Success in Life is the Goal of ADHD Treatment

Raising successful children is hard under the best of circumstances.  When a child is being treated for Attention Deficit Hyperactivity Disorder (ADHD), everyone needs to work harder to provide the child with a solid foundation for successful outcomes later in life.

Any parent of a child with ADHD quickly becomes aware of how challenging it can be to get ADHD kids the help that they need to find relief from their symptoms.    Parents desire to make everything better for their child is natural and is the result of our readiness to protect and nurture the ones we love.   Yet, it is this desire to help and the desire to protect that often makes fighting Attention Deficit Hyperactivity Disorder so frustrating.   It is often very difficult just knowing what to do, how to do it, or even where to start.  The fact is, it is very easy to become overwhelmed by ADHD. That is because ADHD is a serious condition with has many dimensions at home, at school and in most every area of a child’s life.

It is true that many parents often first learn of their child’s ADHD symptoms from teachers.  Elementary school teachers are especially observant of children and often are the first source of feedback about how your child’s ADHD symptoms are disruptive in the classroom. ADHD children are often overly active, visit excessively with their classmates or daydream and just can’t seem to tune into the tasks at hand.   Just because school may have been the source where you first learned about your child’s ADHD symptoms, his or her developing brain doesn’t stop at the classroom door.

Medications are frequently the first line of defense in successfully managing ADHD symptoms.  However, many parents and pediatricians still hold onto the misguided belief that medications are only used to help ADHD children be successful in the classroom. While ADHD medications do often dramatically reduce complaints from teachers during the school day, it is important to understand that life in a classroom is only a portion of a child’s life.  These same ADHD symptoms don’t just somehow magically disappear when the school day ends.  Nor do children somehow acquire ADHD once they get to school.  If you have a child with ADHD, then you probably know that your child’s ADHD symptoms start when the child awakes in the morning, and often does not seem to remit until the child is fast asleep in the evening.   If we only provide relief from ADHD symptoms in the classroom, then we fail to realize the full impact the disorder has on a child’s life and ultimately parents are limiting the child’s full potential for future success in life.

While a decrease in complaints about your child’s disruptive ADHD behavior or  receiving better grades on tests is a welcome change, this progress is often misinterpreted as the child being “cured”.  It is easy to forget that a child’s behavior in the classroom is only part of the big picture of life.  Many parents are still frustrated and confused to find that despite improvements at school, homework, dinner time, and settling for bedtime are still a battle.

Parents unknowingly expect their child to focus and concentrate on homework and family life without having the proper ADHD medications on board to make that possible.  They are surprised to learn that most ADHD medications diminished in effectiveness as the school day ends. Very often the medication is completely worn off by the time the child arrives home.  This creates problems as the ADHD child moves from the more supportive and structured environment of school to a more varied and unstructured home environment.  This increase in variables, and decrease in structure can cause a spike in ADHD symptoms and make life at home very difficult for the child as well as for the family.

ADHD medication is not a “magic bullet” that relieves parents and teachers of dealing with a child’s disruptive symptoms.  It is not the pills that teach our children skills, that is the job of caring parents and skilled teachers. What ADHD medication can do is give a child a sense of clarity, a time to pause before speaking or acting, as well as improve neurocognitive functioning so that information can be stored, retrieved and processed more accurately.   This creates an opportunity to learn how to be successful and to learn new skills.  Medication also allows children to focus more and pay attention better. When kids can pay attention better they are able to build new skill sets and remember what they have learned previously and apply that knowledge when faced with new life events and challenges.

Home and family life provides many important opportunities for children to learn and grow. The critical lessons learned through interactions at home and after school teach children to recognize social cues and to maneuver through interpersonal relationships in the future. Without medication children miss these cues and are often delayed (as much as 30-40% behind their peers) in learning how to develop and handle complex emotional and social circumstances.

Loving parents will do anything for their kids, yet many are hesitant to fully provide their child with an optimal chance to achieve their best.  The stigma of medicating a child, often provoked by sensationalist media stories, can create a prison of doubt and guilt for parents.

“Am I medicating my child too much?  Will he or she become addicted to drugs later in life?”  Shortchanging your child’s developmental years by reducing or eliminating proper dosages of ADHD medication is a decision based more on fear and shame then reliable medical information.

Seeking relief from the exhausting and disruptive behavior of an ADHD child is frequently an initial motivation to begin treatment.  Left untreated, and without the proper structure, guidance and lifestyle changes, ADHD children can drain our emotional resources, deprive siblings of needed parental attention and drag entire families into an endless spiral of battles over homework, oppositional behavior and even arrests and incarceration if the condition is left untreated.

