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Alternative Treatments for ADD/ADHD Robin Ritter Dena Skees March 22, 2012

Attention Deficit Disorder (ADD) and Attention Deficit Hyperactive Disorder (ADHD) have increasingly been diagnosed among young children today. Parents should become more informed about the over diagnosing, side effects, results of the medication and all other pertinent information before they allow their children to become treated with drugs. Today the most common way of dealing with the modern pediatric pandemic of ADD/ADHD involve pharmaceuticals, but some very simple daily methods may work just as well but are often overlooked. There are still many questions to be answered concerning the developmental course, outcome and treatment of ADD/ADHD. Although there are several effective treatments, they are not equally effective for all children with ADD/ADHD. Some of the alternative treatments include but are not limited to dietary interventions, behavior modification, tutoring, school programming and exercise. Treatment should be tailored to the unique needs of each child and family. Studies show that what, and when, you eat makes a difference when it comes to managing ADD/ADHD. Try to schedule regular meals or snacks no more than three hours apart. This will help keep your childs blood sugar level, minimizing irritability and supporting concentration and focus. Include a little protein and complex carbohydrates at each meal or snack. These foods will help your child feel more alert while decreasing hyperactivity. Have your childs zinc, iron, and magnesium levels checked. Many children with ADD/ADHD are low in these important minerals. Boosting their levels may help control ADD/ADHD symptoms. Increasing iron may be particularly helpful. One study found that an iron supplement improved symptoms almost as much as taking stimulant medication.

Add more omega-3 fatty acids to your childs diet. Studies show that omega-3s improve hyperactivity, impulsivity, and concentration in kids (and adults) with ADD/ADHD. Omega-3s are found in salmon, tuna, sardines, and some fortified eggs and milk products. However, the easiest way to boost your childs intake is through fish oil supplements. Over the past few decades, there has been much controversy about sugar and ADHD symptoms such as hyperactivity. Research does show that refined (processed sugars) and carbohydrates can have an effect on a child's activity level. Because these sugars quickly enter the bloodstream, they can produce a rapid increase in blood glucose levels. When blood sugar spikes, a child may become much more active due to an adrenaline rush produced by the rise in blood glucose. Although at this time, there is no proof that a diet high in sugar actually causes ADHD. However, nutritionists suggest adding more fiber to a child's diet to help manage glucose levels and keep them even. High- fiber foods include berries and other fruits, whole grains, and oatmeal. Behavioral therapy, also known as behavior modification, has been shown to be a very successful treatment for children with ADD / ADHD. It is especially beneficial as a co-treatment for children who take stimulant medications and may even allow you to reduce or even stop the medication totally. Behavior therapy involves reinforcing desired behaviors through rewards and praise and decreasing problem behaviors by setting limits and consequences. It begins with modeling behavior by encouraging good behavior with healthy praise or rewards. This works best if the reward or praise immediately follows the positive behavior. Reward the child appropriately for good behavior and tasks completed. Set up a clear reward system for good behavior or for completing a certain number of positive behaviors, such as a merit point or gold star program

with a specific reward, such as a favorite activity. Avoid using food and especially candy for rewards. This helps the child know what to expect when they complete a task or refine their behavior appropriately. The theory is that rewarding the struggle toward change encourages the full new behavior. Parents can set up a customized behavioral modification program for their child who has ADD/ADHD with the help of behavioral specialist, such as a cognitive-behavioral therapist. A cognitive-behavioral therapist focuses on practical solutions to everyday issues. This kind of therapist can set up a behavioral modification program of rewards and consequences for your child at home and at school and support you in shaping your childs behavior. Some parents find that using a timer for activities is a good way to build and reinforce structure. One such way would be to set a reasonable amount of time for a bath or playtime helps train the child to expect limitations, even on pleasurable activities. Giving a child a time limit for chore completion is also useful, especially if a reward is given for finishing on time. Negatively reinforcing bad behavior by allowing appropriate consequences to occur naturally while providing safety to the child at all times. While it may be hard to just walk away from a temper tantrum, do not draw attention to any negative behavior. Often this will lead to a power struggle and no one wins in this type of situation. Bear in mind that as your child gets older they will be more sensitive to how they appear to others and may overreact or be unduly ashamed when they are disciplined in front of others. It is important to have a plan for appropriate discipline for misbehaving that does not require carrying out in front of others. Setting up a specific consequence for a certain behavior is probably the best method of providing consistency and fairness for your child.

