DFWChild reader Jessica of Fort Worth asked this burning parenting question: “What’s a parent to do when school recommends assessing your [child] for ADHD, and you’d like to explore alternative treatments [besides medication]?”
When a teacher is concerned about a child’s behavior, I encourage parents to ask for details about what’s happening. I also recommend having the child evaluated by a pediatrician and, if needed, getting a neuropsychological evaluation to establish the correct diagnosis.
What is labeled as ADHD many times is a symptom of something else, like early childhood trauma, family stressors—and all parents were affected by serious stressors in the last two years—poor sleep, anxiety, screen addiction, visual processing disorder and even poor nutrition, anemia, thyroid problems, or enlarged tonsils, to name a few. A pediatrician can evaluate a child and rule out any medical issues that can mimic focus and attention problems.
With a diagnosis, parents can partner with a pediatrician to develop a treatment plan. That may include therapy with a psychologist; special school accommodations; and daily exercise for at least 1–2 hours per day. Try to spend time outdoors with your child—disconnection from nature can affect mood and behavior.
In addition, develop a sleep hygiene plan. Make sure your child gets plenty of sleep, keep their bedroom cool, and have a consistent bedtime. No screentime for the 2 hours before bed. I advise against processed foods with added artificial dyes, preservatives, or sweeteners. Kids should be getting at least five servings of vegetables per day and plenty of healthy fats and protein. Foods rich in B vitamins, iron, zinc and omega-3 (EPA and DHA) are nourishing for all children but especially for those who struggle with focus and attention.
“One of my top recommendations […] is stress management for the entire family. When the family as a whole is in a better place, children benefit.”
Improving a child’s nutrition with a multivitamin or mineral has been shown in many studies to improve attention, but don’t start supplements without consulting a pediatrician experienced in nutrition and supplements. Many supplements do not undergo the same rigorous evaluations as prescription medications, so it’s easy to buy supplements that are ineffective or expensive. You could also do more harm than good.
Neurofeedback—which measures brainwaves and helps the brain function more optimally—has good data for ADHD treatment, but it is not covered by insurance and is time-consuming. One of my top recommendations for children with behavior problems is stress management for the entire family. When the family as a whole is in a better place, children benefit.
My favorite strategy for stress management is daily meditation. That rewires the brain to be less reactive to stress and to support the prefrontal cortex, the part of the brain responsible for focus and attention. Children who are chronically stressed can’t learn, can’t pay attention and can even present with physical symptoms ranging from headaches to abdominal pain.
A complete ADHD treatment plan includes lifestyle and nutritional counseling as well as behavioral therapy, but it does not rule out prescription medications. Some children really benefit from additional help, at least in the short term. I have many patients who start with a more “natural” approach, and when they are not improving enough, go on medication. I would encourage parents to keep an open mind to all options.
Second image courtesy of Alina Olteanu