Without treatment, guidance, and lifestyle changes, ADHD children grow up believing that they are somehow defective and are robbed of the precious esteem building that occurs after school and during time with the family.  The question arises: why would a parent deprive their child of a treatment that will help them avoid these negative outcomes?  Certainly, no loving parent could conceive of such a choice.  Yet, this is the choice parents make when they limit their child’s medication to time spent in the classroom.

Taking ADHD medication is akin to a child wearing glasses.  Like glasses, ADHD medications help a child to focus, allow a child to see things clearly, and give children the ability to see life as it is.  As long as a person wears their glasses, they have relief from their vision problems, when they remove their glasses, the vision problems return. This is how we think of ADHD medication. When medication is on board, then the symptoms of ADHD remit, when the medication is removed or wears off, then the symptoms of ADHD return.  No one would ever think to ask that a child to only wear glasses during the school day, but not at home. Yet this is often what parents and pediatricians are doing when they only medicate for the school day.

As a child grows to adulthood, every experience shapes and influences their cognitive ability, emotional health, even their bodily safety.  The cumulative results are all influenced by brain chemistry.  Why then, does it make sense to deprive a child of optimized brain chemistry at any moment in the day?  If your child needs glasses to see properly, would you want the job of picking and choosing when your child could wear their glasses and when they could not? Of course, no parent would ever dream of  limiting the amount of time a child can see clearly or read without tremendous difficulty. Yet, this is the very dilemma that uninformed parents find themselves in when trying to understand what is the proper course of action for treating their child’s ADHD.  Caring parents become concerned that their children will become “zombies”, “have changed personalities” and will “lose out on being kids”, if they give them ADHD medication.

The fact is that without proper medication these children often become “the odd one out”, “never live up to their potential” and never learn the skills necessary to be able to successfully live in the world without their parent’s direct support.

When parents have the courage to let go of their desire for an ADHD child’s complete compliance, when they risk being flexible and understanding, children learn to rise to the occasions of life and chaos becomes replaced with success.  When parents arm themselves with the scientific knowledge of experts in the treatment of ADHD they too will find relief in experiencing the joy that is found in raising an amazing ADHD child.  Can any parent of an ADHD child let another day pass knowing they’re not providing that brain the medication it so desperately needs to function well and achieve success in life?

ADHD Kids & Holiday Travel

The holidays create a special and different time for each of us. For kids they are special, and for kids with ADHD they are different, special and much, much more. As a parent of a child with ADD/ADHD you can make life easier for your child and certainly for yourself, if you take certain steps. They are not difficult, they may take a little time and may cost a bit of money [or may cost nothing at all], and they can pay dividends in the form of relaxation and a real good holiday.

The first step is to be aware that the holiday, even one spent at home, will make for a change in the life of your child. Most kids with ADHD don’t react well to change. It may make your kids behavior even more demonstrative. So know this fact; you have to prepare. Prepare yourself, prepare your child and prepare for your journey and your destination.

So let’s consider your child. Take away the surprise element and build on the anticipation aspect. Let your child in on most of the plan, if not everything, which is likely to happen. If they are going to travel, go through the rigmarole of the journey. If it’s by car, plane or train, take out a map and show your child the route. You could use a large piece of blank paper and do simple things like draw your house, draw Grandma’s house and draw the road. Let your child help. Let them have a cut out picture of your car and have the child ‘drive’ the car along the map. If there are stopping points en route, draw or cut out pictures for the McDonalds, restaurant, hotel, etc. as the place you plan to stop for a meal, toilet break, etc. The whole emphasis is on preparing your child for what is going to happen or is likely to happen. Remember the activity needs to be age appropriate. As an example, younger kids may work with crayons and paste, while older kids may prefer to put their project together on the computer.

Next, you will want to prepare your child for what will happen at your destination. If it’s a motel, explain the room, where the child will sleep, where they can play games, etc.  If it’s Grandma’s house, show your child a photo of their room, of the house and garden. Explain where the child can play, who will be in the house and anything likely to happen on the vacation.

Then there’s the actual journey.  Have plenty of ‘quiet’ activities at hand, so your child can have things to do. It might be following a homemade map, ticking off things they can see out the window, a handheld digital game, listening to a CD or MP3 player, and/or watching a video/DVD on a portable player.

So, preparation is the real key. Have a variety of activities planned and once the holiday is under way and your child behaves in an acceptable way, reward them frequently for their good behavior.  It is the best present at holiday time to give to your child; your thanks and love in recognition of their successful attitude, good behavior and achievement. A hug, a kiss and kind appreciative words (positive attention) are the best forms of reward and can carry the most significance.