Patience is the key with behavioral therapy, since people with ADD/ADHD are notoriously variable in their symptoms. One day, your child may behave beautifully, and the next, fall back into old patterns. Sometimes it may seem as if the training is not working. However, over time, behavioral treatment does improve the symptoms of ADHD. Because kids with ADD/ADHD often have difficulty with simple social interactions and struggle with low self-esteem, another type of treatment that can help is social skills training. Normally conducted in a group setting, social skills training is led by a therapist who demonstrates appropriate behaviors and then has the children practice repeating them. A social skills group teaches children how to read others reactions and how to behave more acceptably. The social skills group should also work on transferring these new skills to the real world. Children with ADD / ADHD often have trouble translating what theyve learned from one setting to another. For instance, they may have learned how to control impulsive outbursts at school, but impatiently interrupt others at home. In order to encourage positive change in all settings, children with ADD / ADHD need consistency. It is important that parents of children with ADD / ADHD learn how to apply behavioral therapy techniques at home. Children with ADD/ADHD are more likely to succeed in completing tasks when the tasks occur in predictable patterns and in predictable places, so that they know what to expect and what they are supposed to do. Follow a routine. It is important to set a time and a place for everything to help a child with ADD/ADHD understand and meet expectations. Establish simple and predictable rituals for meals, homework, play, and bed. Use clocks and timers. Consider placing clocks throughout the house, with a big one in your childs bedroom. Allow plenty of time for what your child needs to do, such as homework

or getting ready in the morning. Simplify your childs schedule. Avoiding idle time is a good idea, but a child with ADD/ADHD may become even more distracted and wound up if there are too many after-school activities. Create a quiet place. Make sure your child has a quiet, private space of his or her own. A porch or bedroom can work well tooas long as its not the same place as the child goes for a time-out. Set an example for good organization. Set up your home in an organized way. Make sure your child knows that everything has its place. Do role model neatness and organization as much as possible in all aspects of the childs life. Behavior modification techniques are considered to be an essential part of any successful ADD/ADHD treatment program for children, it is most often used with younger children with ADD/ADHD, but it can be used in adolescents up to 18 years old. School creates multiple challenges for kids with attention deficit disorder, but with patience and an effective plan to overcome these obstacles, a child with ADD/ADHD can thrive in the classroom. Teachers and administrators can help to provide this supportbut it is the parent who can make the biggest difference in a childs successful education. Children with ADD/ADHD often have a difficult time staying on task in school and that causes a child to fall behind in the classroom. Many believe that children with ADD/ADHD have the inability to pay attention. In actuality, children with ADD/ADHD don't have a problem paying attention. The problem lies in the fact that they pay attention to EVERYTHING around them. They don't have the ability to tune things out the way other people do without even thinking. Self-monitoring techniques can be very effective in the school setting. Self-monitoring of attention involves cueing the student so that he/she can determine how well he/she is attending to

the task at hand. Cueing is often done by providing an audio tone such as a random beep, timer, or the teacher can give the cue. The student then notes whether he/she was on or off task on a simple recording sheet. Self-monitoring techniques are more likely to be effective when tied to rewards and accuracy checks. Behavior management techniques must often be used in the learning environment. By examining a student's specific problem behavior, understanding its antecedents and consequences, teachers can help the students to develop behaviors that lead to academic and social successes. Monitor proper behavior frequently and immediately direct the student to an appropriate behavior. Teachers need to enforce classroom rules consistently and avoid ridicule and criticism. Remember that students with ADD/ADHD have difficulty staying in control. Teachers should always provide encouragement, reward more than punish, immediately praise any and all good behavior and performance. If needed teachers may have to change rewards if the current reward is not effective in motivating behavioral change, find alternate ways to encourage the student as well as to teach the student to reward him or herself. Encourage positive self-talk by stating "You did very well remaining in your seat today. How do you feel about that? This encourages the student to think positively about him or herself. Students with ADD/ADHD need to be seated in the front near the teacher with their backs to the rest of the class to keep other students out of view to avoid distractions from their classmates. Be sure to include them as part of the regular class seating. Surround students with ADD/ADHD with good peer models, preferably students whom the ADD/ADHD student views as significant peers.

