! This shift in thinking would change our behaviour FROM trying to treat & fight against the "illness" these kids have, TO helping, teaching, sharing & working with these kids to bring out their god-given gifts & talents.

So as you can see, there is no black & white when it comes to the issue of how to manage a child with the behavioural patterns of ADHD. Some would say there are a lot of grey areas. I would say that there are actually "all the colours of the rainbow". Good luck in trying to bring out these colours in your child!

HERE'S A THOUGHT:

"The controlled person is a powerful person. He who always keeps his head will always get ahead. Edwin Markham said, "At the heart of the cyclone tearing the sky is a place of central calm." The cyclone derives its powers from a calm centre. So does a person." (Norman Vincent Peale)