Remember a child with ADHD loves security, attention and routine. You can decide if the attention they get is going to be positive or negative. If you change the routine as a result of a holiday, you need to take certain steps to help your child and yourself so that you both can have a fantastic time.

Do you have tips to manage kids with ADHD during the holidays?  Please share your tips by adding your comment on this blog.

Once again the myth that ADHD does not exist is busted…..

By Redaksi Web
Harian Global — Published: Saturday, 04 July 2009

Hundreds of variations in genes which more frequently occur among attention-deficit hyperactivity disorder (ADHD) sufferers have been identified by researchers, many of which were known about previously as crucial for behavior and learning.

The variations seen have a broader impact on DNA structure, involving copy number variations (CNVs) which involve repeated or missing stretches of DNA. Many diseases, including schizophrenia and autism, are known to involve CNVs.

Psychiatrist Josephine Elia, M.D., said: “Because the gene alterations we found are involved in the development of the nervous system, they may eventually guide researchers to better targets in designing early intervention for children with ADHD.”

Youth with attention deficit hyperactivity disorder (ADHD) were shown to have brain development delayed an average of three years compared to children without the disorder according to research done in a 2007 study by the National Institute of Mental Health (NIMH).   Of particular interest to parents is the finding that the most prominent delay was in the frontal cortex in ADHD kids. The frontal cortex is important because it regulates our ability to control thinking, attention and planning. These frontal areas also are believed to support the brains ability to suppress inappropriate actions and thoughts, focus attention, remember things from moment-to-moment, work for reward, and control movement – many of these functions are often disturbed in people with ADHD. 

Not surprisingly to parents of hyperactive ADHD kids, the NIMH study also found that the motor cortex, the part of the brain that controls movement, emerged as the only area that matured faster than normal in the youth with ADHD (on average 5 years ahead of their non-ADHD peers). This gives us a better picture of the mismatch between increased motor activity combined with a decreased ability to focus, plan and inhibit thoughts and actions in kids with ADHD.

This sounds very familiar to me as I think of what ADHD in children often looks like in real life. One child told me that “my body is a Ferrari and my mind sometimes feels like a tricycle.”  Sometimes ADHD kids seem to put the gas pedal to the metal while other times getting them to move is like trying to push a car uphill with the emergency brake on.  This mismatch between motor ability and executive function should come as a relief to parents of ADHD kids looking for better insight into the origins of childhood ADHD.

There is hope. Parents should know that it is believed that stimulant medication, the front line defense for treating ADHD, is believed to assist the brain in this delicate balancing act between focus, action and inhibition of the prefrontal regions of the brain.  Helping your child understand the biological realities of ADHD can go a long way in increasing your child’s self-esteem.  Remember, we can only work with the assets our children have not those which are neurologically unavailable at the time.

NIH/National Institute of Mental Health (2007, November 13).  Brain Matures A Few Years Late In ADHD, But Follows Normal Pattern. ScienceDaily. Retrieved December 29, 2008, from http://www.sciencedaily.com  /releases/2007/11/071112172200.htm

CEC SMARTBRIEF, January 02, 2009

Infants and toddlers who suffer head injuries or burns are twice as likely to be diagnosed with ADHD before they turn 10, according to a new British study of 62,000 children. Such injuries may be early signs of risky behavior associated with ADHD, or the injuries might cause later behavioral changes, researchers say.

CEC SMARTBRIEF, January 02, 2009

A small group of middle-school students who practiced transcendental meditation twice daily at school reduced their stress and anxiety by 50% and improved ADHD symptoms as well, according to a new study published in Current Issues in Education. The changes after three months were much more dramatic than researchers expected, including better attention, memory, organizational and behavioral skills, said lead researcher Sarina J. Grosswald. WCVB-TV (Boston) (12/31)

ADHD expert Russell A. Barkely, Ph.D. notes that “recent research suggests that those with ADHD cannot sense or use time as adequately as others in their daily activities, such that they are often late for appointments and deadlines, ill-prepared for upcoming activities, and less able to pursue long-term goals and plans as well as others. Problems with time management and organizing themselves for upcoming events are commonplace in older children and adults with the disorder.” This is confirming evidence of the tyranny of time faced by so many us and our children today.

While medication is often essential to the treatment and management of ADHD, there are several key strategies that must also be in place in order to maximize the outcome of your  medication regimen and optimize your success. Three essential strategies for people with ADHD are adding some type of physical exercise to their life, increasing protein intake to power the brain, and avoiding foods that render many ADHD medications inactive.