Students with ADD/ADHD should have an individualized education program. By identifying each student's individual strengths and specific learning needs, this is a plan for mobilizing those strengths to improve students academic and social performance. Interactive Metronome is often used in the school setting, it involves listening to a computerized rhythmic beat that the person then tries to mimic with hand or foot tapping. The student using Interactive Metronome training is provided feedback that indicates how well they match the beat of the metronome. Supporters of Interactive Metronome training believe that the behavioral problems associated with ADHD stem from a motor planning and timing deficit. They believe that over time, the individual using Interactive Metronome training can learn to focus for extended periods of time, to filter out distractions, and to monitor their physical and mental actions as they occur. Some scientific findings show promising results involving Interactive Metronome training and its ability to reduce ADHD symptoms in boys. In one study involving 56 boys, ages 6-12, diagnosed with ADHD, researchers compared results from the group that received the interactive metronome training, the group that received no training, and the group that received video-game training. Researchers concluded that the group of boys with ADHD who received Interactive Metronome training had a significant improvement in attention span, behavior, and motor control. Exercise can play a vital role in the management of children with ADD/ADHD. While not much is known about what causes the telltale symptoms of ADD/ADHDimpulsivity, attention issues, and the inability to sit still, research suggests that is has to do with a deficiency of dopamine, a chemical in the brain that helps regulate behavior, mood, and movement.

To treat ADD/ADHD, doctors normally prescribe stimulant medication such as Ritalin, which has been shown to increase the availability of dopamine in the brain. Exercising is one of the easiest and most effective ways to reduce the symptoms of ADD/ADHD. Physical activity immediately boosts the brains dopamine, norepinephrine, and serotonin levelsall of which affect focus and attention. In this way, exercise and medications for ADD/ADHD such as Ritalin and Adderall work similarly. But unlike ADD/ADHD medication, exercise doesnt require a prescription and its side effect free. Activities that require close attention to body movements, such as dance, gymnastics, martial arts, and skateboarding, are particularly good for kids with ADD/ADHD. Team sports are also a good choice. The social element keeps them interesting. Regular quality sleep can lead to vast improvement in the symptoms of ADD/ADHD. However, many kids with ADD/ADHD have problems getting to sleep at night. Sometimes, these sleep difficulties are due to stimulant medications, and decreasing the dose or stopping the medication entirely will solve the problem but only under the guidance of a medical professional due to possible severe side effects from abruptly stopping any medication. However, a large percentage of children with ADD/ADHD who are not taking stimulants also have sleep difficulties. If your child is one of them, the following tips can help. Set a regular bedtime (and enforce it). If background noise keeps your child up, try a sound machine or a fan in the childs bedroom. Be sure to turn off all electronics (TV, computer, video games, iPhone) at least an hour before bed and limit physical activity in the evening. The best overall treatment for any child with ADD/ADHD is consistency in all aspects of their lives, providing a structured schedule, regular meals and plenty of exercise. Natural treatments do not have the harmful side effects that medications cause and that can last a

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lifetime. Having a child with ADD/ADHD should not isolate activities that other families do on a regular basis. Love and enjoy the child most of all and remember to provide a schedule of details pertaining to all upcoming activities the family may be involved in to ensure the wholesome fun for everyone involved.

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References

Banks, R.S., Daisy, C., Elliott, P.T., Kennedy, D.M. (2003). ADHD Autism Connection. Colorado Springs, CO: WaterBrook Press Debroitner, R.K., & Hart, A. (1997). Moving Beyond ADD/ADHD. Chicago, IL: Contemporary Haber, J.S. (2000). Great Misdiagnosis ADHD, Dallas, TX: Taylor Trade Hallowell, E.M., & Ratey, J.J. (1996). Answers to Distraction. New York, NY: Bantam Hallowell, E.M., & Ratey, J.J. (1994). Driven to Distraction. New York, NY: Touchstone http://www.add.org http://www.help4adhd.org http://www.kidshealth.org http://www.ldonline.org http://www.russellbarkley.org Moulton-Sarkis, S., (2009). Review of ADD/ADHD drug free: Natural alternatives and practical exercises to help your child focus. The Family Journal, 17(4), 381. Orford, E., (1998). Wrestling with the whirlwind: an approach to the understanding of ADD/ADHD. Journal of Child Psychotherapy, 24(2), 25. Parrish, R.S., (2006). Drugs Versus Reality Therapy. International Journal of Reality Therapy, 25(2), 43-45. Widener, A.J., (1998). Beyond Ritalin: the importance of therapeutic work with parents and children diagnosed ADD/ADHD. Journal of Child Psychotherapy, 24(2), 267.

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