We all know that exercise is good for our bodies, but did you know that it is also good for your brain? I often tell my patients that exercise is like a tiny dose of natural Ritalin.  Exercise and ADHD medications both have something in common, they both almost immediately elevate dopamine and norepinepherine in the brain.   In turn, this helps the brain to quiet down impulsivity, decrease the need for instant gratification, as well as wake up the executive function in the pre-frontal cortex of the brain. Waking up the pre-frontal cortex provides mental space between thoughts and actions, and therefore gives you more time to evaluate consequences and make better decisions.  In addition, exercise has been shown to improve mood, decrease problems with sleep as well as decrease stress and restlessness. Exercise is an essential part of treating and regulating ADHD.

Did you know you might be eating foods that actually render your medication useless! Have you ever had a morning where you just can’t figure out why your medication isn’t working like it normally does?  The facts are simple here. Certain foods, especially those high in Citric Acid or/or high in Vitamin C (also called Ascorbic Acid), decrease or renders many popular ADHD medications inactive. So if you are taking stimulant medication with orange juice in the morning, you have just canceled out part of the effect of that dose of medication. Another culprit are multivitamins, if you take your ADHD medications in the morning, you would be wise to take your multivitamins in the evening. I recommend you limit your intake of juice, soda, and lemonade to the evenings only.  In addition, read the labels of your favorite snack bar and breakfast cereal, you might be surprised to find lots of vitamin C in those products as well.  Mornings for most individuals with ADHD are tough enough, so avoid those foods or beverages in the A.M. and you’ll find that things just work better.  

How about foods you should be eating?  The science here is pretty straight forward. Most medications for ADHD work on the regulation of Dopamine in the brain. Protein and foods that contain protein provide the body with the essential building blocks for the production of Dopamine in the body. If you are not eating enough protein (especially in the morning when your brain’s gas tank is on empty) then you are not providing your brain with what it needs to produce Dopamine. Without protein, the ADHD medications just don’t work as well. Increase your intake of dietary protein and you increase your medications ability to help your brain function better. An easy rule of thumb is protein clarifies thoughts and carbohydrates cloud thoughts.  That does not mean eliminate “carbs” all together. It does mean taking a good look at how much high quality protein you are taking in and how many sugary high carbohydrates could be avoided. 

Living with ADHD can be greatly improved with a few simple steps. First, get regular exercise like walking or riding a bike.  Second, avoid foods that contain Vitamin C or high amounts of Citric Acid one hour before and after taking your ADHD medication.  Finally, give your brain some protein, especially in the morning and avoid empty carbohydrate calories, and you will give your brain a terrific performance boost. 

The principal characteristics of ADHD are inattention, hyperactivity, and impulsivity. These symptoms appear early in a child’s life. Because many normal children may have these symptoms, but at a low level, or the symptoms may be caused by another disorder, it is important that the child receive a thorough examination and appropriate diagnosis by a well-qualified professional.

Symptoms of ADHD will appear over the course of many months, often with the symptoms of impulsiveness and hyperactivity preceding those of inattention, which may not emerge for a year or more. Different symptoms may appear in different settings, depending on the demands the situation may pose for the child’s self-control. A child who “can’t sit still” or is otherwise disruptive will be noticeable in school, but the inattentive daydreamer may be overlooked. The impulsive child who acts before thinking may be considered just a “discipline problem,” while the child who is passive or sluggish may be viewed as merely unmotivated. Yet both may have different types of ADHD. All children are sometimes restless, sometimes act without thinking, sometimes daydream the time away. When the child’s hyperactivity, distractibility, poor concentration, or impulsivity begin to affect performance in school, social relationships with other children, or behavior at home, ADHD may be suspected. But because the symptoms vary so much across settings, ADHD is not easy to diagnose. This is especially true when inattentiveness is the primary symptom.

According to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders2 (DSM-IV-TR), there are three patterns of behavior that indicate ADHD. People with ADHD may show several signs of being consistently inattentive. They may have a pattern of being hyperactive and impulsive far more than others of their age. Or they may show all three types of behavior. This means that there are three subtypes of ADHD recognized by professionals. These are the predominantly hyperactive-impulsive type (that does not show significant inattention); the predominantly inattentive type (that does not show significant hyperactive-impulsive behavior) sometimes called ADD – an outdated term for this entire disorder; and the combined type (that displays both inattentive and hyperactive-impulsive symptoms).